Optimizing an online motivational tobacco cessation program

优化在线激励戒烟计划

• 批准号: 7630300
• 负责人: JENNIFER B MCCLURE
• 金额: $ 64.71万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7630300
• 关键词: Abstinence; Address; Adult; American; Area; Automobile Driving; Cause of Death; Centers for Disease Control and Prevention (U.S.); Characteristics; Classification; Communication; Communication Research; Computers; Country; Effectiveness; Future; Generic Drugs; Health; Health Planning; Health Priorities; Health behavior change; Individual; Individual Differences; Internet; Intervention; Investigation; Learning; Life; Mediating; Modeling; Motivation; Outcome; Participant; Phase; Population; Randomized; Recruitment Activity; Reporting; Research; Risk; Science; Screening procedure; Self Efficacy; Series; Smoke; Smoker; Smoking; Specific qualifier value; Testing; The Sun; Time; To specify; Tobacco Use Cessation; Treatment outcome; United States Dept. of Health and Human Services; Withholding Treatment; Work; base; design; disability; enhancing factor; help-seeking behavior; motivational enhancement therapy; motivational intervention; next generation; outreach; programs; psychosocial; public health relevance; research study; smoking cessation; smoking prevalence; social cognitive theory; theories; therapy design; treatment program; uptake

DESCRIPTION (provided by applicant): Smoking is the leading cause of death and disability in the U.S. Despite this, 21% of U.S. adults continue to smoke on a regular basis and less than about 20% are ready to quit smoking or taking action to quit at any given time. In other words, about 80% or more of smokers are not sufficiently motivated and ready to quit smoking, even though they may want to quit someday. Interventions are critically needed which can reach these people, enhance their motivation for quitting, promote uptake of existing empirically-validated treatments, and ultimately enhance abstinence rates on a population level. Motivational interventions delivered via the Internet can be easily tailored to the needs of individual smokers. There is now a large body of research demonstrating that computer-tailored health behavior change interventions can be more effective than generic interventions, particularly for smoking cessation, but it is less clear what specific content and presentation factors will be most effective and for whom when tailoring an online motivational intervention. The current study will test the effectiveness of five potentially important tailoring factors (decisional framework, message framing, self-efficacy, navigation autonomy, and proactive outreach). Factor choice was largely informed by the principles of Motivational Interviewing, Social Cognitive Theory, Prospect Theory, and the Transtheoretical Model. In addition to examining whether each factor is important for treatment outcome, we will also examine for whom each factor is most important by exploring the influence of relevant individual characteristics which may mediate or moderate outcomes. This level of understanding is important for designing future tailored programs. Participants in this study will be recruited from a large, regional U.S. health plan. Using a fractional factorial design to screen for important main effects and 2-way interactions, participants will be randomized to receive one of 16 different experimental factor combinations and followed for one year to assess program impact on smokers' motivation for quitting, use of empirically-validated cessation treatment, and abstinence. The proposed research is a natural extension of our collaborative team's work in tailoring, developing motivational and action oriented programs for smoking cessation, health risk communications research, and creating online health behavior change programs. Information learned from this study will advance the science of tailoring health risk communications, as well as inform how to best design an online motivational intervention for smoking cessation. This is the first study we are aware of to address this important issue. PUBLIC HEALTH RELEVANCE: Reducing smoking prevalence in the U.S. will require motivational interventions which are both effective at promoting abstinence and can be easily disseminated on a population level. Computer-tailored programs delivered over the Internet hold great potential for this purpose, but research in this area must move beyond simply comparing tailored to non-tailored programs and begin to specify which content and presentation factors enhance tailoring effectiveness and for whom. The proposed study is the first we are aware of to examine this issue in the context of an online motivational intervention for smoking cessation. Information learned from this study will advance the science of tailoring health risk communications, as well as inform how to best design an online motivational intervention for smoking cessation.

吸烟是美国死亡和残疾的主要原因，尽管如此，21%的美国成年人继续定期吸烟，只有不到20%的人准备戒烟或采取行动戒烟。换句话说，大约80%或更多的吸烟者没有足够的动力和准备戒烟，即使他们可能有一天想戒烟。迫切需要干预措施，可以接触到这些人，增强他们戒烟的动机，促进现有经医学验证的治疗方法的使用，并最终提高人口水平的戒烟率。通过互联网提供的激励性干预措施可以很容易地适应个人吸烟者的需要。现在有大量的研究表明，计算机定制的健康行为改变干预措施可能比一般的干预措施更有效，特别是对于戒烟，但不太清楚什么具体的内容和呈现因素将是最有效的，以及在定制在线动机干预时对谁来说。目前的研究将测试五个潜在的重要剪裁因素（决策框架，信息框架，自我效能，导航自主性和主动外展）的有效性。因素的选择在很大程度上受到动机性面试、社会认知理论、前景理论和跨理论模型的影响。除了检查每个因素是否对治疗结果很重要外，我们还将通过探索可能介导或调节结果的相关个体特征的影响来检查每个因素对谁最重要。这种理解水平对于设计未来的定制计划非常重要。本研究的参与者将从一个大型的美国地区健康计划中招募。使用部分析因设计筛选重要的主效应和双向相互作用，受试者将随机接受16种不同实验因素组合之一，并随访一年，以评估计划对吸烟者戒烟动机、使用经医学验证的戒烟治疗和戒烟的影响。拟议的研究是我们合作团队工作的自然延伸，这些工作包括为戒烟、健康风险沟通研究和创建在线健康行为改变计划制定激励和行动导向计划。从这项研究中了解到的信息将促进定制健康风险沟通的科学，并告知如何最好地设计戒烟的在线动机干预。这是我们所知道的第一项针对这一重要问题的研究。公共卫生相关性：减少美国的吸烟流行率将需要激励性干预措施，这些干预措施既能有效地促进戒烟，又能在人口水平上容易地传播。通过互联网提供的计算机定制的程序在这方面具有很大的潜力，但在这一领域的研究必须超越简单地比较定制和非定制的程序和开始，以具体说明哪些内容和演示因素提高剪裁的有效性和为谁。这项拟议中的研究是我们所知道的第一个在网上戒烟动机干预的背景下研究这个问题的研究。从这项研究中了解到的信息将促进定制健康风险沟通的科学，并告知如何最好地设计戒烟的在线动机干预。