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Perinatal Attentional Retraining Intervention for Smoking (PARIS) for Minority Women

针对少数族裔妇女的围产期吸烟注意力再训练干预措施 (PARIS)

基本信息

批准号：
10020194
负责人：
ARIADNA FORRAY
金额：
$ 24.54万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-17 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10020194
关键词：
Abstinence Addictive Behavior Address Affect African American Age Anxiety Area Attention Attenuated Behavior Behavior Therapy Cancer Etiology Cellular Phone Child Rearing Childbirth Cigarette Clinical Trials Cognitive Cognitive Science Colon Carcinoma Control Groups Cues Data Development Disease Ecological momentary assessment Excess Mortality Exhibits Female Fostering Goals Heart Diseases Hispanics Incidence Institutes Intervention Low income Maintenance Malignant Neoplasms Malignant neoplasm of lung Mediating Memory Minority Modification Morbidity - disease rate Mothers Not Hispanic or Latino Outcome Outcome Measure Participant Patient Self-Report Perinatal Pharmacological Treatment Pilot Projects Play Population Postpartum Period Postpartum Women Pregnancy Pregnancy Outcome Pregnant Women Preventable cancer cause Procedures Process Randomized Randomized Controlled Trials Relapse Research Risk Factors Role Safety Self-control as a personality trait Smoke Smoker Smoking Smoking Behavior Smoking Prevention Stimulus Stress Techniques Testing Time Tobacco Tobacco Dependence Tobacco-Related Carcinoma Transportation Treatment Efficacy Visual Water Woman addiction adverse birth outcomes adverse pregnancy outcome attentional bias attentional control barrier to care cancer risk care costs cigarette smoke combat cost craving design disorder later incidence prevention effective therapy ethnic minority population experience handheld mobile device health disparity infant morbidity/mortality innovation interest malignant breast neoplasm maternal cigarette smoking maternal morbidity minority health mortality negative affect new technology news novel novel strategies patient population perceived stress perinatal women pregnant prevent racial minority recruit relapse risk response smoking abstinence smoking cessation smoking cue smoking intervention smoking relapse sound tobacco smokers visual control

项目摘要

ABSTRACT Racial and ethnic minorities and women experience a disproportionate burden of smoking-related diseases, including cancer and heart disease. Maternal smoking is the leading cause of cancer mortality in the mother, and is associated with adverse pregnancy outcomes and increased infant morbidity and mortality. This further compounds the disparities in adverse birth outcomes experienced by racial and ethnic minorities. Nearly half of women who smoke prior to pregnancy achieve abstinence during pregnancy. Unfortunately, nearly 80% of abstinent women relapse within a year after delivery. Despite considerable study, there are few strategies that effectively combat smoking relapse in this population. This is especially true for minority women who are less likely to receive treatment and more likely to relapse to smoking postpartum than non-Hispanic whites. Smokers exhibit an “attention bias” for smoking-related cues. Attentional bias plays a role in the maintenance or escalation of smoking by increasing subjective cravings and directly affecting cigarette seeking behavior. Attentional retraining (AR) using the visual probe task has been used experimentally to reduce attentional bias and blunt cue-provoked craving. Stress and negative affect are considered major drivers of relapse, especially in women. AR is effective at attenuating anxiety related to transition stress, such as that experienced by women postpartum. The overarching goal of this pilot project is to test a novel technique, the use of smartphones to administer AR, as an intervention for smoking relapse prevention in postpartum women. AR will target both smoking cues and stress cues. We will assess whether AR reduces attentional bias, blunts cue-provoking smoking cravings after delivery, attenuates stress, and reduces smoking lapses. We propose to randomize 50 abstinent pregnant African American and/or Hispanic smokers to receive either the AR or control visual probe task. Participants will be asked to carry around a smartphone as they go about their daily lives for 2 weeks in their last month of pregnancy. The smartphone will sound an alert randomly during the day, at which time participants will be asked to respond to a short set of questions assessing subjective states; this will be followed by a request to complete the AR (or control) procedures. This same procedure will be repeated for 2 weeks in the first postpartum month. Outcome measures include attentional bias for smoking and stress stimuli, self-reported craving and perceived stress, and percentage of days and number of cigarettes smoked during the trial. This application is designed to confirm the feasibility and process parameters of the study, and obtain preliminary data on the efficacy of the intervention and the components that comprise the intervention. If AR shows promise as a treatment, it will be tested in a larger randomized controlled trial. The proposed project is a novel intervention for postpartum minority women that builds on the naturally occurring period of abstinence, and has the potential to consolidate and extend abstinence beyond pregnancy.

摘要少数种族和族裔以及妇女在吸烟相关疾病方面承受着不成比例的负担，包括癌症和心脏病母亲吸烟是导致母亲癌症死亡的主要原因，不良妊娠结局和婴儿发病率和死亡率增加。这进一步加剧了少数种族和族裔经历的不良生育结果。近一半的女性在怀孕前吸烟在怀孕期间实现禁欲。不幸的是，近80%的禁欲女性在分娩后一年内复发。尽管进行了大量研究，但有效对抗这一人群吸烟复吸的策略很少。这是尤其是少数民族妇女，她们不太可能接受治疗，更有可能重新吸烟比非西班牙裔白人产后更严重。吸烟者对与吸烟有关的线索表现出“注意力偏差”。注意偏向通过增加主观渴望和直接影响香烟，寻求行为。使用视觉探测任务的注意力再训练（AR）已被实验性地用于减少注意力偏差和迟钝的线索引发的渴望。压力和负面情绪被认为是复发的主要驱动因素，尤其是女性。AR在减轻与过渡压力相关的焦虑方面是有效的，例如女性所经历的焦虑。产后该试点项目的总体目标是测试一种新技术，即使用智能手机管理 AR，作为预防产后妇女吸烟复吸的干预措施。AR将针对吸烟提示和压力线索我们将评估AR是否能减少注意力偏差，减弱分娩后引起吸烟渴望的线索，减轻压力，减少吸烟失误。我们建议随机选择50名禁欲的怀孕的非洲裔美国人和/或西班牙裔吸烟者接受AR或对照视觉探测任务。参加者将被要求随身携带一个在怀孕的最后一个月，她们在日常生活中使用智能手机。智能手机将发出在白天随机提醒，此时参与者将被要求回答一组简短的问题，主观状态;随后将请求完成AR（或控制）程序。同样的程序将产后第一个月重复2周。结果测量包括对吸烟和压力的注意偏向刺激，自我报告的渴望和感知的压力，以及在吸烟期间吸烟的天数和数量审判本申请旨在确认研究的可行性和工艺参数，并获得初步的关于干预措施的功效和构成干预措施的组成部分的数据。如果AR显示出作为一种治疗，它将在一个更大的随机对照试验中进行测试。拟议的项目是一种新的干预措施，产后少数民族妇女，建立在自然发生的禁欲期，并有可能巩固并延长禁欲期至怀孕后。