A mobile intervention to promote cessation in HIV-infected smokers

促进感染艾滋病毒的吸烟者戒烟的移动干预措施

• 批准号: 9056549
• 负责人: LORIEN C ABROMS
• 金额: $ 17.58万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE, INC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9056549
• 关键词: AIDS-Related Opportunistic Infections; Abstinence; Address; Adherence; Alcohol consumption; Alcohol or Other Drugs use; Automobile Driving; Behavior Therapy; Behavioral; Cardiac; Cardiovascular Diseases; Caring; Cellular Phone; Cessation of life; Communities; Comorbidity; Computer Interface; Computer software; Computers; Counseling; Data; Devices; Drug usage; Elements; Epidemic; Evaluation; Event; Free Will; Funding; Group Therapy; Growth; Guidelines; HIV; HIV Infections; HIV Seropositivity; Health; Health Priorities; Healthcare; Highly Active Antiretroviral Therapy; Individual; International; Internet; Intervention; Intervention Trial; Knowledge; Life; Life Expectancy; Literature; Malignant Neoplasms; Malignant neoplasm of lung; Marketing; Measures; Mediating; Mediator of activation protein; Medical; Minority Groups; Morbidity - disease rate; New York; Online Systems; Persons; Phase; Pilot Projects; Population; Provider; Public Health; Publishing; Randomized; Randomized Controlled Trials; Reporting; Research; Research Personnel; Research Priority; Resources; Role; Schedule; Self Efficacy; Services; Site; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social Behavior; Social support; Staging; Technology; Testing; Text; Time; Tobacco; Tobacco Use Cessation; Tobacco-Related Carcinoma; Training; United States National Institutes of Health; United States Public Health Service; Virus; Visit; Vulnerable Populations; Work; base; cigarette smoking; cohort; comparative efficacy; cost; design; ethnic minority population; evidence base; health disparity; improved; innovation; interest; mHealth; meetings; mortality; motivational enhancement therapy; nicotine replacement; programs; prototype; psychosocial; quitline; satisfaction; standard care; therapy design; tool; treatment program; trend; trial comparing; user-friendly; web site

DESCRIPTION (provided by applicant): There are nearly one million persons living with confirmed HIV infection (PLWH) in the US, 60% of them smoke cigarettes, and 75% of them are interested in quitting. Almost none are currently accessing smoking cessation interventions designed to meet their specific needs and concerns. Cigarette smoking is a leading contributor to mortality among PLWH in the HAART era, and it is the direct cause of 30% of non-AIDS defining malignancies. It is driving the alarming rise in cardiac events and lung cancers in this highly vulnerable population. The lack of access to proven, effective, culturally appropriate tobacco cessation services represents a health disparity of the first order. The psychosocial profile of the PLWH-smoker community, characterized by high rates of psychiatric comorbidity, drug and alcohol use, and low levels of social support, suggests that achieving high cessation rates will be a great challenge. Positively Smoke Free is an intensive, multisession, cessation intervention specifically developed for PLWH smokers. It is currently available as a live, group therapy program and also as a web-based version designed for notebook or desktop computers. In its current form, the web-version is not adoptable to the smartphone platform. Pilot data from randomized, controlled, trials of both formats show promise. The number of individuals in the US who own smartphones and who use them to access health information on the internet is steadily growing. This growth is most pronounced in the ethnic minority groups that make up the majority of the PLWH community in the US. Behavioral interventions delivered via smartphones offer the advantage of expansive reach, low cost, and immediacy of access to users. A burgeoning body of literature suggests that this may be an especially effective tool for tobacco treatment. mHealth tobacco treatment interventions for PLWH smokers have not yet been explored. This proposal aims (1) to adapt Positively Smoke Free to the mobile format for smartphones (2) to test the feasibility (i.e. recruitment, adherence, retention, satisfaction, and cost) of mobile Positively Smoke Free (mPSF) in a cohort of 50 PLWH smokers, (3) to complete a pilot randomized controlled trial comparing biochemically confirmed 3-month abstinence rates in subjects (N=50) assigned to the mPSF condition versus those (N=50) assigned to standard care (all subjects will be offered a 3-month supply of nicotine replacement therapy) and (4) to conduct exploratory analyses of putative moderators and mediators of program efficacy. If the mobile version of PSF is proven to be feasible and efficacious, the project will have short term impact by opening a new vista of tobacco (and other behavioral) treatment for a highly vulnerable group. Study data will provide crucial information for a definitive trial of the intervention. The long-term impact will be reduced tobacco-related morbidity and mortality among PLWH, and a clearer understanding of the role of mHealth in comprehensive HIV care.

描述（申请人提供）：美国有近100万人确诊感染艾滋病毒（PLWH），其中60%吸烟，75%有戒烟意向。目前，几乎没有人能够获得旨在满足其具体需求和关切的戒烟干预措施。 在HAART时代，吸烟是导致PLWH死亡的主要因素，并且是30%的非艾滋病定义恶性肿瘤的直接原因。它正在推动这一高度脆弱人群中心脏病事件和肺癌的惊人增长。无法获得经证实的、有效的、文化上适当的戒烟服务是一种最严重的健康差距。艾滋病毒/艾滋病感染者-吸烟者群体的社会心理状况，其特点是精神病合并症、药物和酒精使用率高，社会支持水平低，这表明实现高戒烟率将是一个巨大的挑战。 Positively Smoke Free是一种专门为PLWH吸烟者开发的密集，多阶段戒烟干预。它目前可作为一个现场，团体治疗计划，也作为一个基于网络的版本，专为笔记本电脑或台式电脑。在其目前的形式，网络版本是不适用于智能手机平台。两种形式的随机对照试验的初步数据显示了希望。 在美国，拥有智能手机并使用智能手机在互联网上获取健康信息的人数正在稳步增长。这种增长在构成美国PLWH社区大多数的少数民族群体中最为明显。通过智能手机提供的行为干预具有覆盖面广、成本低和直接接触用户的优点。大量文献表明，这可能是一种特别有效的烟草治疗工具。尚未探索针对PLWH吸烟者的mHealth烟草治疗干预措施。 本提案旨在（1）使Positively Smoke Free适应智能手机的移动的格式（2）以测试可行性（即招募、依从性、保留、满意度和成本），在50名PLWH吸烟者的队列中使用移动的积极无烟（mPSF），（3）完成一项初步随机对照试验，比较经生化证实的受试者3个月戒烟率（N=50）分配到mPSF条件与那些（N=50）分配到标准治疗（所有受试者将提供3个月的尼古丁替代治疗）和（4）进行程序疗效的假定调节剂和介质的探索性分析。 如果PSF的移动的版本被证明是可行和有效的，该项目将通过为高度脆弱的群体开辟烟草（和其他行为）治疗的新前景而产生短期影响。研究数据将为干预措施的最终试验提供关键信息。长期影响将是减少艾滋病毒携带者与烟草相关的发病率和死亡率，并更清楚地了解移动健康在艾滋病毒综合护理中的作用。