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

项目摘要 成功提高非裔美国人的戒烟率将减少死亡率的种族差异 非洲裔美国人和白人之间的差异高达20%。许多戒烟干预措施包括身体活动 成分，以提高戒烟率，但没有研究试图促进久坐不动的行为减少， 停止战略。此外，智能手机可以促进密集的行为干预，而不需要繁琐的 面对面的治疗，这些干预措施可以针对非裔美国人的具体需求， 利用文化优势，减少障碍，鼓励行为改变。我们的研究团队开发了 采取大量智能手机干预措施，以应对弱势群体中一系列可改变的健康风险因素， 能够为非裔美国人量身定制的文化。与本研究建议相关的是， 基于智能手机的应急管理干预，为戒烟后的戒烟提供经济奖励 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态 (i.e., PrevailGO）。另一种是基于智能手机的久坐减少干预，使用腕戴式活动 监控器与智能手机技术相结合，以实时监控活动，并在 个体进行长时间的久坐行为（即，SMARTpath）。我的长期目标是提高 非裔美国人使用基于证据的、文化定制的智能手机戒烟的结果 干预措施。本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，HealthyCells），将通过以下方式实现 整合两种现有的循证智能手机干预措施PrevailGO和SMARTpath，（B）在文化上创造 定制的治疗内容（即，信息，图像和视频），以及（c）评估 HealthyCells解决非裔美国人吸烟和久坐行为的可行性。一个试点样本， 非裔美国人吸烟者（N = 15）将短暂使用HealthyCells应用程序，并通过半定量分析提供关键反馈。 结构化访谈，以完善智能手机的干预。一旦HealthyCells应用程序完善，非裔美国人（N = 30）有兴趣戒烟的人将在计划戒烟尝试期间使用该应用程序。按计划开始 戒烟日期，HealthyCells将提示参与者完成每天两次的远程吸烟状态评估， 禁欲的奖励该应用程序将提供实时消息，告诉参与者在过程中站起来并四处走动。 长时间的久坐行为（即，≥ 30分钟不间断的坐、斜躺或躺着时间 姿势）。与会者还将按需获得文化定制的信息和战略， 在HealthyCells应用程序中禁欲和减少久坐行为。主要结果将是生物化学 戒烟后8周的戒烟率和久坐时间的差异 戒烟前连续几天与戒烟后8周连续7天相比，根据一项研究的测量结果， 坡度加速度计

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.