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

项目总结/摘要 重新提交的职业发展建议旨在为Adrienne约翰逊博士提供培训 有必要成为烟草依赖，阿尔茨海默病和 相关痴呆症（ADRD）和传播与实施（D&I）科学。约翰逊博士接受过 临床心理学家，在共病医学和 精神病人群和这些人群中戒烟的专业知识。专家指导团队 将指导她实现四个培训目标：（1）全面了解ADRD 病因学因素，预防文献和治疗方法;（2）发展D&I科学及其 （3）发展公共卫生营销方面的专业知识， 激励信息;（4）获得更大规模临床试验方法的培训。本次培训，包括 正式的课程，指导指导，学徒，并参加国家科学会议， 将使约翰逊博士能够开发和测试一种旨在帮助激励老年吸烟者戒烟的干预措施 smoking.老年吸烟者认知能力下降和ADRD发展的风险增加，除非他们 能够成功戒烟，其患病率将继续上升。不幸的是，年龄较大的吸烟者 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不作为 以及老年吸烟者的不正常信念/动机缺陷。拟议的工作将开发和测试一个容易 可翻译的第1阶段老年人戒烟的动机干预，包括：（1）一本小说 患者知情的激励信息，促进戒烟，（2）明确的EBST的访问路径 在一个医疗机构中。拟议的研究将使用三个相互关联的目标，连续发生， 根据先前目标的调查结果，实现这一目标。目标1将确定最有前途的 在医疗保健中，关于戒烟动机和EBST的有效性以及获得EBST的信息内容 设置.目标2将使用调查方法评估有前途的动机干预方案。最后，Aim 3将研究一种新的综合动机干预的可行性和初步有效性， 增加戒烟的动机，戒烟尝试，以及在现实世界的临床环境中对老年吸烟者使用EBST。 博士约翰逊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 开发并使用经过充分验证的D&I科学框架（RE-AIM），以确保她正在进行翻译。 结果将为未来的R 01应用程序提供信息，该应用程序旨在更广泛地实施和评估该干预措施。 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.