Using Mobile Technology to Understand and Encourage Mindfulness for Smoking Cessa

描述(申请人提供)：在美国，烟草使用是可预防的发病率和死亡率的主要原因。尽管大多数吸烟者表示有戒烟的兴趣，但每年只有6%的吸烟者戒烟。基于正念的干预显示了改善戒烟的希望；然而，潜在的机制尚不清楚。此外，缺乏关于服务不足人群(即种族/少数民族成员和社会经济地位较低的个人)的正念和戒烟的研究，他们往往戒烟难度更大，与烟草有关的健康差距也很大。移动健康技术(“mHealth”)正在给医疗保健带来革命性的变化，可能被用来阐明正念背后的机制，并加强基于正念的戒烟干预。克莱尔·亚当斯博士，美国天主教大学(CUA)心理学助理教授，正在通过K23导师以患者为导向的研究职业发展奖寻求为期五年的支持，以提供与正念、mHealth、高级统计学和健康差异研究相关的培训和研究。亚当斯博士的首要职业目标是告知、开发、评估和传播以正念为基础的干预措施，以促进戒烟、预防癌症和其他慢性疾病，并提高不同人群的福祉。通过拟议的培训计划，亚当斯博士将扩展她在正念、戒烟和健康差异研究方面的知识和技能。为了填补她迄今经验中的重要空白，她将接受与移动健康相关的专门培训，以及分析多层次和纵向数据所需的高级统计知识。亚当斯博士将与她的指导团队(由大卫·维特博士领导，由心理学、工程学、公共卫生和生物统计学领域的专家组成)合作，完成正式的课程作业、专门的研讨会和定向阅读。主要研究目标是：1)利用先进的统计学和mHealth技术来确定正念影响戒烟的机制，以及2)设计和测试mHealth增强的正念戒烟干预的可行性。为了实现第一个目标，亚当斯博士将学习并应用先进的多水平建模技术，在包括不同吸烟者样本的三个现有数据集中，确定专注力和戒烟的潜在机制。对于第二个目标，亚当斯博士将与她的指导团队合作，开发和测试以正念为基础的戒烟疗法的可行性，并辅之以治疗间歇的短信。该计划旨在为参与者在其自然环境中以及在他们可能受益最大的时刻提供个性化干预。这项可行性研究的结果将为R01应用一项更大的随机对照试验提供信息和试点数据。亚当斯博士将在CUA进行拟议的工作，为研究和培训提供空间、时间、设备和其他资源。这项拟议的研究将是已知的第一项使用移动技术来检查正念和吸烟背后的机制，以及第一项已知的使用短信来促进基于正念的戒烟的研究。此外，所有拟议的研究都将以种族/民族多样性和低SES人群为目标(他们与烟草相关的健康差距的风险不成比例，而且通常不是正念研究的参与者)。研究结果可能对推进正念的科学研究、改善戒烟干预的患者结果、预防癌症和其他慢性病以及改善多样化和服务不足人群的生活质量至关重要。拟议的培训和研究计划将使亚当斯博士成为一名独立的临床科学家，他进行多学科研究，以告知、开发、评估和传播创新的正念干预措施，以改善不同人群的健康。

DESCRIPTION (provided by applicant): Tobacco use is the leading cause of preventable morbidity and mortality in the U.S. Although most smokers indicate interest in quitting, only 6% quit each year. Mindfulness-based interventions show promise for improving smoking cessation; however, underlying mechanisms are unclear. Furthermore, there is a dearth of research on mindfulness and smoking cessation in underserved populations (i.e., members of racial/ethnic minority groups and individuals with low socioeconomic status [SES]), who often have greater difficulty quitting smoking and experience profound tobacco-related health disparities. Mobile health technology ("mHealth") is revolutionizing healthcare and might be used to elucidate mechanisms underlying mindfulness and enhance mindfulness-based interventions for smoking cessation. Claire Adams, Ph.D., an Assistant Professor of Psychology at the Catholic University of America (CUA), is seeking five years of support through the K23 Mentored Patient-Oriented Research Career Development Award for training and research related to mindfulness, mHealth, advanced statistics, and health disparities research. Dr. Adams' overarching career goals are to inform, develop, evaluate, and disseminate mindfulness- based interventions to promote smoking cessation, prevent cancer and other chronic diseases, and enhance well-being in diverse populations. Through the proposed training plan, Dr. Adams will expand her knowledge and skills with regard to mindfulness, smoking cessation, and health disparities research. In order to fill important gaps in her experience thus far, she will gain specialized training related to mHealth and the advanced statistics necessary for analyzing multi-level and longitudinal data. Dr. Adams will work with her mentoring team (led by Dr. David Wetter and comprising experts in fields of psychology, engineering, public health, and biostatistics) to complete formal coursework, specialized workshops, and directed readings. Primary research aims are to: 1) utilize advanced statistics and mHealth technology to determine mechanisms through which mindfulness influences smoking cessation, and 2) design and test the feasibility of a mHealth-enhanced mindfulness-based intervention for smoking cessation. Toward the first aim, Dr. Adams will learn and apply advanced multilevel modeling techniques to determine mechanisms underlying mindfulness and smoking cessation in three existing datasets that include diverse samples of smokers. Toward the second aim, Dr. Adams will work with her mentoring team to develop and test the feasibility of a mindfulness-based smoking cessation treatment that is supplemented by between-session text messaging. This program aims to deliver personalized intervention to participants in their natural environments and in the moments when they might benefit most. Findings from this feasibility study will inform and provide pilot data for an R01 application of a larger randomized controlled trial. Dr. Adams will conduct the proposed work at CUA, which will provide space, time, equipment, and other resources for research and training. The proposed research will be the first known to use mobile technology to examine mechanisms underlying mindfulness and smoking, as well as the first known study to use text messaging to enhance mindfulness- based smoking cessation. Furthermore, all proposed studies will target racially/ethnically diverse and low-SES populations (who are at disproportionate risk for tobacco-related health disparities and have not typically served as participants in mindfulness research). Research findings could be critical in moving forward the scientific study of mindfulness, improving patient outcomes in smoking cessation interventions, preventing cancer and other chronic diseases, and improving quality of life in diverse and underserved populations. The proposed training and research plan would launch Dr. Adams as an independent clinical scientist who conducts multidisciplinary research to inform, develop, evaluate, and disseminate innovative mindfulness- based interventions to improve health in diverse populations.