A SMART Pilot of Adaptive Treatment Strategies to Improve Engagement with a Web-based Smoking Intervention for Socially Anxious Smokers

适应性治疗策略的明智试点，以提高社交焦虑吸烟者对基于网络的吸烟干预的参与度

• 批准号: 10192687
• 负责人: Noreen Watson
• 金额: $ 17.58万
• 依托单位: FRED HUTCHINSON CANCER RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2021-12-03
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10192687
• 关键词: Abstinence; Address; Adherence; Adult; Applications Grants; Applied Research; Area; Behavior Therapy; Biochemical; Characteristics; Communities; Data; Development; Diagnostic; Effectiveness; Effectiveness of Interventions; Electronic Mail; Empirical Research; Ensure; Feedback; General Population; Goals; Individual; Integrative Therapy; Internet; Intervention; Knowledge; Manuscripts; Mental disorders; Mentorship; Methods; Modality; National Institute of Drug Abuse; Online Systems; Outcome; Patient Self-Report; Phase; Preparation; Prevalence; Procedures; Process; Randomized; Research; Research Priority; Research Training; Risk; Science; Scientist; Sequential Multiple Assignment Randomized Trial; Smoker; Smoking; Social Anxiety Disorder; Subgroup; Symptoms; Testing; Text Messaging; Time; Training; Training Support; United States; United States National Institutes of Health; Vulnerable Populations; acceptability and feasibility; alternative treatment; anxious; base; behavioral outcome; career; clinical trial analysis; design; digital health; experience; flexibility; high risk; high risk population; improved; improved outcome; innovation; intervention effect; iterative design; meetings; pilot trial; programs; satisfaction; skills; smoking addiction; smoking intervention; social; social anxiety; social interventions; symposium; theories; treatment strategy; user centered design; web site; web-based intervention

PROJECT SUMMARY/ABSTRACT This K23 application proposes focused training and research to facilitate the applicant’s transition to an independent scientist focused on developing innovative, engaging, and impactful digital health interventions (DHIs) for high-risk smokers—including those with social anxiety. CONTEXT: Individuals with social anxiety— those who meet full diagnostic criteria for social anxiety disorder (SAD) as well as those with subthreshold symptoms of SAD)—are an understudied and undertreated group of smokers. An estimated 14.6 million (36%) adult smokers in the United States meet lifetime criteria for SAD. Compared to the general population, socially anxious smokers have double the prevalence rates of smoking (33% vs. 17%) and are less likely to remain abstinent (29% vs. 36%). However, there are no targeted interventions for this high-risk group. Although digital health interventions (DHIs) offer an ideal treatment modality for these smokers, engagement with DHIs is strikingly low. Because greater engagement with DHIs is associated with better cessation outcomes, the full potential of DHIs for smoking is far from realized and research is needed to optimize engagement with these interventions in ways that improve outcomes. A single approach to increasing engagement is unlikely to be efficacious for all smokers. Adaptive treatment strategies (ATSs) that allow flexibility in what intervention components are offered over time to different smokers based on their individualized needs hold promise for improving effective engagement with and effectiveness of these interventions. RESEARCH STRATEGY: Building upon the applicant’s NIDA F32 project in which she is developing the core content of a targeted web intervention for socially anxious smokers (MyWebQuit), the objective of the current proposal is to develop and assess the feasibility and acceptability of new engagement components that will be ultimately be sequenced to comprise an ATS for improving engagement with and effectiveness of MyWebQuit. The project includes phases to: (1) develop the new components to enhance engagement using an iterative, user-centered design approach (Aim1), and (2) conduct a pilot sequential multiple assignment randomized trial (SMART) to assess: the feasibility of conducting a full-scale SMART, the acceptability and utilization of the new components, the potential impact on process (website utilization) and cessation outcomes, and explore secondary tailoring variables that may enable a more deeply tailored ATS (Aim2). TRAINING PLAN: To achieve her short- and long-term career goals, this proposal will provide the applicant with advanced training in the following: (1) theory and science of improving engagement with DHIs, (2) experimental methods that inform the construction of high-quality ATSs, and (3) conduct, management, and analysis of clinical trials involving DHIs for vulnerable groups of smokers. These goals will be accomplished through close mentorship from experts in these areas, carefully selected didactic activities and conference attendance, applied research experiences, and manuscript and grant proposal (i.e. an R01 for a fully-powered SMART) preparation.

项目摘要/摘要 这项K23申请提案集中于培训和研究，以促进该申请的过渡到 独立科学家致力于发展创新，引人入胜且有影响力的数字健康干预措施 （DHIS）对于高风险的吸烟者 - 包括社交焦虑的人。背景：有社交焦虑的人 那些符合社交焦虑症（SAD）的完整诊断标准的人以及具有子焦虑症的人 悲伤的症状） - 一群吸烟者的理解和被培养的人。估计有1460万（36％） 美国的成年吸烟者符合SAD的终身标准。与一般人口相比 焦虑吸烟者的吸烟率是两倍（33％比17％），并且不太可能留下 戒酒（29％比36％）。但是，这个高风险群体没有针对性的干预措施。虽然数字 健康干预措施（DHIS）为这些吸烟者提供了理想的治疗方式，与DHIS的互动是 惊人的低。因为与DHI的更多参与与更好的停止结果有关，所以 DHI的吸烟潜力远非实现，需要研究以优化参与这些 干预以改善结果的方式。一种增加参与度的方法不太可能 所有吸烟者都很容易。自适应治疗策略（ATSS），可以灵活地干预 随着时间的推移，组件根据其个性化需求提供给不同的吸烟者的承诺 改善这些干预措施的有效参与和有效性。研究策略： 在申请人的NIDA F32项目的基础上，她正在开发目标网的核心内容 干预社会焦虑的吸烟者（mywebquit），当前提案的目的是发展和 评估最终将测序的新参与组件的可行性和可接受性 包括提高MyWebquit参与和有效性的ATS。该项目包括 阶段至：（1）使用迭代，以用户为中心的设计开发新组件以增强参与度 方法（AIM1）和（2）进行飞行员顺序多次分配随机试验（SMART）进行评估： 进行全面智能的可行性，新组件的可接受性和利用， 对过程（网站利用）和停止结果的潜在影响，并探索次要裁缝 可以使更深入量身定制的ATS的变量（AIM2）。培训计划：实现她的短暂和 长期职业目标，该建议将为申请人提供以下高级培训：（1） 改善与DHIS参与的理论和科学，（2）实验方法，这些方法为构建提供了信息 高质量的ATSS以及（3）涉及DHI的临床试验的行为，管理和分析 一群吸烟者。这些目标将通过这些领域的专家的密切指导来实现， 精心选择的教学活动和会议出席，应用研究经验和手稿 和赠款提案（即用于全功能的智能的R01）准备。

项目成果

The association between frequency of e-cigarette use and long-term smoking cessation outcomes among treatment-seeking smokers receiving a behavioral intervention.

• DOI: 10.1016/j.drugalcdep.2020.108394
• 发表时间: 2021-01-01
• 期刊: Drug and alcohol dependence
• 影响因子: 4.2
• 作者: Watson NL;Mull KE;Bricker JB
• 通讯作者: Bricker JB

Identifying Content-Based Engagement Patterns in a Smoking Cessation Website and Associations With User Characteristics and Cessation Outcomes: A Sequence and Cluster Analysis.

• DOI: 10.1093/ntr/ntab008
• 发表时间: 2021-06-08
• 期刊: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
• 作者: Perski O;Watson NL;Mull KE;Bricker JB
• 通讯作者: Bricker JB