Preventing Postpartum Smoking Relapse: A C-SHIP Based Text Messaging Intervention

预防产后吸烟复吸：基于 C-SHIP 的短信干预

• 批准号: 7943051
• 负责人: Suzanne M Miller
• 金额: $ 48.1万
• 依托单位: FOX CHASE CANCER CENTER
• 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 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7943051
• 关键词: Abstinence; Address; Adherence; Adult; Area; Behavioral; Belief; Biological Factors; Businesses; Car Phone; Caring; Categories; Cessation of life; Child; Clinic; Clinical; Cognitive; Collection; Communities; Computer software; Counseling; Country; Data Storage and Retrieval; Dimensions; Distress; Dose; Effectiveness; Employment; Employment Opportunities; Equilibrium; Evaluation; Face; Family; Fetal Mortality Statistics; Focus Groups; Friends; Health; Health Communication; Healthcare; Individual; Infant; Institution; Instruction; Intervention; Knowledge; Low Income Population; Low income; Measures; Minority; Minority Groups; Modeling; Motivation; Needs Assessment; Nicotine Withdrawal; Parents; Participant; Population; Postpartum Period; Pregnancy; Preventive Intervention; Process; Public Health; Questionnaires; Recruitment Activity; Relapse; Reporting; Research Infrastructure; Review Literature; Risk; Risk Factors; Schedule; Self Efficacy; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Status; Social support; Societies; Stimulus; System; Target Populations; Technology; Telephone; Testing; Text; Time; Transportation; Underrepresented Minority; Underserved Population; Woman; Women' s Health; base; community based participatory research; cost; craving; design; disorder later incidence prevention; distraction; evidence base; experience; health information technology; improved; information processing; innovation; meetings; motherhood; new technology; prenatal; prevent; psychologic; psychosocial; risk perception; satisfaction; skills; smoking cessation; smoking intervention; smoking relapse; social; stressor; theories; therapy design; therapy development; transmission process; uptake; young adult

DESCRIPTION (provided by applicant): This application addresses Challenge Area (06): Enabling Technologies, and specific Challenge Topic, 06-OD (OBSSR)-101*, Using new technologies to improve or measure adherence, and is entitled "Preventing postpartum smoking relapse: A C-SHIP based Text Messaging intervention." In this country, an estimated 40% of women who smoke quit during their pregnancy. However, up to 80% of these women relapse in the postpartum period, despite the health risks for themselves and their children. Relapse prevention in the postpartum period offers a unique opportunity to capitalize on a positive behavioral change (cessation during pregnancy) to protect the health of women and their families over the long-term. Yet, the design of effective smoking interventions for postpartum relapse prevention is challenging, due in large part to the competing needs and stressors in this population, especially among low income women. New, innovative intervention delivery models are needed to provide three key components: high levels of social support for ongoing behavioral change, while simultaneously addressing the new psychological and practical demands associated with young babies. Text Messaging (TM) via mobile telephone is a health information technology with demonstrated effectiveness as an intervention channel in many health contexts and holds considerable promise in the area of postpartum relapse prevention, where it has yet to be applied. Therefore, this study will develop and pilot-test an evidence-based, cognitive-behavioral TM intervention designed to reduce postpartum smoking relapse among low-income minority women who have quit immediately before or during their pregnancies. Guided by the Cognitive-Social Health Information Processing (C-SHIP) framework, as well as by health communication best practices, the messages to be included in the TM intervention will be developed through a formative evaluation and community-based participatory research process that includes literature review and needs assessment followed by an iterative cycling through message drafting, review by target community focus groups and a scientific advisory panel, and message revision. The actual messages will also be user-tested prior to being pilot-tested, as will the text messaging system and the specially equipped mobile phones to be employed in intervention delivery. Once the intervention is developed, it will be pilot-tested to determine its feasibility through delivery over a 1 month timeframe with 100 racially and ethnically diverse, low income women recruited through local clinics of the national network of Women, Infants, and Children's Clinics (WIC). The intervention will consist of four components: a) system-initiated text messages: text messages sent on a scheduled basis that target C-SHIP-based postpartum relapse factors (i.e., messages designed to have the following effects: increase knowledge/perceived risk regarding the harmful effects of smoking on infants, children, and adults; impact decisional balance (increase the pros and decrease the cons of continued abstinence); reduce the distress of new motherhood; influence beliefs (increase self-efficacy for remaining quit and decrease fatalism); and promote the utilization of self-regulatory strategies and social support; b) TXT crave messages: participant-initiated use of a "TXT crave" function on the mobile phone to request receipt of a C-SHIP-based text message that provides support and distraction when an urge or craving to smoke is experienced; c) TXT lapse messages: participant-initiated use of a "TXT lapse" function on the mobile phone to request receipt of a C-SHIP-based text message that provides information, motivation, and support to help the participant resume cessation; d) free texting and calling with friends and family to increase relapse prevention- specific support: participants will be encouraged (through text messages and participant instructions) to call and text family and friends to receive social support for their efforts to remain abstinent. The following dimensions of feasibility will be assessed: a) completion (receipt and opening) of system- initiated text messages; b) transmission of participant-initiated TXT Crave and TXT lapse messages; c) participant satisfaction with the intervention as assessed through use of a verbally administered questionnaire. As a secondary aim, the study will also examine, on an exploratory basis, impact of the intervention's on C- SHIP-based postpartum relapse risk factors and the association of these factors with smoking status. This examination will be implemented through an assessment of participants on the risk factors and smoking status at baseline, one month, and three months. The TM relapse prevention intervention has the potential to serve as a breakthrough approach to preventing postpartum relapse among low-income, ethnically diverse women, given its potential for around-the- clock delivery; customizability for the target population; low-cost, time-efficient implementation; low participant burden; easily controlled dosing at high or variable levels; targeted and tailored application; and ease of dissemination into the current healthcare infrastructure. In terms of stimulus impact, this study will provide for continued employment of several individuals at the applicants' institution, generate revenue for both a small and a large business, and enhance employment opportunities for the low income focus group and advisory panel community participants who will build skills through their participation in intervention development. H Smoking, the leading cause of preventable death in the U.S., is one of the most pressing public health issues that we face as a society, particularly among those who are from lower income minority communities. The proposed study is designed to develop and pilot test a technologically innovative and theory-based intervention to reduce postpartum smoking relapse among minority and underserved women in order to improve both their health and the health of their children. The intervention has the potential for wide-scale dissemination into the current care infrastructure, as it is evidence-based, highly transportable, and low-cost.

描述（由申请人提供）：本申请涉及挑战领域 (06)：支持技术和具体挑战主题 06-OD (OBSSR)-101*，使用新技术改善或衡量依从性，标题为“预防产后吸烟复发：基于 C-SHIP 的短信干预”。在这个国家，估计有 40% 的吸烟女性在怀孕期间戒烟。然而，高达 80% 的女性在产后复发，尽管这会给她们自己和孩子带来健康风险。产后的复发预防提供了一个独特的机会，可以利用积极的行为改变（怀孕期间戒烟）来长期保护妇女及其家人的健康。然而，设计有效的预防产后复吸的吸烟干预措施具有挑战性，这在很大程度上是由于该人群（尤其是低收入女性）的相互竞争的需求和压力因素。需要新的、创新的干预实施模式来提供三个关键组成部分：为持续的行为改变提供高水平的社会支持，同时满足与幼儿相关的新的心理和实际需求。通过移动电话进行的短信 (TM) 是一种健康信息技术，在许多健康环境中作为干预渠道已被证明是有效的，并且在产后复发预防领域具有相当大的前景，但该领域尚未得到应用。因此，本研究将开发并试点测试一种基于证据的认知行为 TM 干预措施，旨在减少在怀孕前或怀孕期间戒烟的低收入少数族裔妇女的产后复吸。在认知社会健康信息处理（C-SHIP）框架以及健康传播最佳实践的指导下，TM干预中包含的信息将通过形成性评估和基于社区的参与性研究过程来制定，其中包括文献综述和需求评估，然后通过信息起草、目标社区焦点小组和科学咨询小组的审查以及信息修订进行迭代循环。实际消息也将在进行试点测试之前进行用户测试，短信系统和用于干预交付的专门配备的移动电话也将进行用户测试。一旦制定出干预措施，将通过全国妇女、婴儿和儿童诊所网络 (WIC) 的当地诊所招募 100 名不同种族和民族的低收入妇女，在 1 个月的时间内进行试点测试，以确定其可行性。干预措施将由四个部分组成：a) 系统发起的短信：针对基于 C-SHIP 的产后复发因素定期发送的短信（即，旨在产生以下效果的消息：增加关于吸烟对婴儿、儿童和成人有害影响的知识/感知风险；影响决策平衡（增加继续戒烟的利弊）；减少新妈妈的痛苦；影响信念（增加吸烟对婴儿、儿童和成人的有害影响） 保持戒烟和减少宿命论的自我效能）；促进利用自律策略和社会支持； b) TXT 渴望信息：参与者发起使用手机上的“TXT 渴望”功能来请求接收基于 C-SHIP 的短信，该短信在出现吸烟的冲动或渴望时提供支持和分散注意力； c) TXT 失效消息：参与者发起使用手机上的“TXT 失效”功能，请求接收基于 C-SHIP 的短信，该短信提供信息、动机和支持，以帮助参与者恢复戒烟； d) 与朋友和家人免费发短信和打电话，以增加预防复发的具体支持：将鼓励参与者（通过短信和参与者指示）给家人和朋友打电话和发短信，以获得社会支持，以支持他们保持戒酒的努力。将评估以下方面的可行性： a) 系统发起的短信的完成（接收和打开）； b) 传输参与者发起的 TXT Crave 和 TXT lapse 消息； c) 通过使用口头问卷评估参与者对干预措施的满意度。作为次要目标，该研究还将在探索性的基础上检查干预措施对基于 C-SHIP 的产后复发危险因素的影响以及这些因素与吸烟状况的关联。这项检查将通过评估参与者在基线、一个月和三个月的危险因素和吸烟状况来实施。鉴于 TM 复发预防干预措施有可能成为低收入、多种族女性预防产后复发的突破性方法，因为它具有全天候分娩的潜力；针对目标人群的可定制性；实施成本低、时间高效；参与者负担低；易于控制高水平或可变水平的剂量；有针对性和量身定制的应用；并易于传播到当前的医疗基础设施中。就刺激影响而言，这项研究将为申请人所在机构的多名人员提供持续就业机会，为小型和大型企业创造收入，并增加低收入焦点小组和咨询小组社区参与者的就业机会，他们将通过参与干预措施的发展来培养技能。 H 吸烟是美国可预防死亡的主要原因，也是我们社会面临的最紧迫的公共卫生问题之一，特别是对于来自低收入少数族裔社区的人来说。拟议的研究旨在开发和试点测试一种技术创新和基于理论的干预措施，以减少少数族裔和服务不足的妇女产后吸烟复吸，从而改善她们及其子女的健康。该干预措施具有在当前护理基础设施中广泛传播的潜力，因为它是基于证据的、高度可移植的且成本低廉。

项目成果

Introduction to special series: The great debate--evaluating the health implications of positive psychology.

特别系列简介：大辩论——评估积极心理学对健康的影响。

• DOI: 10.1007/s12160-010-9173-9
• 发表时间: 2010
• 期刊: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
• 作者: Miller,SuzanneM;Sherman,AllenC;Christensen,AlanJ
• 通讯作者: Christensen,AlanJ

A content analysis of self-reported barriers and facilitators to preventing postpartum smoking relapse among a sample of current and former smokers in an underserved population.

对服务不足人群中当前和以前吸烟者样本中自我报告的预防产后吸烟复吸的障碍和促进因素进行内容分析。

• DOI: 10.1093/her/cyu048
• 发表时间: 2015
• 期刊: Health education research
• 影响因子: 2.4
• 作者: Wen,Kuang-Yi;Miller,SuzanneM;Roussi,Pagona;Belton,TanishaD;Baman,Jayson;Kilby,Linda;Hernandez,Enrique
• 通讯作者: Hernandez,Enrique