Development of a Targeted, Web-Based Intervention for Smokers with Social Anxiety Disorder Using Acceptance and Commitment Therapy

使用接受和承诺疗法为患有社交焦虑症的吸烟者制定有针对性的、基于网络的干预措施

• 批准号: 9324695
• 负责人: Noreen Watson
• 金额: $ 6.16万
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9324695
• 关键词: Abstinence; Acceptance Process; Address; Adult; Aftercare; Behavioral; Chronic; Cigarette; Cigarette Smoker; Clinical Research; Communities; Data; Data Analyses; Development; Enhancement Technology; Exercise; Focus Groups; General Population; Government; Guidelines; Individual; Internet; Intervention; Lead; Literature; Mediating; Mental Health; Mental disorders; Modeling; National Institute of Drug Abuse; Nature; Online Systems; Outcome; Population; Population Theory; Prevalence; Process; Public Health; Published Comment; Reporting; Research; Research Personnel; Research Priority; Risk Factors; Sampling; Scientist; Site; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social Anxiety Disorder; Subgroup; Symptoms; Testing; Therapeutic Intervention; Time; Treatment Efficacy; United States; United States Public Health Service; Update; Withholding Treatment; base; career; cigarette smoking; cost effective; craving; design; effective intervention; experience; follow-up; improved; individualized medicine; innovation; novel; programs; prototype; smoking cessation; smoking intervention; smoking prevalence; smoking relapse; social; social anxiety; targeted treatment; theories; therapy development; usability; web site; willingness

PROJECT SUMMARY Individuals with social anxiety disorder (SAD) are an understudied, undertreated sub-group of smokers. Of the 40 million smokers in the United States, an estimated 14.3 million (36%) meet lifetime criteria for SAD. Compared to the general population, individuals with SAD have double the prevalence rates of cigarette smoking (33% vs. 17%), have significantly more unsuccessful quit attempts (64% vs. 49%), and are less likely to remain abstinent after treatment (29% vs. 36%). Despite the evidence that SAD is a significant risk factor for continued smoking and smoking relapse, no known interventions are specifically designed to address the unique needs of this group of smokers. Specifically, the key barriers to successful cessation among this group are: (1) smoking cigarettes to avoid and/or cope with symptoms of social anxiety, and (2) significantly greater levels of craving during times of abstinence. A new, targeted treatment addressing the needs of this significant group of smokers is needed. Web-based Acceptance and Commitment Therapy (ACT) is a new model for delivering smoking cessation treatment that yielded twice the cessation rates as the US government’s Smokefree.gov site at 3-month follow-up (23% vs. 10%) in a sample of smokers from the general population. Tailoring this intervention to address the unmet needs for smokers with SAD could significantly increase the quit rates of the substantial proportion of smokers with SAD. The proposed treatment development project will tailor an existing web-based ACT intervention for a general population of smokers (WebQuit) into one specifically designed for smokers with SAD (WebQuit-SAD). Development of WebQuit-SAD will be informed by: (1) literature on barriers to smoking cessation in adults with SAD (including applicant’s previous lab-based research), (2) data from the original, non-targeted WebQuit intervention for the general population of smokers, including user receptivity and efficacy data among smokers who screened positive for SAD (n = 395), (3) qualitative comments about WebQuit made by smokers with SAD who completed the intervention, (4) focus groups consisting of smokers with SAD, and (5) the clinical and research expertise of the team of investigators in treating smokers with psychiatric disorders, in using ACT for smoking cessation, and in delivering ACT for smoking cessation via the Internet. After three waves of usability testing, the final product of this project will be an intervention that is technology-enhanced and community-friendly, guided by theory-based mechanisms of change, and with a focus on co-occurring mental health conditions. Thus, it has great potential for broad dissemination to the 14.3 million smokers with social anxiety disorder.

项目总结 社交焦虑症(SAD)是一个研究不足、治疗不足的吸烟者亚群。中的 在美国有4000万吸烟者，估计有1430万(36%)符合SAD的终生标准。 与普通人群相比，SAD患者的香烟患病率是普通人的两倍。 吸烟(33%比17%)，戒烟不成功的尝试明显更多(比49%)，而且不太可能戒烟 在治疗后保持戒酒(29%比36%)。尽管有证据表明SAD是一种重要的风险因素 持续吸烟和吸烟复发，目前还没有专门针对吸烟的干预措施 这群吸烟者的独特需求。具体地说，这一群体成功戒烟的关键障碍是 是：(1)吸烟是为了避免和/或应对社交焦虑症状，以及(2)明显更严重 禁欲时期的渴望程度。一种新的、有针对性的治疗方法，满足了这一显著的 需要一群吸烟者。基于网络的接受和承诺治疗(ACT)是一种新的治疗模式 提供戒烟治疗，戒烟率是美国政府的两倍 Gov网站对普通人群中的吸烟者进行了3个月的跟踪调查(23%比10%)。 为解决患有SAD的吸烟者未得到满足的需求而量身定做这种干预措施可能会显著增加 患有SAD的吸烟者中相当大比例的戒烟率。拟议的治疗开发项目将 将现有的针对普通吸烟者的基于网络的ACT干预措施(WebQuit)调整为一个 专门为患有SAD的吸烟者设计(WebQuit-SAD)。WebQuit-SAD的发展将被告知 作者：(1)有关成人自闭症患者戒烟障碍的文献(包括申请人以前的实验室研究 研究)，(2)来自针对普通吸烟者的原始、非定向WebQuit干预的数据， 包括筛查出SAD阳性的吸烟者的用户接受度和有效性数据(n=395)，(3) 完成干预的SAD吸烟者对WebQuit的定性评价，(4)焦点 由患有SAD的吸烟者组成的小组，以及(5)调查小组的临床和研究专业知识 在治疗患有精神障碍的吸烟者，使用ACT戒烟，以及在提供ACT治疗 通过互联网戒烟。经过三波可用性测试，这个项目的最终产品将是 一种技术增强和社区友好的干预措施，由基于理论的机制指导 变化，重点放在共同发生的精神健康问题上。因此，它具有广阔的应用前景。 向1430万患有社交焦虑症的吸烟者传播。