A Text Messaging Intervention for Smoking Cessation Among Community Health Center Patients

 描述（由申请人提供）：在过去十年中，美国的戒烟率变化不大。显然需要新的戒烟干预措施。短信已被确定为提供戒烟支持的一种有前途的方式。几乎没有现有的研究，探讨模型，整合短信干预戒烟的医疗保健系统。医疗保健系统是提供戒烟支持的重要场所，因为每年有70%的吸烟者去看医生。整合医疗保健中的服务，使行为和药理干预的协调，并利用患者与提供者的关系。戒烟药物的依从性差被认为会限制其有效性。短信已被用于促进其他条件下的药物依从性，但使用短信促进戒烟药物尚未得到充分研究。该科学计划有两个研究目标：（1）在社区卫生中心的吸烟者（n=30）中进行定性焦点小组，以评估他们对来自医疗保健提供者的短信的偏好，并探索他们使用尼古丁替代疗法的经验和药物依从性的障碍，以便为短信干预的设计提供信息，以及（2）为了测试，在一项初步随机对照试验（N=106）中，通过短信和尼古丁替代治疗提供药物治疗支持的行为戒烟内容对自我报告的戒烟尝试（故意不吸烟≥ 24小时）、药物治疗依从性和治疗结束时生化证实的戒烟的影响。主要研究者（PI）提出了一个职业发展计划，其中包括方法培训和指导由哈佛教师设计和评估短信干预针对吸烟者在社区卫生中心。这个职业发展奖的长期目标是培养吉娜·克鲁斯医学博士，医学硕士，M.P.H.作为一名独立的戒烟研究人员，拥有针对弱势群体的技术解决方案的专业知识。在为期五年的奖励期间，她将开发一个知识库，支持初级保健患者戒烟短信干预的开发，实施和评估。职业发展活动将包括定性研究培训、使用移动的技术作为提供健康建议的沟通方法以及临床试验设计。该提案解决了文献中的重要空白，包括将吸烟者的短信程序整合到医疗保健系统中的可行性，以及检查短信对戒烟药物依从性的影响。

 DESCRIPTION (provided by applicant): Tobacco cessation rates in the U.S. have changed little in the last decade. New interventions for smoking cessation are clearly needed. Text messaging has been identified as a promising modality for delivering smoking cessation support. There is little existing research which examines models that integrate text messaging interventions for smoking cessation within healthcare systems. Healthcare systems are important sites for delivering smoking cessation support given that 70% of smokers visit a physician each year. Integrating services within healthcare enables coordination of behavioral and pharmacologic interventions and leverages patient-provider relationships. Poor adherence to smoking cessation medications is thought to limit their effectiveness. Text-messaging has been used to promote adherence to medication in other condition but the use of text messaging to promote smoking cessation medication is not well studied. The proposed scientific program has two research aims: (1) To conduct qualitative focus groups among smokers (n=30) in community health centers to assess their preferences for text messaging from their healthcare provider and to explore their experience with nicotine replacement therapy and barriers to medication adherence in order to inform the design of a text messaging intervention, and (2) To test, in a pilot randomized controlled trial (N=106), the effect of delivering behavioral smoking cessation content with pharmacotherapy support by text message plus nicotine replacement therapy on self-reported quit attempts (intentional non-smoking for =24 hours), pharmacotherapy adherence, and biochemically confirmed smoking abstinence at the end of treatment. The principal investigator (PI) proposes a career development program that includes methodological training and mentorship by Harvard faculty to design and evaluate a text messaging intervention targeting smokers in community health centers. The long-term goal of this career development award is to develop Gina Kruse M.D., M.S., M.P.H. as an independent tobacco cessation researcher with expertise in technology-based solutions for vulnerable populations. During the five-year award period, she will develop a knowledge base that supports the development, implementation, and evaluation of a text messaging intervention for smoking cessation among primary care patients. Career development activities will include training in qualitative research, use of mobile technologies as a communication method for delivering health advice, and clinical trial design. This proposal addresses important gaps in the literature including the feasibility of integrating text messaging programs for smokers into healthcare systems and examining the effect of text messaging on smoking cessation medication adherence.