Comparative Effectiveness of Web-based Mobile Support for the DC Tobacco Quitline

DC 烟草戒烟热线基于网络的移动支持的比较效果

• 批准号: 7838084
• 负责人: Thomas Robert Kirchner
• 金额: $ 49.79万
• 依托单位: TRUTH INITIATIVE FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7838084
• 关键词: Abstinence; Address; American; Area; Behavioral; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Client; Clinical; Clinical Practice Guideline; Communities; Community Outreach; Consensus; Counseling; Data Analyses; Development; Devices; District of Columbia; Documentation; Effectiveness; Evidence based treatment; Funding; Health; Health Psychology; Informatics; Low income; Memory; Methodology; Modality; Online Systems; Outcome; Participant; Pattern; Population; Positioning Attribute; Prevalence; Process; Professional counselor; Public Health; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Recommendation; Recovery; Relative (related person); Research; Research Infrastructure; Resources; Science; Services; Smoker; Smoking Cessation Intervention; Solid; Substance abuse problem; System; Technology; Testing; Time; Tobacco; Tobacco Use Cessation; United States National Institutes of Health; Work; base; comparative effectiveness; cost; design; disorder later incidence prevention; effectiveness research; falls; improved; innovation; meetings; nicotine replacement; outreach; programs; quitline; smoking prevalence; standard care; symposium; tobacco control; treatment as usual; treatment effect; web-enabled

DESCRIPTION (provided by applicant): The application, titled Comparative Effectiveness of Web-based Mobile Support for the DC Tobacco Quitline, addresses Broad Challenge Area (05) Comparative Effectiveness Research, and Specific Challenge Topic 05-DA- 102 Treatment of Substance Abuse and Related Health Consequences Using Web-Based Technologies. Many national consensus documents, including the 2007 National Institutes of Health (NIH) State-of-the-Science Conference and 2008 Clinical Practice Guideline, emphasize the enormous potential to maximize the reach, use, and population impact of smoking cessation interventions via tobacco quitlines. The national network of tobacco-cessation quitlines provides a population-level framework for dissemination, yet quitline effectiveness remains modest, producing only a small impact (reach x efficacy / cost) on smoking prevalence in the U.S. While their potential to improve cessation rates via community outreach is widely acknowledged, it is also true that tobacco quitlines are principally a time-limited counseling service, providing what amount to "booster" sessions as smokers attempt to initiate and maintain abstinence between a handful of calls. As they stand, quitlines are neither intended nor staffed to provide intensive, momentary support following the dozens of temptations and lapses that typically characterize a cessation attempt. The proposed project is an additive two-group randomized controlled trial to test whether the addition of a web-based mobile quitline enhancement (MQE) system improves abstinence rates at 1-, 3-, 6-, and 9-months relative to standard care provided by the Washington D.C. Quitline (DCQL) program. This MQE system is designed to fill the gaps between quitline calls with ready access to a menu of evidenced-based treatment components, while also providing DCQL counselors with detailed information about their clients' ongoing progress with cessation - two developments that constitute a major advance over standard quitline programming. Participants will be 700 smokers who contact the DCQL and are randomized to receive either standard DCQL programming (N=300) or DCQL plus MQE (N=400). Participants assigned to standard DCQL programming will receive 6 proactive counseling sessions and free nicotine replacement therapy (NRT). Participants assigned to DCQL plus MQE will also receive mobile access to the MQE system via a web-enabled cellular telephone provided by the study. Relative to usual care, we expect that MQE will improve outcomes by improving delivery, utilization and thereby effectiveness of DCQL programming. This project is well suited for American Recovery and Reinvestment Act (ARRA) funds because it represents an extraordinary opportunity to jump-start a collaborative effort that spearheads the use of web-enabled mobile devices to enhance the efficiency, fidelity, and impact of an established tobacco quitline program that benefits underserved communities in Washington D.C. To meet this challenge our transdisciplinary team brings expertise in tobacco control, behavioral informatics, data analysis, and clinical health psychology together with solid collaborative relationships across the DC Tobacco Consortium. As such, the project is positioned to take full advantage of DCQL infrastructure to conduct a randomized trial in an accelerated timeframe. The study is unconventional and innovative in the way it leverages web-based ecological assessment methodology to literally "close the loop" between research and practice. Bolstering the effectiveness of tobacco quitlines is a critical and timely endeavor, promising to expand the potential public health impact of this "broad reach" treatment modality. Many national consensus documents emphasize the enormous potential to maximize the reach, use, and population impact of smoking cessation interventions via tobacco quitlines. The population impact of quitlines remains small (reach x efficacy / cost), because while their potential for outreach is unrivaled, they are principally a time-limited counseling service, neither intended nor staffed to provide intensive, momentary support following the dozens of temptations and lapses that typically characterize a cessation attempt. The proposed project represents an extraordinary opportunity to spearhead the use of web-enabled mobile devices to directly supplement and thereby enhance the efficiency, fidelity, and impact of an established community-based tobacco quitline program that targets underserved communities in Washington D.C.; bolstering the effectiveness of tobacco quitlines via web-based mobile technologies is a critical and timely endeavor, promising to expand the potential public health impact of this "broad reach" treatment modality.

描述（由申请人提供）：该申请名为“基于Web的移动的支持对DC戒烟热线的比较有效性”，涉及广泛的挑战领域（05）比较有效性研究和特定挑战主题05-DA- 102使用基于Web的技术治疗药物滥用和相关健康后果。许多国家共识文件，包括2007年美国国立卫生研究院（NIH）的国家科学会议和2008年临床实践指南，强调了通过戒烟热线最大限度地扩大戒烟干预措施的覆盖面，使用和人口影响的巨大潜力。全国戒烟热线网络提供了一个人口一级的传播框架，但戒烟热线的效果仍然有限，只产生了很小的影响虽然通过社区外展提高戒烟率的潜力得到了广泛认可，但戒烟热线主要是一种有时间限制的咨询服务，提供相当于“助推器”的会议，因为吸烟者试图在少数电话之间开始并保持禁欲。就目前的情况而言，戒烟热线既不打算也不配备人员，在数十次诱惑和失误之后提供密集的、短暂的支持，而这些诱惑和失误通常是戒烟尝试的特征。拟议项目是一项附加的两组随机对照试验，旨在测试添加基于网络的移动的戒烟热线增强（MQE）系统相对于华盛顿特区戒烟热线（DCQL）计划提供的标准护理是否能提高1个月、3个月、6个月和9个月的戒烟率。该MQE系统旨在填补戒烟热线电话之间的空白，随时可以访问基于证据的治疗组件菜单，同时还为DCQL顾问提供有关其客户正在进行的戒烟进展的详细信息-这两项发展构成了标准戒烟热线编程的重大进步。参与者将是700名联系DCQL的吸烟者，并随机接受标准DCQL程控（N=300）或DCQL + MQE（N=400）。分配到标准DCQL编程的参与者将接受6次主动咨询会议和免费尼古丁替代疗法（NRT）。分配至DCQL + MQE的受试者还将通过研究提供的支持网络的蜂窝电话获得对MQE系统的移动的访问。相对于常规护理，我们预计MQE将通过改善DCQL编程的交付，利用率和有效性来改善结果。该项目非常适合美国复苏和再投资法案（ARRA）基金，因为它代表了一个非凡的机会，可以启动一项合作努力，率先使用支持网络的移动的设备，以提高效率，保真度和既定戒烟计划的影响，该计划使华盛顿特区服务不足的社区受益。行为信息学、数据分析和临床健康心理学，以及整个DC烟草联盟的坚实合作关系。因此，该项目的定位是充分利用DCQL基础设施，在加速的时间框架内进行随机试验。这项研究是非传统的和创新的方式，它利用基于网络的生态评估方法，从字面上“闭环”研究和实践之间。加强戒烟热线的有效性是一项关键而及时的奋进，有望扩大这种“广泛接触”治疗方式的潜在公共卫生影响。许多国家共识文件强调了通过戒烟热线最大限度地扩大戒烟干预措施的覆盖面、使用和人口影响的巨大潜力。戒烟热线对人群的影响仍然很小（达到x功效/成本），因为虽然它们的外展潜力是无与伦比的，但它们主要是一种有时间限制的咨询服务，既不打算也不配备人员在数十次诱惑和失误之后提供密集的，短暂的支持，这通常是戒烟尝试的特征。拟议的项目代表了一个非凡的机会，可以率先使用支持网络的移动的设备，直接补充并从而提高以社区为基础的戒烟计划的效率，保真度和影响力，该计划针对华盛顿特区服务不足的社区;通过基于网络的移动的技术提高戒烟热线的有效性是一项关键和及时的奋进，有望扩大这种“广泛接触”治疗方式的潜在公共卫生影响。