Mindfulness-based ecological momentary intervention for smoking cessation among cancer survivors

基于正念的生态瞬时干预对癌症幸存者戒烟的影响

• 批准号: 10590358
• 负责人: Min-Jeong Yang
• 金额: $ 11.88万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10590358
• 关键词: Acceptance Process; Acute; Address; Affect; Affective; Attention; Awareness; Benchmarking; Breathing; Cancer Center; Cancer Prevention Intervention; Cancer Survivor; Cancer Survivorship; Cellular Phone; Chronic; Client satisfaction; Clinical; Clinical Trials; Cognitive; Data; Development; Distress; Ecological momentary assessment; Effectiveness; Elements; Fatigue; Feasibility Studies; Feedback; Fright; Future; General Population; Goals; Guilt; Health; Hour; Individual; Intervention; Interview; Knowledge; Link; Literature; Malignant Neoplasms; Measures; Meditation; Methodology; Mission; Nature; Outcome; Pain; Participant; Patient Self-Report; Patients; Perception; Persons; Phase; Population; Preparation; Procedures; Process; Psychometrics; Qualitative Methods; Quality of life; Randomized; Randomized, Controlled Trials; Recording of previous events; Recurrent Malignant Neoplasm; Relapse; Risk; Risk Factors; Role; Second Primary Cancers; Self-Examination; Shame; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Stress; Structure; Survivors; Testing; Therapeutic; Time; Tobacco; Tobacco Use Cessation; Tobacco use; Training; Treatment Cost; Work; acceptability and feasibility; anticancer research; arm; barrier to care; cancer diagnosis; cancer recurrence; cancer therapy; career; cost effective intervention; craving; efficacy testing; experience; feasibility testing; follow-up; handheld mobile device; improved; innovation; mHealth; mindfulness; mindfulness intervention; mortality; negative affect; novel; patient-level barriers; portability; primary outcome; prototype; relapse risk; satisfaction; secondary analysis; smartphone application; smoking abstinence; smoking cessation; smoking prevalence; smoking relapse; sound; standard care; temporal measurement; tobacco abstinence

PROJECT SUMMARY/ABSTRACT Continued tobacco use among cancer survivors is linked to an increased risk of lowered effectiveness of cancer treatment, greater cancer-related mortality, developing a secondary primary cancer, worse quality of life, and increased cancer treatment costs ($3.4 billion/year). Despite high quit rates at cancer diagnosis, more than half of survivors who quit resume smoking shortly thereafter. Mindfulness-based interventions (MBIs) hold great promise in enhancing smoking abstinence among cancer survivors given its emphasis on purposefully paying attention to immediate experience, thereby reducing reactivity to smoking triggers. The current proposal addresses significant gaps in the extant smoking cessation literature for cancer survivors, which include: (1) A limited understanding of the role of dynamic relations between cancer-specific (e.g., fatigue, pain, fear of cancer recurrence) and general smoking risk factors (e.g., negative affect) contributing to smoking relapse given the known chronic high stress level among cancer survivors, (2) Lack of real-time cessation interventions using portable mobile devices such as smartphones (i.e., mobile health [mHealth]), (3) Little attention given to cancer- specific cessation barriers for cancer survivors (e.g., shame, guilt) and (4) Barriers to treatment accessibility among existing MBIs due to the time-intensiveness and in-person format. To address these gaps, the objective of this proposal is to develop a mindfulness-based ecological momentary intervention (mindEMI) that delivers MBI content in real-time and in the real world where quitting smoking takes place, and, when an elevated level Dr. Yang’s long-term career goal is to develop and evaluate accessible and scalable mHealth smoking cessation interventions for cancer prevention with expertise in real-time measurement of cognitive-affective constructs. As such, training goals address tobacco use and cancer survivorship, mHealth and clinical trials methodology, quantitative and qualitative methods, clinical delivery of MBIs, and professional development. of cancer-specific smoking relapse risk is indicated through ecological momentary assessment (EMA). There are three specific aims. The K99 phase will take place at the Moffitt Cancer Center. The aims during the K99 phase include: (1) To identify the most psychometrically sound EMA items for measuring negative affect, positive affect, and state mindfulness and (2) to develop a mindEMI targeting cancer-specific smoking vulnerabilities through an iterative multi-step process among cancer survivors who smoke. The R00 phase aims to conduct a 2-arm pilot randomized controlled trial (RCT) among cancer survivors to test the feasibility and acceptability of the mindEMI for smoking cessation. Feasibility of RCT procedures in preparation for a larger subsequent study will also be examined. This proposal is highly innovative because the mindEMI will address a crucial gap in the literature by targeting cancer-specific smoking vulnerabilities and deliver an MBI in real-time when relapse risk is high for cancer survivors. This work will inform a future trial to fully test the efficacy of mindEMI and directly addresses the NCI’s mission to conduct and support cancer research to promote longer and healthier lives.

项目总结/摘要 癌症幸存者继续吸烟与癌症有效性降低的风险增加有关 治疗，癌症相关死亡率更高，发生继发性原发性癌症，生活质量更差， 癌症治疗费用增加（34亿美元/年）。尽管癌症诊断的戒烟率很高，但超过一半的人 戒烟的幸存者在戒烟后不久又开始吸烟。基于正念的干预（MBIs） 承诺加强癌症幸存者的戒烟，因为它强调有目的地支付 注意即时体验，从而减少对吸烟触发器的反应。现时的建议 解决了现存的癌症幸存者戒烟文献中的重大空白，其中包括：（1）A 对癌症特异性（例如，疲劳、疼痛、对癌症的恐惧 复发）和一般吸烟风险因素（例如，消极影响）导致吸烟复吸， 癌症幸存者中已知的慢性高压力水平，（2）缺乏实时戒烟干预， 诸如智能电话的便携式移动的设备（即，移动的健康[mHealth]），（3）很少关注癌症- 癌症幸存者的特定戒烟障碍（例如，羞耻、内疚）和（4）治疗可及性的障碍 由于时间密集性和面对面的形式，现有的MBIs之间存在差异。为了弥补这些差距，目标 该建议的一个重要目的是开发一种基于正念的生态瞬时干预（mindEMI）， MBI含量在实时和真实的世界戒烟发生时， 博士 Yang的长期职业目标是开发和评估可访问和可扩展的mHealth戒烟 癌症预防干预与认知情感结构的实时测量专业知识。作为 例如，培训目标涉及烟草使用和癌症存活率、移动健康和临床试验方法， 定量和定性方法，MBIs的临床交付，以及专业发展。 癌症特异性吸烟复发的风险是通过生态瞬时评估（EMA）。 有三 具体目标。K99阶段将在Moffitt癌症中心进行。K99阶段的目标包括： (1)确定最心理测量学上健全的EMA项目，用于测量消极影响，积极影响， 状态正念和（2）制定一个针对癌症特定的吸烟弱点的正念EMI，通过一个 在吸烟的癌症幸存者中的迭代多步骤过程。R 00阶段旨在进行双臂试验 在癌症幸存者中进行随机对照试验（RCT），以测试心理EMI的可行性和可接受性 为了戒烟。RCT程序在准备更大规模的后续研究中的可行性也将被评估。 考察这一建议是高度创新的，因为mindEMI将解决文献中的一个关键空白， 针对癌症特定的吸烟弱点，并在复发风险高时实时提供MBI， 癌症幸存者这项工作将为未来的试验提供信息，以充分测试mindEMI的功效，并直接解决 NCI的使命是进行和支持癌症研究，以促进更长和更健康的生活。