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Small Financial Incentives to Promote Smoking Cessation in Safety Net Hospital Patients

促进安全网医院患者戒烟的小额经济激励

基本信息

批准号：
9768975
负责人：
Darla Elizabeth Kendzor
金额：
$ 25.84万
依托单位：
UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-11-16 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9768975
关键词：
Abstinence Adherence Adoption Adult Applications Grants Attention Biochemical Cellular Phone Clinic Data Collection Ecological momentary assessment Economically Deprived Population Effectiveness Exposure to Financial cost Gifts Goals Health Healthcare Systems Hospitals Incentives Individual Intervention Intervention Studies Link Malignant Neoplasms Malignant neoplasm of esophagus Malignant neoplasm of larynx Malignant neoplasm of lung Malignant neoplasm of urinary bladder Methods Motivation Nicotine Dependence Outcome Participant Patients Population Poverty Prevalence Questionnaires Randomized Randomized Controlled Trials Renal carcinoma Reporting Research Personnel Resources Sampling Self Efficacy Smoke Smoker Smoking Smoking Cessation Intervention Smoking Status Stress Technology Testing Time Tobacco Tobacco Use Cessation Tobacco smoking behavior Tobacco use United States Visit Work base behavioral/social science clinical practice contextual factors contingency management cost disability disadvantaged population financial incentive follow-up health disparity improved insight intervention participants malignant mouth neoplasm negative affect preventable death primary outcome programs psychosocial public health relevance safety net smoking abstinence smoking cessation smoking prevalence social science research socioeconomic disadvantage stressor theories treatment adherence treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Tobacco use is the leading cause of preventable death in the U.S. Although the prevalence of smoking has declined to 18.1 percent among U.S. adults, 27.9 percent of those living in poverty report current smoking. Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. There is mounting evidence that offering incentives for abstinence (i.e., Contingency Management [CM]) may be an effective approach for promoting short-term smoking cessation, though few studies have demonstrated longer-term effectiveness. In addition, little attention has been paid to socioeconomically disadvantaged smokers specifically (e.g., safety- net hospital populations) in CM intervention studies. Our preliminary work indicates that offering small escalating financial incentives for smoking abstinence dramatically increases short-term cessation rates among socioeconomically disadvantaged smokers when incentives are included as an adjunct to standard clinic- based smoking cessation treatment. However, additional work is needed to evaluate the influence of this CM approach in the longer-term with a rigorous and adequately powered trial. Thus, the aims of the proposed study are to: 1) evaluate the longer-term impact of an adjunctive, low-cost CM intervention (relative to usual care) on smoking abstinence rates among socioeconomically disadvantaged individuals participating in a safety-net hospital smoking cessation program, and 2) identify treatment mechanisms and contextual factors associated with cessation outcomes among intervention participants using both traditional and ecological momentary assessment approaches. Participants seeking smoking cessation treatment at an urban safety net hospital (N = 320) will be randomly assigned to 1) usual care (UC; n = 160) or 2) UC plus financial incentives for biochemically-confirmed abstinence (CM; n = 160). Those randomized to the CM intervention will have the opportunity to earn small gift cards for biochemically-verified abstinence through 12 weeks post-quit. Specifically, participants may earn $20 for abstinence on the quit date, and this amount will increase by $5 with each successive abstinent visit through 4 weeks post-quit ($150 total). Participants may additionally earn $50 gift cards for abstinence at 8 and 12 weeks post-quit. Biochemically-verified 7-day point prevalence abstinence at 26 weeks post-quit (longer-term abstinence) will be the primary outcome variable, though smoking status will be assessed at all visits. We also hope to gain a better understanding of CM treatment mechanisms and to identify other factors that directly influence cessation via traditional questionnaire and smartphone-based ecological momentary assessment approaches. Smartphone technology allows for "real-time" data collection to more accurately capture important cessation-related variables, and will be used to deliver gain-framed messages to support and strengthen the CM intervention. Findings will provide insight about new treatment targets for intervention research, and will demonstrate an effective, inexpensive, and easily implementable means by which to improve longer-term smoking cessation rates among economically disadvantaged smokers.