MOBILE HEALTH INTERVENTION FOR FAMILY SMOKING CESSATION IN ROMANIA

吸烟仍然是全球可预防疾病和死亡的主要原因， 每年约有600万人死亡，其中大多数死亡发生在低收入和中等收入国家（LMIC）。 移动医疗的潜力，特别是基于移动的手机的战略，改变医疗保健，改变健康 行为和改善健康对中低收入国家具有特别重要的意义， 是有限的。在中欧和东欧（CEE），怀孕前和怀孕期间吸烟率很高， 对妇女及其子女的健康产生负面影响。女性吸烟的几率更高- 怀孕期间的紧张，以及复发一旦孕妇戒烟，当男性伴侣也吸烟。它 对于解决夫妇在生育期内的吸烟行为至关重要。 在我们在罗马尼亚和其他中东欧国家工作的基础上，这项申请的目标是阻止- 我在一项随机对照试验（RCT）中发现，移动健康夫妇干预是否有望增加 在吸烟的怀孕夫妇中戒烟，并在罗姆人中建立移动健康研究能力， nia。我们将建立在自我决定理论（SDT）和动机面试（MI），辅导风格 成功帮助人们戒烟。干预将是新颖的，在其使用的独特的 智能手机的功能，它对戒烟的双重功效的强调，以及对 怀孕的夫妇。我们的目标是（1）测试实施的可行性，可接受性，和初步疗效的一个 在怀孕和产后期间对夫妇进行适应文化的mHealth戒烟干预 罗马尼亚的有我们将招募60名怀孕吸烟者及其伴侣;（2）通过以下方式发展移动健康研究能力： 提高罗马尼亚的个人和机构研究能力，扩大现有的国际研究能力， 研究网络。 这项研究将产生一个初步证据的基础，可用于启动一个大规模的R01亲， 测试建议的预防吸烟措施的成效。关于预期的- 来，预计拟议的应用程序将促进对主动预防的有效性的理解， 通过解决夫妇对戒烟的双重功效来加强mHealth夫妇干预， 怀孕吸烟和产后复发。预计这些成果将在全系统范围内实现可持续发展 干预效果高，对预防产前产后家庭吸烟有积极影响 可能会在罗马尼亚的全民医疗系统中采用，并应用于美国和其他民众， 选择。这项研究也有望对mHealth的方法和设计产生重大影响 在生育期间进行干预。国际研究网络的发展和 个人和机构的移动健康研究能力建设预计将积极影响移动健康再 在中欧和东欧及邻近地区的搜索适用于烟草控制和其他当地相关的主题。

Tobacco cigarette smoking remains the leading global cause of preventable disease and death killing near- ly 6 million people each year, with most of these deaths occurring in low and middle income countries (LMICs). The potential of mHealth, especially mobile phone-based strategies, to transform health care, change health behaviors, and improve health has particular significance for LMICs where access to health providers and care is limited. Preconception and pregnancy smoking are high in the Central and Eastern Europe (CEE) with life- time negative health effects for the women and their children. There are higher odds of female smoking persis- tence during pregnancy, as well as relapse once pregnant women quit, when the male partner also smokes. It is critically important to address the smoking behavior of couples during their reproductive life. Building on our work in Romania and other CEE countries, the objectives of this application are to deter- mine in a randomized controlled trial (RCT) whether a mHealth couples intervention shows promise in increas- ing smoking cessation among pregnant couples who smoke and to build mHealth research capacity in Roma- nia. We will build on Self-Determination Theory (SDT) and Motivational Interviewing (MI), a counselling style that is successful in assisting people to quit smoking. The intervention will be novel in its use of the unique functionality of smartphones, its emphasis on the dyadic efficacy for smoking cessation, and the focus on pregnant couples. Our aims are to (1) Test the implementation feasibility, acceptability, and initial efficacy of a culturally-adapted mHealth smoking cessation intervention among couples during pregnancy and postpartum in Romania. We will recruit 60 pregnant smokers and their partners; (2) Develop mHealth research capacity by enhancing individual and institutional research capabilities in Romania and expanding the existing international research network. The study will generate a base of preliminary evidence that can be used to launch a large scale R01 pro- ject to test the effectiveness of the proposed smoking prevention intervention. With respect to expected out- comes, the proposed application is anticipated to advance understanding of the effectiveness of a proactive mHealth couple intervention enhanced by addressing couples' dyadic efficacy for smoking cessation in reduc- ing pregnancy smoking and postnatal relapse. Such results are anticipated to have a system wide sustainable positive impact on the prevention of prenatal and postnatal family smoking as the intervention has a high po- tential to be adopted in the universal health system in Romania, with applications to the US and other popula- tions. This research is also expected to have a significant impact on the methodology and design of mHealth interventions during the reproductive years. The development of the international research network and the individual and institutional mHealth research capacity building is expected to positively impact mHealth re- search in CEE and the neighboring region applied to tobacco control and other locally-relevant topics.