Internet-based Group Contingency Management to Promote Smoking Abstinence

描述(由申请人提供)：基于互联网的团体应急管理促进戒烟项目摘要/摘要吸烟是发达国家发病率和死亡率的最大可预防风险因素。除了需要新的药物疗法外，还迫切需要额外的和补充的行为策略来降低吸烟率。互联网和相关信息技术越来越多地提供了前所未有的途径，可以获得强大的、基于科学的行为干预。我们开发并测试了一种创新的基于互联网的应急管理干预措施，以促进戒烟，其中应对变化的应急措施适用于个人吸烟者。尽管该系统在两项随机对照研究中产生了较高的初始戒烟率，但一些吸烟者在退出基于凭单的意外情况后并未戒烟或复发。鉴于这些发现，有必要制定一项战略，以加强最初的效果并维持长期禁欲。在拟议的项目中，我们将开发和评估现有治疗模式的一个潜在的强大补充：基于互联网的群体应急管理。具体而言，变化应急将适用于吸烟者群体--而不是个人--其中一个群体中的所有吸烟者必须达到特定目标，才能在最初的治疗期间获得部分或全部代金券。小组成员可以通过主持的论坛提供社会支持和指导。我们试行了这种方法，一小群吸烟者发现这个论坛非常有价值和有效。事实上，越来越多的文献表明，社会因素可能在促进和维持戒烟方面起着关键作用。在不增加治疗成本的情况下，团体模式可以保持比经济激励长得多的时间。我们将在主要治疗阶段之后的三个月内评估维持社会支持和戒烟的情况，在这一阶段将提供财政奖励和团体支持。团体应急模式将利用两个强大的影响行为改变的来源，经济激励和社会支持，它应该导致一个负担得起的、实用的和可持续的战略，以促进戒烟。总体而言，本研究将产生一个丰富的数据集，关于团体意外情况下促进戒烟的承诺。 与公共健康相关：拟议的治疗方法将把互联网的覆盖范围和便利性与最先进的、经验性的吸烟行为治疗方法结合起来。我们将研究一种群体应急治疗模式，该模式将利用两个强大的影响行为改变的来源-经济激励和社会支持，它应该导致一个负担得起的、实用的和可持续的促进戒烟的战略。因此，促进戒烟的团体应急行动有望成为降低与吸烟相关的高发病率和死亡率的一种方式。

DESCRIPTION (provided by applicant): Internet-based group contingency management to promote smoking abstinence Project Summary/Abstract Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries. In addition to the need for novel pharmacotherapies, there is an urgent need for additional and complementary behavioral strategies to reduce smoking prevalence. Increasingly, the Internet and related information technologies are providing unprecedented access to powerful, science-based behavioral interventions. We developed and tested an innovative Internet-based contingency management intervention to promote smoking cessation, where contingencies for change were applied to individual smokers. Although the system generated high rates of initial abstinence in two randomized, controlled studies, some smokers did not quit or relapsed following withdrawal of the voucher-based contingencies. Given these findings, it is necessary to develop a strategy to enhance initial effects and to sustain long-term abstinence. In the proposed project, we will develop and evaluate a potentially powerful addition to our existing treatment model: Internet-based group contingency management. Specifically, contingencies for change will be applied to groups of smokers - instead of individuals - where all smokers in a group must meet specified goals to receive either some or all of their vouchers during an initial treatment period. Group members can offer social support and guidance through a moderated discussion forum. We piloted the method, and a small group of smokers found the discussion forum to be highly valuable and effective. Indeed, a growing literature suggests that social factors may be critical in promoting and maintaining smoking cessation. The group model can be maintained much longer than financial incentives without an increase in treatment costs. We will evaluate maintenance of social support and cessation for three months following a main treatment phase where both financial incentives and group support will be available. A group contingency model would harness two powerful sources of influence over behavior change, financial incentives and social support, and it should lead to an affordable, practical, and sustainable strategy to promote cessation. Overall, the present study will yield a rich dataset on the promise of group contingencies to promote smoking cessation. PUBLIC HEALTH RELEVANCE: The proposed treatment will integrate the reach and convenience of the internet with a state-of-the-art, empirically-derived behavioral treatment for cigarette smoking. We will examine a group contingency treatment model, which will harness two powerful sources of influence over behavior change, financial incentives and social support, and it should lead to an affordable, practical, and sustainable strategy to promote cessation. As such, group contingencies to promote smoking cessation hold significant promise as a way to reduce the high rates of morbidity and mortality associated with smoking.