STRESS MANAGEMENT EXPERT SYSTEM FOR CANCER PREVENTION

描述：针对压力管理的阶段性配对干预措施是互动的和个性化的，并主动提供给整个人群，可能会产生前所未有的影响。与自助手册链接的基于计算机的专家系统可以与咨询人员一样有效，但成本低得多，而且更容易获得。压力是癌症和其他慢性和急性疾病的重要原因，也是医疗保健、工作表现和残疾方面代价最高的行为之一。5000万美国人没有进行有效的压力管理。现有方案是以行动为导向的，是为准备采取行动的30%的人口设计的。阶段匹配的方案可以满足所有人的需求；45%的人处于预想阶段，25%的人处于沉思阶段。这项快速通道研究的第一阶段将证明招募70%的高危人群的可行性和专家系统干预措施的可接受性。第二阶段将完成招募1200名随机分配到治疗或对照的参与者，并可在六个月内证明这些干预措施的有效性。超过18个月的随访显示，干预后很长一段时间内，影响会越来越大。有效和具有成本效益的压力管理系统可以广泛传播，具有一致的质量和用户友好的接受度。

DESCRIPTION: Stage matched interventions for stress management that are interactive and individualized, and are delivered proactively to entire populations can have unprecedented impacts. Computer based expert systems linked to self-help manuals can be as effective as counselors but at much lower cost and greater accessibility. Stress is an important cause of cancer and other chronic and acute diseases and is one of the most costly behaviors in terms of health care, job performance and disability. Fifty million Americans do not practice effective stress management. Existing programs are action-oriented and are designed for the 30% of populations who are prepared to take action. Stage matched programs can meet the needs of all; the 45% in the Pre-contemplation stage and the 25% in the Contemplation stage. Phase I of this Fast-Track research will demonstrate the feasibility of recruiting 70% of at-risk populations and the acceptability of the expert system interventions. Phase II will complete recruitment of 1200 participants randomly assigned to treatment or control and can demonstrate efficacy of these interventions over six months. Follow-up over 18 months can show increasing impact long after the intervention. Effective and cost-effective stress management systems can be broadly disseminated with consistent quality and user friendly acceptability.