ADRD Prevention Messaging to Increase Smoking Cessation Attempts in Older Adult Smokers

项目总结/文摘

PROJECT SUMMARY/ABSTRACT This career development proposal resubmission is designed to provide Adrienne Johnson, PhD, the training necessary to become an independent investigator in the fields of tobacco dependence, Alzheimer’s disease and related dementias (ADRD), and dissemination and implementation (D&I) science. Dr. Johnson is trained as a clinical psychologist and has substantial experience with patient-oriented research in comorbid medical and psychiatric populations and expertise in smoking cessation within these populations. An expert mentoring team will guide her in achieving four training objectives: (1) develop a comprehensive understanding of ADRD etiological factors, prevention literature, and treatment approaches; (2) develop expertise in D&I science and its application to intervention development and testing; (3) develop expertise in public health marketing and motivational messaging; and (4) obtain training in larger scale clinical trial methodology. This training, consisting of formal coursework, guided mentoring, an apprenticeship, and participation in national scientific conferences, will allow Dr. Johnson to develop and test an intervention designed to help motivate older smokers quitting smoking. Older adult smokers are at elevated risk for cognitive decline and ADRD development and, unless they can successfully quit smoking, their prevalence will continue to rise. Unfortunately, older smokers are half as likely to attempt to quit smoking and less likely to receive evidence-based smoking treatments (EBSTs) compared to younger adults. Lower cessation efforts in older smokers may be a function of both clinician inaction and dysfunctional beliefs/motivational deficits of older smokers. The proposed work will develop and test a readily translatable Stage 1 motivational intervention for smoking cessation in older adults consisting of: (1) a novel patient-informed motivational message promoting smoking cessation, and (2) clear access routes to EBSTs within a healthcare setting. The proposed research will use three interrelated aims, occurring consecutively and building off of findings from the previous aim, to achieve this objective. Aim 1 will identify the most promising message content in terms of smoking cessation motivation and efficacy of and access to EBSTs in a healthcare setting. Aim 2 will evaluate promising motivational intervention packages using survey methodology. Finally, Aim 3 will examine the feasibility and preliminary effectiveness of a novel comprehensive motivational intervention to increase motivation to quit, quit attempts, and use of EBSTs for older adult smokers in a real-world clinical setting. Dr. Johnson will apply a widely used model of health behavior change (Health Belief Model) to guide treatment development and use a well validated D&I science framework (RE-AIM) to ensure she is building for translation. Results will inform a future R01 application aimed at implementing and evaluating this intervention in a broader context and examining the relation between smoking cessation and brain health.