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危险因素。除了需要新的药物治疗外，迫切需要额外的和互补的行为策略来减少吸烟率。互联网和相关信息技术正日益提供前所未有的、强有力的、基于科学的行为干预手段。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，其中应急改变适用于吸烟者个人。尽管该系统在两项随机对照研究中产生了很高的初始戒断率，但一些吸烟者在退出基于代金券的突发事件后没有戒烟或复发。鉴于这些发现，有必要制定一项战略，以提高初期效果，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潜在强大补充：基于互联网的群体应急管理。具体来说，改变的附带条件将适用于吸烟者群体，而不是个人，其中一组中的所有吸烟者必须达到规定的目标，才能在初始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讨论论坛提供社会支持和指导。我们试用了这个方法，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，社会因素可能是促进和维持戒烟的关键因素。在不增加治疗费用的情况下，团体模式可以比财政激励维持更长时间。在主要治疗阶段后，我们将评估维持社会支持和戒烟三个月的情况，该阶段将提供财政奖励和团体支持。群体权变模型将利用对行为改变的两种强大影响来源，即经济激励和社会支持，它应该导致一种负担得起的、实用的、可持续的策略来促进戒烟。总的来说，目前的研究将产生一个丰富的数据集，关于促进戒烟的群体突发事件的承诺。

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.