Technological Innovations for the Remote Monitoring of Smoking in Adolescents

简介（由申请人提供）：麦克卢尔博士是南卡罗来纳医科大学（MUSC）精神病学和行为科学系临床神经科学部门的[研究讲师]。麦克卢尔博士通过国家药物滥用研究所寻求指导研究科学家发展奖（K01）。该奖项将为她提供必要的培训，以促进她向独立过渡，以开展以技术创新为重点的研究议程，以促进青少年戒烟。候选人。McClure博士是一名行为心理学家，在药物滥用研究和治疗领域接受过广泛的临床前和临床培训，特别关注烟草和大麻依赖。麦克卢尔博士需要通过K01奖获得职业发展，以实现她的长期目标，专注于吸烟和复发的多学科研究，以及这些知识如何为个性化、以患者为中心的治疗干预提供信息。麦克卢尔博士精心设计了一个结构化的职业发展计划，为期5年的K01奖励期。麦克卢尔博士的目标将是：1)获得移动医疗（mHealth）方面的培训，包括广泛的方法论、分析、工程和隐私/保密问题知识；[2)在纵向数据分析中获得生物统计学训练]；3)拓宽对青少年戒烟和成瘾的认识；4)扩大对开展随机临床试验的认识；[5]提高论文写作技巧，成功过渡到独立研究。)环境。MUSC是一个协作的、富有成效的环境，将为麦克卢尔博士通过K01奖获得指导的职业发展提供理想的环境。研究生产力是一流的，2012财年获得了1242笔校外资助，总额超过2.32亿美元。MUSC对成瘾有很强的关注，在药物和酒精滥用医学教育方面排名全国前10位。30多名教师从事跨部门和学科的成瘾培训和研究。精神病学和行为科学系在美国国立卫生研究院精神病学研究经费中排名第七，2012财年获得173项资助和合同奖励，总额为4080万美元。所有的研究程序将通过临床神经科学部（CND；主任，麦克雷-克拉克）进行，候选人，主要导师（格雷）和共同导师（布雷迪）在那里预约。CND为成功执行研究程序提供了基础设施和专用空间。技术专长、培训和软件开发将由MUSC护理学院内的健康生活方式技术应用中心（TACHL）提供，该中心由Frank Treiber博士（联合导师）指导。[生物统计学培训和课程将通过公共卫生科学系提供，该候选人的联合导师（Ramakrishnan）在该系任职。MUSC通过南卡罗莱纳临床和转化研究所和研究发展和赞助项目研究办公室向早期职业调查员提供一些资源，如试点资金、研讨会、赠款写作课程和咨询、模拟研究部分、研究和招聘服务。在美国，吸烟是导致可预防死亡的主要原因，绝大多数成年吸烟者在18岁之前就开始吸烟。了解在戒烟过程中复吸的过程对于开发高效的治疗干预措施至关重要，但人们对吸烟人群复吸的自然历史知之甚少

DESCRIPTION (provided by applicant): Dr. McClure is a [Research Instructor] in the Clinical Neuroscience Division of the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina (MUSC). Dr. McClure seeks a Mentored Research Scientist Development Award (K01) through the National Institute on Drug Abuse. This award will provide the essential training to facilitate her transition to independence to pursue a research agenda focused on technological innovations to advance smoking cessation in adolescents. Candidate. Dr. McClure is a behavioral psychologist with extensive preclinical and clinical training in the areas of substance abuse research and treatment, with a specific focus on tobacco and cannabis dependence. Dr. McClure requires career development through the K01 award in order to realize her long-term goals focused in the multidisciplinary research of smoking and relapse and how that knowledge can inform personalized, patient-centered treatment interventions. Dr. McClure has carefully devised a structured career development plan for the 5-year K01 award period. Dr. McClure's objectives will be to: 1) obtain training in mobile health (mHealth), including extensive knowledge of methodology, analyses, engineering, and privacy/confidentiality concerns; [2) obtain biostatistical training in the analysis of longitudina data]; 3) broaden understanding of adolescent smoking cessation and addiction; 4) expand understanding in conducting randomized clinical trials; and [5) improve grant writing skills to successfully transition to research independence.] Environment. MUSC is a collaborative, productive environment that will provide the ideal setting for Dr. McClure to receive mentored career development through the K01 award. Research productivity is stellar, with 1,242 extramural grants awarded during FY2012, totaling more than $232 million. MUSC has a strong addictions focus, and ranks among the top 10 medical schools in the country for drug and alcohol abuse medical education. Over 30 faculty are engaged in training and research in addiction across departments and disciplines. The Department of Psychiatry and Behavioral Sciences ranks 7th in NIH research funding among domestic psychiatry departments, with faculty receiving 173 grant and contract awards, totaling $40.8 million in FY2012. All study procedures will take place through the Clinical Neuroscience Division (CND; Director, McRae-Clark), where the candidate, Primary Mentor (Gray) and Co-Mentor (Brady) hold appointments. The CND provides the infrastructure and dedicated space for successful execution of study procedures. Technological expertise, training, and software development will be provided by the Technology Applications Center for Healthful Lifestyles (TACHL) within the School of Nursing at MUSC, which is directed by Dr. Frank Treiber (Co-Mentor). [Biostatistical training and coursework will be provided through the Department of Public Health Sciences, where the candidate's Co-Mentor (Ramakrishnan) holds an appointment.] MUSC offers several resources to Early Career Investigators, such as pilot funds, seminars, grant writing courses and consultations, mock study sections, and research and recruitment services through the South Carolina Clinical and Translational Research Institute and the Offices of Research Development and Sponsored Programs Research. Cigarette smoking is the leading cause of preventable death in the US, with the vast majority of adult smokers starting prior to age 18. Understanding the process of relapse to smoking during a quit attempt is critical for the development of highly efficacious treatment interventions, yet little is known about the natural history of relapse among adolescent smokers. Technological innovations for the remote monitoring of smoking that do not primarily rely on self-report would allow for the fine-grained analysis of relapse and may be a highly fruitful avenue to explore. The studies in this K01 application propose to develop and evaluate a comprehensive remote monitoring system combining self-reports of smoking through ecological momentary assessment (EMA) with biochemical verification of smoking through breath carbon monoxide (CO) in adolescents (ages 14-21). In Aim 1, feasibility, acceptability, and compliance of the EMA + CO system will be evaluated during 1 week of smoking through quantitative and qualitative methods (Experiment 1). Experiment 2 will then monitor relapse to smoking following a quit attempt and compare the EMA + CO system vs. traditional EMA alone plus weekly clinic visits to obtain biochemical verification of smoking. In Aim 2, agreement between CO and self-reported smoking across groups will be compared. Participants in the EMA + CO group are expected to exhibit higher agreement between self-reported smoking and CO verification compared to the EMA alone group. Additionally, in Exploratory Aim 1, the trajectory of relapse following a quit attempt will be characterized across groups. Finally, in Exploratory Aim 2, EMA ratings of situational and momentary states will be compared during smoking and non-smoking occasions. The remote monitoring of smoking allows for the fine-grained characterization of behavioral processes, rather than outcomes that may not capture the complex process of relapse. The evaluation of this system is a critical first step in the eventual goal of facilitating its use for future studies to answer questions regarding relapse. Thi knowledge can then inform maximally effective, just-in-time interventions delivered at critical moments to promote long-term abstinence.