Positive Psychotherapy for Smoking Cessation Enhanced with Text Messaging: A Randomized Controlled Trial

通过短信增强戒烟积极心理治疗：随机对照试验

• 批准号: 9310231
• 负责人: Christopher W. Kahler
• 金额: $ 56.44万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-04 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9310231
• 关键词: Abstinence; Address; Affect; Aftercare; Area; Attention; Behavior Therapy; Behavioral; Biochemical; Cognition; Cognitive; Counseling; Development; Effectiveness; Emotions; Exercise; Frequencies; Goals; Happiness; Health Benefit; Human; Individual; Intervention; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Monitor; Outcome; Participant; Psychology; Psychotherapy; Public Health; Randomized; Randomized Controlled Trials; Relapse; Research; Residual state; Resources; Schedule; Self Efficacy; Smoker; Smoking; Smoking Cessation Intervention; Stress; Techniques; Testing; Text; Thinking; Time; Training; Withholding Treatment; addiction; base; behavioral health; behavioral pharmacology; cigarette smoking; depressive symptoms; design; efficacy testing; experience; follow-up; improved; innovation; nicotine patch; nicotine replacement; novel; pleasure; population health; positive emotional state; positive mood; programs; public health priorities; response; smoking cessation; smoking intervention; smoking prevalence

Project Summary/Abstract There continues to be an urgent need to increase the effectiveness of behavioral counseling for promoting long-term smoking cessation. Research on positive psychology has been growing rapidly over the past two decades and provides a valuable perspective for developing novel and more effective approaches to addictions treatment that are likely to have broad appeal. Building from a substantial body of research on positive psychology interventions for increasing positive affect and reducing stress and depression, we recently developed and pilot tested a treatment called Positive Psychotherapy for Smoking Cessation (PPT-S). PPT-S is designed to harness personal strengths to assist smoking cessation, to enhance focus on the mental health benefits of quitting smoking, and to increase the frequency of and the attention to positive experiences and cognitions during quitting. In a pilot randomized controlled trial, PPT-S resulted in greater odds of smoking abstinence over 6 months of follow-up compared to a time-matched control condition. We also found that greater engagement in PPT-consistent strategies was associated with increased odds of abstinence over time, that those with higher baseline positive affect engaged in more PPT-consistent strategies, and that the efficacy of PPT-S was greatest at higher levels of positive affect. Results show the potential promise of PPT-S and suggest that increasing engagement in PPT-consistent behavioral and cognitive strategies, especially for those with low positive affect, may further enhance the efficacy of this approach. Towards this end, we have developed an enhanced version of PPT-S (PPT-S+) that uses text messaging to provide PPT-related content and to prompt daily engagement in PPT-consistent strategies; pilot testing indicates high acceptability of this approach with participants responding to over 80% of daily interactive text messages. The overall objective of the proposed project is to conduct a randomized controlled trial to test the efficacy of PPT-S+. Specifically, we will randomize 340 smokers to either PPT-S+ or a time-matched standard behavioral smoking cessation treatment plus text messaging (ST+). Both treatment conditions will include nicotine replacement therapy and a text-messaging intervention for smoking cessation. We will test the hypotheses that PPT-S+ will result in superior smoking outcomes compared to ST+ and that this effect will be mediated by greater engagement in PPT-consistent strategies, increased self-efficacy for quitting smoking, and reduced residual attraction to smoking. We also will examine whether the effect of PPT-S+ remains stronger for those with higher baseline positive affect even when text messaging is utilized to increase treatment engagement. This project can have significant public health impact by establishing the efficacy of a highly innovative approach to improving behavioral smoking cessation counseling, which can be readily implemented and is likely to appeal to a broad range of smokers due to its emphasis on personal strengths and enhancing overall well-being and happiness.

项目概要/摘要 仍然迫切需要提高行为咨询的有效性，以促进 长期戒烟。近两年来积极心理学的研究发展迅速 几十年来，为开发新颖且更有效的方法提供了宝贵的视角 可能具有广泛吸引力的成瘾治疗。以大量研究为基础 积极心理学干预措施可以增加积极情绪并减少压力和抑郁，我们最近 开发并试点测试了一种称为戒烟积极心理疗法（PPT-S）的治疗方法。 PPT-S 旨在利用个人优势帮助戒烟，加强对心理健康的关注 戒烟的好处，以及增加积极经历和关注的频率和注意力 戒烟期间的认知。在一项随机对照试验中，PPT-S 导致吸烟的几率更大 与时间匹配的对照条件相比，在 6 个月的随访期间禁欲。我们还发现 随着时间的推移，更多地参与与 PPT 一致的策略与戒烟的几率增加相关， 那些具有较高基线积极影响的人会采取与 PPT 更加一致的策略，并且效果 PPT-S 的效果在积极情感水平较高时最大。结果显示了 PPT-S 的潜在前景 建议增加对与 PPT 一致的行为和认知策略的参与，特别是对于那些 积极影响较低，可能会进一步提高这种方法的功效。为此，我们有 开发了PPT-S的增强版（PPT-S+），利用短信提供PPT相关内容 并促进日常参与与 PPT 一致的策略；试点测试表明这一点的可接受性很高 参与者回复了超过 80% 的日常互动短信。总体目标 拟议的项目是进行一项随机对照试验来测试 PPT-S+ 的功效。具体来说，我们 将随机将 340 名吸烟者分为 PPT-S+ 组或时间匹配的标准行为戒烟组 治疗加短信 (ST+)。两种治疗条件都将包括尼古丁替代疗法和 短信干预戒烟。我们将测试 PPT-S+ 将导致的假设 与 ST+ 相比，吸烟效果更好，并且这种效果将通过更多地参与来介导 PPT一致的策略，提高戒烟的自我效能，减少对吸烟的残余吸引力 吸烟。我们还将检查 PPT-S+ 的效果对于基线较高的人是否仍然更强 即使利用短信来提高治疗参与度，也会产生积极影响。这个项目可以有 通过建立高度创新的方法来改善公共卫生的有效性 行为戒烟咨询，易于实施，可能会吸引广泛的人群 由于它强调个人优势并提高整体福祉和幸福感，因此受到了广大吸烟者的欢迎。