Development and pilot testing of a multimodal web-based program to address heavy drinking during smoking cessation

开发和试点测试多模式网络计划，以解决戒烟期间酗酒问题

• 批准号: 9017537
• 负责人: Christopher W. Kahler
• 金额: $ 32.36万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9017537
• 关键词: Abstinence; Address; Alcohol consumption; Alcoholic beverage heavy drinker; Alcohols; Clinical; Collaborations; Communities; Computers; Counseling; Development; Effectiveness; Elements; Enrollment; Failure; Feedback; Foundations; Head Cancer; Head and neck structure; Health; Heavy Drinking; Individual; Internet; Intervention; Link; Malignant neoplasm of pancreas; Modality; Motivation; Neck Cancer; New York; Online Systems; Outcome; Outcome Assessment; Pancreas; Participant; Persons; Pilot Projects; Population; Preparation; Program Development; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recommendation; Recruitment Activity; Reporting; Research; Research Personnel; Resources; Risk; Sampling; Site; Smoker; Smoking; Specific qualifier value; Staging; Telephone; Testing; Text; Treatment Efficacy; Woman; Work; alcohol effect; alcohol intervention; arm; brief alcohol intervention; cigarette smoking; cost; design; drinking; evidence base; follow-up; high risk; improved; men; non-smoker; pilot trial; population health; programs; public health relevance; quitline; randomized trial; response; satisfaction; smoking cessation; smoking intervention; smoking prevalence; smoking relapse; success; trafficking; web page; web site

 DESCRIPTION (provided by applicant): Comorbid cigarette smoking and heavy drinking (HD) - for women consuming 8+ drinks a week or 4+ drinks on a single occasion and for men consuming 15+ drinks a week or 5+ on a single occasion - is a major public health concern. Smokers engage in HD at high rates, and HD is robustly associated with low rates of smoking cessation. Furthermore, smoking and HD combine to dramatically increase the risk of head, neck, and pancreatic cancers in addition to having strong detrimental effects on overall health. To address this public health challenge, we have developed and tested a counseling approach that incorporates brief alcohol intervention into smoking cessation counseling. In both face-to-face and telephone formats, this combined counseling approach has demonstrated substantial promise for improving both drinking and smoking outcomes compared to matched control conditions? Adapting this approach for use in a web-based smoking cessation program for HD smokers is a compelling next step for increasing its population reach. Millions of smokers search online for smoking cessation information each year, and hundreds of thousands register on publicly available web-based cessation programs, yet none of these sites address heavy drinking in a comprehensive and integrated manner. A website specifically designed for HD smokers would provide an exceptional opportunity to enhance smoking cessation rates and concurrently intervene on HD. The overall objective of this project is to develop and pilot test a web-based smoking cessation program that specifically addresses HD. The project builds upon a well-established, evidence-based smoking cessation website, BecomeAnEX.org, which enrolls approximately 2,300 new users each month. The project will occur in two stages. In Stage 1a, we will to create EX-HD, an expanded mirror version of BecomeAnEx.org that incorporates key elements of our previously tested approaches for addressing HD in smoking cessation and NIAAA's evidence-based website for HD, Rethinking Drinking. We will pilot this beta version of EX-HD with 30 HD smokers recruited from BecomeAnEX, examining feasibility and acceptability using participant feedback and site use metrics. EX-HD will be revised in response to this feedback in preparation for Stage 1b work. Stage 1b will involve a pilot randomized clinical trial in which 120 HD smokers recruited through BecomeAnEX will be randomly assigned to either the standard BecomeAnEX program or to EX-HD and followed for 6 months in order to obtain initial estimates of the potential of EX-HD to reduce HD and increase smoking cessation. Results will provide the foundation for a fully-powered Stage II randomized trial. Ultimately, this research could result in a well- specified, efficacious intervention that wuld have great population reach with limited cost relative to in-person counseling and could have an especially powerful impact on public health by concurrently increasing smoking cessation and reducing HD.

 描述（由申请人提供）：吸烟和大量饮酒（HD）共病-女性每周饮酒8次以上或单次饮酒4次以上，男性每周饮酒15次以上或单次饮酒5次以上-是一个主要的公共卫生问题。吸烟者参与HD的比率很高，HD与戒烟率低密切相关。此外，吸烟和HD联合收割机除了对整体健康产生强烈的有害影响外，还显著增加了患头颈癌和胰腺癌的风险。为了应对这一公共卫生挑战，我们开发并测试了一种咨询方法，将短暂的酒精干预纳入戒烟咨询。在面对面和电话形式中，与匹配的对照条件相比，这种综合咨询方法已证明在改善饮酒和吸烟结果方面有很大的希望？调整这种方法用于基于网络的HD吸烟者戒烟计划是增加其人口覆盖范围的引人注目的下一步。每年有数百万吸烟者在网上搜索戒烟信息，数十万人在公开的基于网络的戒烟计划上注册，但这些网站都没有以全面和综合的方式解决酗酒问题。专为HD吸烟者设计的网站将提供一个绝佳的机会，以提高戒烟率并同时干预HD。该项目的总体目标是开发和试点测试一个基于网络的戒烟计划，专门解决HD。该项目以一个完善的循证戒烟网站BecomeAnEX.org为基础，该网站每月招收约2 300名新用户。该项目将分两个阶段进行。在第1a阶段，我们将创建EX-HD，这是BecomeAnEx.org的扩展镜像版本，其中包含我们先前测试的解决戒烟中HD问题的方法的关键要素，以及NIAAA的HD循证网站，反思饮酒。我们将在BecomeAnEX招募的30名HD吸烟者中试用EX-HD的测试版，使用参与者反馈和网站使用指标检查可行性和可接受性。EX-HD将根据这一反馈进行修订，为第1b阶段工作做准备。阶段1b将涉及一项试点随机临床试验，其中通过BecomeAnEX招募的120名HD吸烟者将被随机分配到标准BecomeAnEX计划或EX-HD，并随访6个月，以获得EX-HD减少HD和增加戒烟的潜力的初步估计。结果将为完全有效的II期随机试验提供基础。最终，这项研究可能会产生一个明确的，有效的干预措施，将有很大的人口覆盖率与有限的成本相对于面对面的咨询，并可能有一个特别强大的影响，对公共卫生的同时增加戒烟和减少HD。