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)--女性每周饮酒8+或一次饮酒4+，男性每周饮酒15+或5+饮酒--是一个主要的公共卫生问题。吸烟者高吸烟率，而高吸烟率与低戒烟率密切相关。此外，吸烟和HD除了对整体健康有强烈的有害影响外，还会极大地增加患头部、颈部和胰腺癌的风险。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，将短暂的酒精干预结合到戒烟咨询中。在面对面和电话两种形式下，与匹配的对照条件相比，这种联合咨询方法在改善饮酒和吸烟结果方面显示出了实质性的前景？将这种方法用于HD吸烟者的基于网络的戒烟计划，是增加其人口覆盖面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，数十万人注册了公开的基于网络的戒烟计划，但这些网站都没有以全面和综合的方式解决酗酒问题。一个专门为HD吸烟者设计的网站将提供一个特殊的机会来提高戒烟率，同时干预HD。该项目的总体目标是开发和试行一个专门针对HD的基于网络的戒烟计划。该项目建立在一个完善的、基于证据的戒烟网站BecomeAnEX.org的基础上，该网站每月约有2300名新用户。该项目将分两个阶段进行。在1a阶段，我们将创建ex-HD，这是BecomeAnEx.org的扩展镜像版本，其中结合了我们之前测试的在戒烟中解决HD问题的方法的关键元素，以及NIAAA关于HD的循证网站，反思饮酒。我们将在从BecomeAnEX招募的30名高清吸烟者中试用这一测试版的ex-HD，使用参与者反馈和网站使用指标来测试可行性和可接受性。将根据这一反馈对前HD进行修订，为1b阶段的工作做准备。1b阶段将包括一项试点随机临床试验，通过BecomeAnEX招募的120名HD吸烟者将被随机分配到标准的BecomeAnEX计划或EX-HD组，并进行6个月的跟踪，以获得对EX-HD减少HD和增加戒烟的潜力的初步估计。结果将为一项完全有效的第二阶段随机试验奠定基础。最终，这项研究可能会产生一种明确、有效的干预措施，与面对面咨询相比，这种干预将以有限的成本覆盖更多的人群，并可能通过同时增加戒烟和减少HD对公共健康产生特别强大的影响。