Development of an Integrated mHealth App-Based Intervention to Support Smoking Cessation in People Living with HIV

开发基于移动医疗应用程序的综合干预措施以支持艾滋病毒感染者戒烟

• 批准号: 10265170
• 负责人: Bettina B. Hoeppner
• 金额: $ 25.2万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10265170
• 关键词: Abstinence; Acquired Immunodeficiency Syndrome; Adherence; Biological; Caring; Client satisfaction; Clinical; Clinical Practice Guideline; Collaborations; Community Health; Complement; Computers; Consultations; Data; Development; Disease; Equilibrium; Feedback; Funding; General Population; HIV; HIV Seropositivity; Health Technology; Highly Active Antiretroviral Therapy; Internet; Intervention; Interview; Life; Life Style; Measures; Medical; Meta-Analysis; Mobile Health Application; National Cancer Institute; Outcome; Participant; Patient Self-Report; Persons; Population; Prevalence; Primary Health Care; Process; Psychology; Public Health; Randomized; Randomized Controlled Trials; Reporting; Research Design; Sampling; Scientist; Self Efficacy; Smiling; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Specific qualifier value; Structure; Study models; Technology; Testing; Text Messaging; Time; Training; Viral; Visit; Woman; Work; base; brief intervention; burden of illness; clinical care; design; experience; feasibility testing; flexibility; health goals; interest; mHealth; men; mortality; non-smoker; positive emotional state; primary care setting; programs; satisfaction; scale up; skills; smartphone Application; smoking cessation; smoking prevalence; social cognitive theory; software development; success; therapy development; treatment duration; user centered design; user-friendly

PROJECT SUMMARY / ABSTRACT The advent of highly active antiretroviral therapy (HAART) has greatly reduced mortality in persons living with HIV (PLWH), to the point where now lifestyle-related factors pose greater threat to long-term survival than HIV, chief among them smoking. Although interest in quitting smoking is high amongst PLWH, the prevalence of smoking among PLWH remains more than twice as high as that in the general population. Encouragingly, there have been successes in leveraging HIV primary care settings to engage PLWH smokers in smoking cessation efforts. Scaling up and expanding on this success has been difficult, however, as past evidence has indicated that interventions with more sessions produced stronger effects. High intensity face-to-face interventions are not readily scalable. Mobile health (mHealth) approaches, however, can provide continuous and as-needed support over longer periods of time, reducing the need for in-person treatment while providing prolonged support. To this end, and building on our previous work, we propose to develop an mHealth intervention that integrates (1) the “Smiling instead of Smoking” (SiS) app, a conceptually-grounded, iteratively developed smoking cessation smartphone app (M-PI Hoeppner), (2) a successful face-to- face smoking cessation treatment for SLH, called QUIT (M-PI O'Cleirigh), and (3) Life Steps, our efficacious brief intervention to promote adaptive engagement in HIV care. This integrated treatment will be informed and specified through the completion of the treatment development aims. We anticipate that it will combine initial face-to-face, SLH-focused treatment with SLH-adapted, real-time, temporally tailored smartphone app support over 8 weeks. Aim 1 is to build the integrated mHealth app intervention (SiS-H) based on feedback derived in user-centered design research with smokers living with HIV (SLH), consultation with HIV smoking cessation scientists and clinicians, and collaboration with our software development partner. Aim 2 is to conduct a proof-of-concept randomized controlled trial to test the feasibility, acceptability, and preliminary efficacy of SiS-H, while tracking HIV-specific outcomes. The app to be adapted is Version 3 of the SiS app, which is based on social cognitive theory, and implements clinical practice guidelines within a positive psychology framework. The proposed integrated treatment will emphasize protecting the experience of positive emotions among SLH as they navigate quitting smoking, and support increased self-efficacy through the complementing skills-based training of the QUIT and Life Steps components. The proposed project advances the critically important public health goal of making smoking cessation support more readily available to PLWH smokers. More pragmatically, data from this project could inform the design of a larger R01-funded RCT and the necessary regulatory strategy to advance towards approval of SiS-H as a prescription treatment that could well be sustainable in HIV primary care and other community health clinical settings.

项目摘要 /摘要 高度活跃的抗逆转录病毒疗法（HAART）的冒险经历大大降低 艾滋病毒（PLWH），以至于现在与生活方式相关的因素对长期生存构成比艾滋病毒更大的威胁 他们中的主要吸烟。虽然在静静的吸烟中很有趣，但普遍存在 PLWH之间的吸烟仍然是普通人群的两倍以上。令人鼓舞的是， 已经成功利用艾滋病毒初级保健环境让PLWH吸烟者吸烟 停止工作。但是，由于过去的证据已经有了扩大和扩展，因此很难 表明更多会议的干预措施产生了更强的影响。高强度面对面 干预措施不容易扩展。但是，移动健康（MHealth）方法可以提供连续的 并需要在更长的时间内支持，从而减少了对面对面治疗的需求 长期支持。为此，我们在以前的工作中建立了基础，我们建议开发MHealth 整合（1）“微笑而不是吸烟”（SIS）应用程序的干预措施，这是一个概念上的， 迭代开发的戒烟智能手机应用程序（M-PI Hoeppner），（2）成功面对面 面对SLH的戒烟治疗，称为戒烟（M-Pi O'Clairigh），以及（3）生命步骤，我们 简单的简短干预措施以促进适应性参与艾滋病毒护理。这种综合治疗将 通过完成治疗开发的目的来了解和指定。我们预计会 将初始面对面的，以SLH为中心的治疗与SLH适应的实时，临时量身定制 智能手机应用程序支持8周。目标1是建立集成的MHealth应用程序干预（SIS-H） 基于以用户为中心的设计研究得出的反馈，与艾滋病毒（SLH）的吸烟者（SLH）咨询 与艾滋病毒戒烟科学家和临床医生一起，并与我们的软件开发伙伴合作。 目标2是进行概念验证随机对照试验，以测试可行性，可接受性和 SIS-H的初步效率，同时跟踪HIV特异性结果。要改编的应用程序是 基于社会认知理论的SIS应用程序，并将临床实践指南实现 心理学框架。拟议的综合治疗将强调保护 SLH在吸烟中引起积极情绪，并通过 基于技能的戒烟和生命步骤组件的补充培训。拟议的项目 促进使吸烟支持更容易获得的至关重要的公共卫生目标 吸烟者。更务实地，该项目的数据可以为较大的R01资助的设计提供信息 RCT和促进SIS-H批准作为处方处理的必要监管策略 这在HIV初级保健和其他社区健康临床环境中很可能是可持续的。