ADRD Prevention Messaging to Increase Smoking Cessation Attempts in Older Adult Smokers

项目摘要/摘要 这份职业发展提案的重新提交旨在为Adrienne Johnson博士提供培训 成为烟草依赖、阿尔茨海默氏病和 相关痴呆症(ADRD)以及传播和实施(D&I)科学。约翰逊博士被训练成一名 临床心理学家，在以患者为中心的并存医学和医学研究方面拥有丰富的经验 精神科人群和这些人群中的戒烟专业知识。专家指导团队 将指导她实现四个培训目标：(1)全面了解ADRD 致病因素、预防文献和治疗方法；(2)发展D&I科学和其专业知识 应用于干预措施的开发和测试；(3)发展公共卫生营销和 激励信息；以及(4)获得更大规模临床试验方法学方面的培训。这项培训包括 正式课程、指导、学徒和参加国家科学会议， 将允许约翰逊博士开发和测试一种旨在帮助老年吸烟者戒烟的干预措施 抽烟。老年吸烟者认知能力下降和ADRD的风险增加，除非他们 如果能成功戒烟，他们的患病率将继续上升。不幸的是，年长的吸烟者只有 可能尝试戒烟，不太可能接受循证吸烟治疗(EBST) 与年轻人相比。老年吸烟者较低的戒烟努力可能是临床医生无所作为的结果 以及老年吸烟者的功能失调的信念/动机缺陷。拟议的工作将开发和测试一个容易的 可翻译的老年人戒烟第一阶段动机干预包括：(1)一项新的 患者告知的促进戒烟的激励信息，以及(2)明确获得EBST的途径 在医疗保健环境中。拟议的研究将使用三个相互关联的目标，连续发生和 建立在先前目标的基础上，以实现这一目标。目标1将确定最有希望的 医疗保健中关于戒烟动机、EBST有效性和获得EBST的信息内容 布景。AIM 2将使用调查方法评估有前景的动机干预方案。最后，瞄准 3将研究一种新的全面动机干预的可行性和初步效果 在现实世界的临床环境中，增加老年吸烟者戒烟、戒烟尝试和使用EBST的动机。 约翰逊博士将应用一种广泛使用的健康行为改变模型(健康信念模型)来指导治疗 开发并使用经过良好验证的D&I科学框架(RE-AIM)，以确保她正在为翻译而构建。 结果将为未来的R01应用程序提供信息，旨在更广泛地实施和评估这一干预措施 并研究戒烟与大脑健康之间的关系。

PROJECT SUMMARY/ABSTRACT This career development proposal resubmission is designed to provide Adrienne Johnson, PhD, the training necessary to become an independent investigator in the fields of tobacco dependence, Alzheimer’s disease and related dementias (ADRD), and dissemination and implementation (D&I) science. Dr. Johnson is trained as a clinical psychologist and has substantial experience with patient-oriented research in comorbid medical and psychiatric populations and expertise in smoking cessation within these populations. An expert mentoring team will guide her in achieving four training objectives: (1) develop a comprehensive understanding of ADRD etiological factors, prevention literature, and treatment approaches; (2) develop expertise in D&I science and its application to intervention development and testing; (3) develop expertise in public health marketing and motivational messaging; and (4) obtain training in larger scale clinical trial methodology. This training, consisting of formal coursework, guided mentoring, an apprenticeship, and participation in national scientific conferences, will allow Dr. Johnson to develop and test an intervention designed to help motivate older smokers quitting smoking. Older adult smokers are at elevated risk for cognitive decline and ADRD development and, unless they can successfully quit smoking, their prevalence will continue to rise. Unfortunately, older smokers are half as likely to attempt to quit smoking and less likely to receive evidence-based smoking treatments (EBSTs) compared to younger adults. Lower cessation efforts in older smokers may be a function of both clinician inaction and dysfunctional beliefs/motivational deficits of older smokers. The proposed work will develop and test a readily translatable Stage 1 motivational intervention for smoking cessation in older adults consisting of: (1) a novel patient-informed motivational message promoting smoking cessation, and (2) clear access routes to EBSTs within a healthcare setting. The proposed research will use three interrelated aims, occurring consecutively and building off of findings from the previous aim, to achieve this objective. Aim 1 will identify the most promising message content in terms of smoking cessation motivation and efficacy of and access to EBSTs in a healthcare setting. Aim 2 will evaluate promising motivational intervention packages using survey methodology. Finally, Aim 3 will examine the feasibility and preliminary effectiveness of a novel comprehensive motivational intervention to increase motivation to quit, quit attempts, and use of EBSTs for older adult smokers in a real-world clinical setting. Dr. Johnson will apply a widely used model of health behavior change (Health Belief Model) to guide treatment development and use a well validated D&I science framework (RE-AIM) to ensure she is building for translation. Results will inform a future R01 application aimed at implementing and evaluating this intervention in a broader context and examining the relation between smoking cessation and brain health.