Developing a Smartphone App with Mindfulness Training for Teen Smoking Cessation

描述（由申请人提供）：新的卫生部长报告（SGR），预防青少年和年轻人吸烟，强调尼古丁的成瘾性，并强调需要为超过360万吸烟的青少年提供有效和可获得的戒烟治疗。该申请是对PA-13-078行为和综合治疗开发计划（R34）的回应，该计划支持针对药物滥用的行为干预措施的开发和测试，包括专注于干预措施生成和改进（IA阶段）的研究，以及试点或可行性（IB阶段），以及旨在“通过创造性地使用技术来提高干预措施的可实施性”的研究。我们开发了渴望戒烟（C2 Q），这是一种针对成年人的戒烟智能手机干预，将正念训练（MT）整合到戒烟课程中。虽然MT已被证明对成年人戒烟有效，但尚未在青少年中进行测试。此外，由于需要经验丰富的MT治疗师，时间需求高，难以安排会议，以及亲自提供治疗的高成本，MT的传播具有挑战性。移动的智能手机技术为克服这些传播障碍提供了一个有前途的媒介。我们建议调整和完善我们现有的渴望戒烟（C2 Q）应用程序，供青少年吸烟者使用（第IA阶段），并进行可行性和试点测试（第IB阶段），为R 01应用程序做准备，以明确测试 并探讨了MT引起变化的心理机制。在试点测试中，六所公立高中将被随机分配到三种条件之一，每种条件两所学校：（1）C2 Q-Teen应用程序（通过智能手机应用程序通过MT提供戒烟），（2）NCI的QuitSTART应用程序专为青少年吸烟者（NCI-QS）设计（通过智能手机应用程序提供戒烟而不使用MT），或（3）仅书面戒烟材料（MO）。将招募144名有兴趣戒烟的青少年吸烟者（24/学校，48/条件）。学校护士将在学校环境中介绍这三种干预措施。我们的首要目标是调整C2 Q应用程序，供青少年吸烟者使用（C2 Q-Teen）。我们的第二个主要目的是评估干预措施的可行性和可接受性，以确保每种干预措施对于专门用于比较疗效率的大型RCT的充分性。次要目的是评估三种干预措施的相对有效性以及智能手机干预措施和正念在3个月和6个月随访时增加可替宁验证的7天点戒烟率的独立贡献，以充分支持更大规模的试验，并确定C2 Q-Teen使用和戒烟之间的关系。如果最终发现是有效的，C2 Q-Teen提供了一种创新的和潜在的强大的干预措施，以支持青少年戒烟，这将是相对容易的广泛传播，并具有巨大的公共卫生意义，解决了SGR的呼吁，即为想要戒烟的青少年吸烟者提供现成的治疗。

DESCRIPTION (provided by applicant): The new Surgeon General's Report (SGR), Preventing Tobacco Use Among Youth and Young Adults, highlights the addictive nature of nicotine and emphasizes the need for effective and accessible cessation treatment for the more than 3.6 million youth who smoke. This application is in response to PA-13-078, Behavioral and Integrative Treatment Development Program (R34), which supports the development and testing of behavioral interventions targeting substance abuse, including studies focused on Intervention generation and refinement (Stage IA), and pilot or feasibility (Stage IB), and research designed to "increase implementability of interventions with creative use of technology". We have developed Craving to Quit (C2Q), a smartphone intervention for smoking cessation for adults that integrates mindfulness training (MT) into a smoking cessation curriculum. While MT has been shown to be efficacious for smoking cessation in adults, it has not been tested in adolescents. In addition, dissemination of MT is challenging due to the need for experienced MT therapists, high time demand, difficulties in scheduling sessions, and high costs of in-person treatment delivery. Mobile, smartphone technologies provide a promising medium for overcoming these barriers to dissemination. We propose to adapt and refine our existing Craving to Quit (C2Q) app for use by adolescent smokers (Stage IA), and to conduct feasibility and pilot testing (Stage IB) in preparation for an R01 application to definitively test efficacy and probe psychological mechanisms of change resulting from MT. In the pilot test, six public high schools will be randomly assigned to one of three conditions, two schools per condition: (1) C2Q-Teen app (smoking cessation delivered through a smartphone app via MT), (2) NCI's QuitSTART app designed for teen smokers (NCI-QS) (smoking cessation delivered through a smartphone app without MT), or (3) written smoking cessation materials only (MO). One hundred forty four adolescent smokers interested in quitting will be recruited (24/school, 48/condition). School nurses will introduce the three interventions in the school setting. Our firs primary aim is to adapt the C2Q app for use by adolescent smokers (C2Q-Teen). Our second primary aim is to evaluate the feasibility and acceptability of the interventions to ensure adequacy of each intervention for a larger RCT designed specifically to compare efficacy rates. Secondary aims are to assess relative efficacy of the three interventions and independent contributions of smartphone intervention delivery and mindfulness in increasing cotinine-validated 7-day point prevalence abstinence at 3- and 6-month follow-up in order to adequately power a larger trial, and to determine the relationship between C2Q-Teen usage and abstinence. If eventually found to be effective, C2Q-Teen offers an innovative and potentially powerful intervention for supporting teens in their efforts to quit that would be relatively easy t disseminate widely and have tremendous public health significance, addressing the SGR's call for readily available treatment for adolescent smokers wanting to quit.