A Mobile App Based Cognitive Dissonance Intervention for Smoking Cessation

摘要 尽管美国的烟草使用率在过去30年中总体下降，但近38 数以百万计的美国人仍然吸烟，这对长期健康问题和死亡构成了极高的风险。近期 审查指出，在临床和公共卫生的应用方面取得了重大进展 帮助吸烟者戒烟的干预措施；然而，他们也得出结论，吸烟者的总体戒烟成功率 戒烟的情况并没有明显改善。个人、团体和公共卫生干预--包括有无干预 辅助辅助手段，如尼古丁替代疗法，通常使用某种认知疗法的组合- 行为干预，但仍然需要新的、理论驱动的方法来提高戒烟率。 通过计算机或移动应用程序提供的创新干预措施可以扩大覆盖范围并 订婚。我们建议改编和测试之前试行的认知失调的可行性。 通过手机应用程序提供戒烟干预(CDI)。认知失调干预有 已被证明在治疗与健康有关的问题以及药物使用方面取得了成功，并初步 研究结果支持它在戒烟中的应用。这个名为CoQuit的项目是基于认知失调的 和戒烟组件在我们的第一阶段原型移动应用程序中进行了测试。此原型应用程序 已证明的有效性和我们的评估研究的结果符合进入第二阶段的标准。我们将 扩展和修订六模块COQUIT计划，该计划包括12个视频组件(6个指导性组件 组件和6个认知不协调活动)，以提高易用性，增加与其他 正在戒烟的吸烟者，并与Emberex合作改善社会支持要素，Emberex 在移动应用的开发和商业化方面有丰富的经验。这一进展将评估 与成年日常吸烟者进行导航和可用性，并进行试点测试，以指导CoQuit的开发 用于评估的应用程序。我们的研发团队拥有丰富的开发和测试经验 移动应用程序以及开发和测试认知失调和戒烟干预措施。这个 评估研究将包括通过社交媒体招募的500名成年人，并随机分配到 没有认知不和谐任务的认知不和谐移动应用或类似应用；参与者将 在基线、1个月和3个月的随访时进行评估。戒烟尝试的显著变化，不戒烟的天数 吸烟(无烟天数)、戒烟率和吸烟态度的改变将被用来 确定CoQuit应用程序的疗效。可用性数据、计划使用的系统日志数据和参与者 满意度数据也将被分析。

Abstract Despite overall declines in the rate of tobacco use in the United States over the past 30 years, nearly 38 million Americans still smoke, posing extremely high risk for long-term health problems and death. Recent reviews note that there has been significant progress in the application of both clinical and public health interventions to help smokers quit; however, they have also concluded that the overall success rate of smokers quitting has not significantly improved. Individual, group and public health interventions – both with and without adjunctive aids such as nicotine replacement therapy – have generally used some combination of cognitive- behavioral interventions, but there remains a need for novel, theory-driven approaches to enhance quit rates. Innovative interventions such as those offered via computer or mobile app can increase reach and engagement. We propose to adapt and test the feasibility of a previously piloted cognitive dissonance intervention (CDI) for smoking cessation delivered via a mobile app. Cognitive dissonance interventions have been shown to be successful in treating health-related problems, as well as substance use, and preliminary findings support its use in smoking cessation. The program, entitled CoQuit, is based on cognitive dissonance and smoking cessation components tested in our Phase I prototype mobile app. This prototype app demonstrated efficacy and the results of our evaluation study met criteria for moving to Phase II. We will expand and revise the six module CoQuit program, which includes 12 video components (6 instructional components and 6 cognitive dissonance activities) to improve ease of use, increase interactivity with other smokers who are quitting, and improve social support elements in partnership with Emberex, who has extensive experience in the development and commercialization of mobile apps. This development will assess navigation and usability with adult daily smokers and conduct pilot testing to guide development of the CoQuit app for evaluation. Our research and development team has extensive experience developing and testing mobile apps and developing and testing cognitive dissonance and smoking cessation interventions. The evaluation study will include 500 adults recruited through social media and randomly assigned to either the Cognitive Dissonance mobile app or a comparable app without cognitive dissonance tasks; participants will be assessed at baseline, 1- and 3-month follow-up. Significant changes in quit attempts, number of days without smoking (smokefree days), point prevalence cessation, and changes in smoking attitudes will be used to determine the efficacy of the CoQuit app. Usability data, system log data on program use, and participant satisfaction data will also be analyzed.