Internet-based Group Contingency Management to Promote Smoking Abstinence

描述（由申请人提供）：基于互联网的群体应急管理，以促进戒烟项目摘要/摘要吸烟是最大的可预防的危险因素的发病率和死亡率在发达国家。除了需要新的药物治疗外，还迫切需要额外和补充的行为策略来降低吸烟率。互联网和相关的信息技术正越来越多地提供前所未有的途径，以获得强大的、以科学为基础的行为干预。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，其中改变的应急措施适用于个人吸烟者。虽然该系统在两项随机对照研究中产生了较高的初始戒烟率，但一些吸烟者在撤回基于代金券的应急措施后没有戒烟或复发。鉴于这些发现，有必要制定一项战略，以加强初步效果和维持长期禁欲。在拟议的项目中，我们将开发和评估一个潜在的强大的除了我们现有的治疗模式：基于互联网的群体应急管理。具体而言，改变的应急措施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的目标，才能在最初的治疗期间获得部分或全部代金券。小组成员可以通过一个有主持人的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讨论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。小组模式可以维持比财政奖励更长的时间，而不会增加治疗费用。我们将在主要治疗阶段后评估三个月的社会支持和戒烟的维持情况，在主要治疗阶段，将提供经济奖励和团体支持。一个群体应急模型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，可持续的战略，以促进戒烟。总的来说，本研究将产生一个丰富的数据集的承诺，群体意外事件，以促进戒烟。 公共卫生相关性：拟议的治疗将整合互联网的覆盖范围和便利性，以及最先进的、衍生的吸烟行为治疗。我们将研究一个群体应急治疗模型，该模型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，可持续的战略，以促进戒烟。因此，促进戒烟的群体应急措施作为降低与吸烟相关的高发病率和死亡率的一种方式，具有重大的前景。

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.