Re-Connect: Personalized, Non-Monetary Smartphone-based Rewards for Smoking Cessation

项目摘要 吸烟是美国可预防死亡的头号原因。约14%的美国 成年人目前是吸烟者，10个吸烟者中约有7个报告有戒烟的愿望。可惜 在最好的戒烟干预措施中，复发是最有可能的结果。基于internet 应急管理（CM）是一种远程交付的、基于证据的干预措施， 视乎戒烟的客观证据而提供经济诱因。基于Internet的CM 已被证明是可接受的和高度有效的，所以研究工作现在集中在使 通过探索禁欲的非货币激励措施，使干预措施可扩展和可持续。约81%的 美国成年人拥有智能手机，人们在手机上花费的时间中有90%涉及使用应用程序 用于发送消息、玩手机游戏、社交网络、购物和阅读的应用程序（app）。鉴于 移动的手机应用程序的广泛使用，以及它们的多样性，它们可以作为一个理想的个性化，低- 成本，非货币激励戒烟，这将是相关的广大受众在 移动的CM干预的上下文。应用程序阻止程序阻止用户访问某些应用程序， 它们已经可用，并且需求量很大;但是，现有的应用程序阻止程序中没有一个 旨在通过要求目标行为的客观证据来促进健康行为（在这种情况下 目前提案的目的是（1）开发和（2） 评估Re-Connect，这是一种基于智能手机应用程序阻止的个性化CM干预， 参与者获得高价值但非必需的（例如，社交媒体、购物、游戏）、手机应用程序， 戒烟的客观证据已经得到证实。首先，我们将使用 动态系统开发，迭代测试，在每个阶段涉及寻求治疗的吸烟者的方法， 通过焦点小组和反馈会议进行可用性测试。其次，我们会随机分配治疗方案- 寻求吸烟者（N=50）：（1）禁欲特遣队（AC），其中可以使用解锁应用程序的令牌 根据戒烟的客观证据（CO < 6ppm）获得，或（2）根据提交情况获得 (SC)在那里，代币可以根据提交CO视频而获得，但独立于在6- 10天内退出。 个月观察期。将评估重新连接的可行性和可接受性的主要结局 通过（a）入组，（B）使用持续时间，（c）停药原因和（d）参与者报告的可接受性。 初步疗效的主要结局将通过（e）阴性每日CO样本的百分比，以及 (f)两组之间通过CO验证的自我报告吸烟状态的7天点患病率。我们的团队 在移动的CM干预、技术开发、焦点小组、单一案例 设计、生物统计学、人为因素测试和临床试验测试，使我们处于开展 提出的概念验证开发和测试。

Project Summary Smoking is the number one cause of preventable death in the United States (U.S.). Approximately 14% of U.S. adults are current cigarette smokers, and about 7 out of 10 smokers report a desire to quit. Unfortunately, even among the best smoking cessation interventions, relapse is the most likely outcome. Internet-based contingency management (CM) is a remotely-delivered, evidence-based intervention that involves the provision of financial incentives contingent on objective evidence of smoking abstinence. Internet-based CM has been shown to be both acceptable and highly efficacious, so research efforts are now focused on making the intervention scalable and sustainable by exploring non-monetary incentives for abstinence. About 81% of U.S. adults own a smartphone and 90% of the time people spend on their phones involves using applications (apps) for sending messages, playing mobile games, social networking, shopping, and reading. Given the widespread use of mobile phone apps, and their variety, they may serve as an ideal personalized, low- cost, non-monetary incentive for smoking abstinence that would be relevant to a broad audience in the context of a mobile CM intervention. App blocking programs prevent users from accessing certain apps and they are already available and in high demand; however, none of the existing app-blocking programs are designed to promote health behavior by requiring objective evidence of the target behavior (in this case smoking abstinence) before unblocking the app. The aims of the current proposal are to (1) develop and (2) evaluate Re-Connect, a personalized, smartphone app-blocking-based CM intervention that would limit participants’ access to high-valued, but non-essential (e.g., social media, shopping, games), phone apps until objective evidence of smoking abstinence has been verified. First, we will develop and test Re-Connect using a dynamic systems development, iterative testing, approach involving treatment-seeking smokers at each stage, conducting usability tests via focus groups and feedback sessions. Second, we will randomly assign treatment- seeking smokers (N=50) to either: (1) abstinent contingent (AC) where tokens for unblocking apps can be earned contingent on objective evidence of smoking abstinence (CO < 6ppm), or (2) submission contingent (SC) where tokens can be earned contingent on submitting CO videos, but independent of quitting during a 6- month observation period. Primary outcomes of feasibility and acceptability of Re-Connect will be assessed via (a) enrollment, (b) duration of use, (c) reasons for discontinuation, and (d) participant-reported acceptability. Primary outcomes of preliminary efficacy will be assessed via (e) percent of negative daily CO samples, and (f) 7-day point prevalence of self-reported smoking status, verified by CO, between the two groups. Our team has extensive experience with mobile CM interventions, technology development, focus groups, single-case designs, biostatistics, human factors testing, and clinical trial testing, making us ideally positioned to carry out the proposed proof-of-concept development and testing.