HealthyCells: A Culturally-Tailored Smoking Cessation Smartphone Intervention for African Americans with Adjunctive Treatment for Sedentary Behavior

项目摘要 成功地提高非裔美国人的戒毒率将减少死亡率的种族差异 非裔美国人和白人之间的差距高达20%。许多戒烟干预措施包括体力活动。 成分可以提高戒烟率，但还没有研究试图将减少久坐行为作为一种 停止策略。此外，智能手机可以促进密集的行为干预，而不需要负担 面对面治疗，这些干预措施可以量身定做，以满足非裔美国人和 充分利用文化优势，减少障碍，鼓励行为改变。我们的研究团队已经开发出 大量智能手机干预措施，以解决脆弱人群中一系列可改变的健康风险因素， 能够在文化上为非裔美国人量身定做。与这项研究提案相关的是，一个是 基于智能手机的应急管理干预，为戒烟提供经济奖励 使用低成本便携式一氧化碳监测器和面部识别软件远程验证吸烟状况 (即PrevailGO)。另一种是基于智能手机的减少久坐干预，使用手腕活动 与智能手机技术相结合的监控器，可实时监控活动并在以下情况下提供活动提示 个人会长时间地进行久坐不动的行为(即SmartPath)。我的长期目标是提高 使用循证的、文化定制的智能手机的非裔美国人的戒烟结果 干预措施。这项研究提案的总体目标，是实现这一长期目标的下一步 目标是(A)创建用于戒烟的智能手机应用程序(即Healthy Cells)，这将通过以下方式实现 将PrevailGO和SmartPath这两种先前存在的基于证据的智能手机干预措施整合在一起，(B)在文化上创建 为非裔美国人吸烟者量身定做的治疗内容(即信息、图像和视频)，以及(C)评估 HealthCells在解决非裔美国人吸烟和久坐行为方面的可行性。一个测试样本 非裔美国吸烟者(N=15)将短暂使用Healthy Cells应用程序，并通过半 有组织的采访以完善智能手机的干预。一旦Healthy Cells应用程序得到改进，非洲裔美国人(N =30)有兴趣戒烟的人将在预定的戒烟尝试期间使用该应用程序。从预定时间开始 戒烟日期，Healthy Cells将提示参与者完成每天两次的远程吸烟状态评估，以赚取 对禁欲的奖励。这款应用程序将发送实时信息，告诉参与者在 长时间的久坐不动(例如，≥30分钟不间断地坐着、躺着或躺着 姿势)。参与者还将按需访问针对文化定制的信息和战略，以便 在Healthy Cells应用程序中禁欲和减少久坐行为。主要的结果将是生化的 戒烟8周后确认的戒烟点患病率和久坐时间的差异 根据一项研究，戒烟前的连续天数与戒烟后8周的连续7天相比- 等级加速度计。

PROJECT ABSTRACT Successfully increasing cessation rates among African Americans would reduce the racial disparity in mortality between African Americans and Whites by up to 20%. Many smoking cessation interventions include physical activity components to boost cessation rates, but no studies have attempted to promote sedentary behavior reduction as a cessation strategy. Further, smartphones can facilitate intensive behavioral interventions without requiring burdensome in-person treatment, and these interventions can be tailored to address the specific needs of African Americans and capitalize on cultural strengths to reduce barriers and encourage behavior change. Our research team has developed numerous smartphone interventions to address a range of modifiable health risk factors among vulnerable populations, which are capable of being culturally tailored for African Americans. Of relevance to this research proposal, one is a smartphone-based contingency management intervention that provides financial rewards for smoking abstinence after remote verification of smoking status using low-cost portable carbon monoxide monitors and facial recognition software (i.e., PrevailGO). The other is a smartphone-based sedentary reduction intervention that uses wrist-worn activity monitors in combination with smartphone technology to monitor activity in real-time and deliver activity prompts when individuals are engaged in prolonged bouts of sedentary behavior (i.e., SMARTpath). My long-term goal is to improve smoking cessation outcomes among African Americans using evidence-based, culturally tailored smartphone interventions. The overall objectives of this research proposal, which is the next step toward achieving this long-term goal, are to (a) create a smartphone application for smoking cessation (i.e., HealthyCells), which will be achieved by integrating two pre-existing evidence-based smartphone interventions, PrevailGO and SMARTpath, (b) create culturally tailored treatment content (i.e., messages, images, and videos) for African American smokers, and (c) evaluate the feasibility of HealthyCells at addressing smoking and sedentary behavior among African Americans. A pilot sample of African American smokers (N = 15) will briefly use the HealthyCells app and provide critical feedback through semi- structured interviews to refine the smartphone intervention. Once the HealthyCells app is refined, African Americans (N = 30) who are interested in quitting smoking will use the app during a scheduled quit attempt. Starting on the scheduled quit date, HealthyCells will prompt participants to complete twice-daily remote smoking status assessments to earn rewards for abstinence. The app will deliver real-time messages telling participants to stand up and move around during prolonged bouts of sedentary behavior (i.e., ≥ 30 minutes of uninterrupted time spent in a sitting, reclining, or lying posture). Participants will also have on-demand access to culturally tailored information and strategies for remaining abstinent and reducing sedentary behavior within the HealthyCells app. The primary outcomes will be biochemically confirmed point prevalence smoking abstinence at 8 weeks post-quit date, and the difference in sedentary time 7 consecutive days before quitting compared with 7 consecutive days at 8-weeks post-quit, as measured by a research- grade accelerometer.