BREATHE FREE: Smartphone Videogame-Based Incentives for Smoking Cessation

描述（由申请人提供）：吸烟仍然是美国可预防的发病率和死亡率的头号原因，每年，三分之一到一半的吸烟者试图戒烟至少一次；然而，大约94%的戒烟尝试失败了。许多干预措施已经开发出来，以帮助吸烟者开始和保持戒烟。不幸的是，尽管大多数吸烟者表达了戒烟的愿望，但最可能的结果是复发。因此，制定更有效的干预措施以减少复发不仅至关重要，而且确保以低成本向吸烟者广泛提供以证据为基础的戒烟干预措施也是一项主要的公共卫生目标。最有效的、基于证据的戒烟行为干预措施之一是应急管理（CM）。戒烟的CM包括提供奖励（通常是金钱），这取决于戒烟的客观证据（例如，呼出气体中的一氧化碳水平）。然而，提供激励的成本，管理项目所需的时间，以及参与监督监控过程的距离，经常被认为是CM的障碍。这项SBIR快速通道提案旨在开发一种基于移动视频游戏的戒烟应急管理干预措施。本提案的目标是显著降低成本，提高可持续性，并进一步增加戒烟CM干预措施的可及性。为了增加访问，干预的所有方面都可以通过Android或iOS智能手机获得，并与火柴盒大小的外围设备一起使用，用于监测呼吸CO。为了降低成本并提高可持续性，我们将开发的手机游戏将允许我们用游戏内的“虚拟奖励”取代CM干预中通常使用的货币激励，这种奖励可以立即用于帮助玩家实现游戏目标，并具有社会强化作用。在游戏情境中得到提示和激励。在第一阶段，将采用迭代设计和形成性评估过程，为第二阶段开发的移动游戏设计游戏设计和故事板，制作CO数据收集软件并与CO Monitor集成，并开发视频游戏演示。创建的演示将呈现给拥有目标平台设备的20名寻求治疗的吸烟者，然后他们将完成计划干预的调查和前瞻性评估。在第二阶段，将完成视频游戏的开发，能够支持7周的游戏，并将对114名受试者进行为期7周的随机对照试验结果评估，以评估戒烟干预的可行性，可接受性，吸引力和有效性。

DESCRIPTION (provided by applicant): Cigarette smoking remains the number one cause of preventable morbidity and mortality in the U.S. Each year, one third to one half of smokers attempt to quit at least once; however, approximately 94% of quit attempts fail. A number of interventions have been developed to help smokers initiate and maintain abstinence. Unfortunately, even though most smokers express a desire to quit, relapse is the most likely outcome. Thus, it is not only critically important that more effective interventions be developed to reduce relapse, but it is also a primary public health goal to ensure that evidence-based smoking cessation interventions be made widely available, and at a low cost, to smokers. One of the most powerful, evidence-based behavioral interventions for smoking cessation is contingency management (CM). CM for smoking cessation consists of delivering incentives (typically money) contingent on objective evidence of smoking abstinence (e.g., carbon monoxide [CO] levels in the exhaled breath). However, the cost of providing incentives, the time it takes to administer the program, and the distance that must be traveled to participate in supervised monitoring procedures are often cited as barriers to CM. This SBIR Fast-Track proposal seeks to develop a mobile videogame-based contingency management intervention for smoking cessation. The goals of the present proposal are to markedly decrease costs, improve sustainability, and further increase accessibility of CM interventions for smoking cessation. To increase access, all aspects of the intervention will be available via Android or iOS smartphones used in conjunction with a matchbox-sized peripheral device for monitoring breath CO. To decrease costs and improve sustainability, the mobile game we will develop will allow us to replace the monetary incentives typically used in CM interventions with in-game "virtual rewards" that can immediately be used to help players meet game objectives, as well as with social reinforcement, prompted and incentivized in the context of the game. In Phase I, an iterative design and formative evaluation process will be used to create a game design and storyboard for the mobile game to be developed in Phase II, the CO data collection software will be produced and integrated with the CO Monitor, and a demo of the videogame will be developed. The demo created will be presented to 20 treatment-seeking smokers owning the target platform devices, who will then complete a survey & prospective evaluation of the planned intervention. In Phase II the development of the videogame, capable of supporting 7 weeks of play, will be completed, and a 7 week randomized control trial outcome evaluation will be conducted with 114 subjects to assess the feasibility, acceptability, appeal, and efficacy of the smoking cessation intervention.