Testing Alternative Stage Models of Smoking Cessation: An Intervention Study

描述（由申请人提供）：健康行为的阶段理论在过去的20年里一直很有影响力。在戒烟的情况下，舞台模特的吸引力和潜力很容易理解。尽管许多变量与戒烟有关，但很难将这些变量组织成一个关于人们如何戒烟的连贯理论。阶段模型可以帮助以一种告知干预措施的方式为这些变量带来结构。如果吸烟者可以被安排在一个有序的阶段，那么就可以为每个阶段设计干预措施，以促进渐进的阶段运动，最终导致戒烟。在过去的20年里，改变阶段的广泛使用反映了戒烟阶段模型的直观吸引力。变化阶段是跨理论模型（Transtheoretical model， TTM）的关键。然而，一些研究人员最近得出结论，TTM没有充分的经验证据支持。当前应用的假设是，改变阶段结构系统地低估了戒烟动机，并且这种系统性低估破坏了基于TTM的研究和干预。提出了一项干预研究，其中参与者接受阶段匹配的戒烟干预。三种研究条件将使用三种不同的分期系统来确定每个吸烟者的阶段。一个阶段系统将是变化的阶段。第二种分期方法将是由PI开发的替代方法。过去的研究表明，这两种系统产生了明显不同的阶段分布，与改变阶段算法相比，替代算法将吸烟者归类为更有动力戒烟。第三个“系统”是一种控制条件，在这种条件下，所有吸烟者都被视为有很强的戒烟动机。拟议研究的假设是，与使用变化阶段算法或分配到控制条件的参与者相比，使用替代分期系统的参与者将表现出更高的戒烟率和更大的戒烟动机。鉴于TTM在公共卫生研究和实践中的突出地位，本研究可能对通过提高戒烟干预措施的有效性来预防癌症和其他疾病具有深远的意义。

DESCRIPTION (provided by applicant): Stage theories of health behavior have been influential over the past 20 years. In the case of smoking cessation, the appeal and potential of a stage model is easily understood. Whereas many variables are associated with smoking cessation, it is difficult to organize these variables into a coherent theory of how people quit smoking. A stage model could help bring structure to these variables in a way that would inform interventions. If smokers could be arranged in an ordered set of stages, then interventions could be designed for each stage to foster progressive stage movements leading ultimately to cessation. The intuitive appeal of a stage model for smoking cessation is reflected by the widespread use of the stages of change over past 20 years. The stage of change construct is the linchpin of a larger model known as the Transtheoretical Model (TTM). However, several researchers recently have concluded that the TTM is insufficiently supported by empirical evidence. The hypothesis of the current application is that the stage of change construct systematically underestimates motivation to quit smoking, and that this systematic underestimation undermines research and interventions based on the TTM. An intervention study is proposed in which participants receive stage-matched interventions for smoking cessation. The three study conditions will use three different staging systems to determine the stage of each smoker. One staging system will be the stages of change. A second staging method will be an alterative developed by the PI. Past research has shown that these two systems produce significantly different stage distributions, and that the alternative algorithm classifies smokers as being significantly more motivated to quit compared to the stages of change algorithm. A third "system" is a control condition in which all smokers are treated as though they were highly motivated to quit. The hypothesis of the proposed study is that participants staged using the alternative staging system will evince greater rates of cessation and greater increases in motivation to quit smoking compared to participants staged with the stage of change algorithm, or participants assigned to the control condition. Given the prominence of the TTM in public health research and practice, this study could have far reaching implications for preventing cancer and other diseases by enhancing the effectiveness of smoking cessation interventions.