Promoting Tobacco and Cancer Control: Message Framing for Telephone Quitline Call

描述(由申请人提供)：大量证据表明，电话戒烟咨询比不那么强烈的干预更有效。此外，展望理论认为，由于戒烟是一种具有相当确定结果的预防行为(即戒烟显然与预防健康问题有关)，与潜在的损失相反，以潜在收益(即收益)为框架的信息在激励戒烟方面应该更有说服力。事实上，来自之前四项研究的试点数据表明，以收益为框架的信息在鼓励戒烟方面更有效。因此，在专注于优化癌症预防信息的十年研究的基础上，我们打算比较纽约州吸烟者的Quitline咨询和打印信息，这些信息要么完全是获得框架的(例如，如果你戒烟，你会活得更长)，要么是标准护理，后者同时包含获得框架和损失框架的元素(例如，如果你继续吸烟，你会更早死亡)。因为这项研究将比较两种不同类型的咨询，没有来电的人会被拒绝服务，消除了研究放弃电话的一个重要障碍。这项研究将分为两个阶段。在第一阶段，将进行一项预试研究，以：1)制定增益框架咨询方案和印刷材料，以及2)培训Quitline专家，使那些处于专门收益框架条件下的专家主要提供增益框架信息。在第二阶段，将对2500名Quitline呼叫者进行随机试点临床试验，比较唯一的增益框架咨询+增益框架印刷材料(GF条件)和标准护理Quitline咨询+标准印刷材料(SC条件)。这项试验的疗效数据将被用来确定1周和3个月自我报告的点流行率戒断率的效果大小估计。大约60%的来电者将接受短期尼古丁替代疗法。信息框架效应的中介者也将被考察。我们希望，这项研究的结果将使我们能够开发有效的咨询和打印材料，可以用于大规模的R01研究拨款，以资助一项研究，测试增益框架咨询的有效性，并向多个州的戒烟电话的呼叫者打印戒烟材料。如果在一项大规模研究中证明信息框架可以改善治疗结果，那么戒烟热线咨询师的信息框架干预措施可以被翻译成供整个纽约州戒烟热线和全国其他戒烟热线使用。这将为提高中等强度戒烟干预的有效性提供一种具有成本效益的方法，该干预措施有可能惠及数百万吸烟者，从而加强美国各地的烟草和癌症控制努力。研究改善吸烟者电话戒烟咨询的方法可能会通过提高打电话戒烟者的戒烟率来改善烟草控制干预。由于戒烟电话每年有可能接触到数百万吸烟者，更好的干预措施可以极大地影响美国的烟草和癌症控制努力。

DESCRIPTION (provided by applicant): A substantial body of evidence shows that telephone counseling for smoking cessation is more effective than less intense interventions. Moreover, Prospect Theory suggests that because smoking cessation is a prevention behavior with a fairly certain outcome (i.e., quitting is clearly linked to preventing health problems), messages framed in terms of potential gains (i.e., benefits), in contrast to potential losses, should be more persuasive in motivating smoking cessation. Indeed, pilot data from four previous studies shows that gain-framed messages are more effective in encouraging smoking cessation. Thus, building on a decade of research focused on optimizing messages for cancer prevention, we intend to compare New York State Smokers' Quitline counseling and print messages that are either exclusively gain-framed (e.g., you will live longer if you quit smoking) to standard care, which has elements of both gain-framed and loss-framed (e.g., you will die sooner if you continue to smoke) messages. Because this study will compare 2 different types of counseling, no callers to the quitline will be refused services, removing an important barrier to research on quitlines. This study will have two phases. In Phase I, a Pre-Pilot Study will be conducted to: 1) develop the gain-framed counseling protocol and print materials, and 2) train Quitline Specialists such that those in the exclusively gain-framed condition provide primarily gain-framed messages. In Phase II, a randomized pilot clinical trial will be conducted with 2,500 Quitline callers to compare exclusively gain-framed counseling + gain-framed print materials (GF condition) to standard care Quitline counseling + standard print materials (SC condition). Efficacy data from this trial will be used to determine effect size estimates for both 1-week and 3-month self- reported point prevalence abstinence rates. Approximately 60% of callers will receive short-term nicotine replacement therapy. Mediators of message framing effects will also be examined. It is our hope that findings from this study will allow us to develop effective counseling and print materials that can be used for a large- scale, R01 research grant to fund a study testing the effectiveness of gain-framed counseling and print materials for smoking cessation amongst callers to multiple state quitlines. If message framing is shown to enhance treatment outcome in a large-scale study, message framing interventions with quitline counselors could be translated for use by the entire NY state quitline and other quitlines across the country. This would provide a cost-effective method for increasing the effectiveness of a moderate intensity intervention for smoking cessation that has the potential to reach millions of smokers, thereby bolstering tobacco and cancer control efforts across the United States. Studying ways to improve telephone quitline counseling for smokers may improve tobacco control interventions by enhancing quit rates of callers to quitlines. As telephone quitlines have the potential to reach millions of smokers annually, better interventions can greatly impact tobacco and cancer control efforts in the United States.