Utilizing Augmented Reality as an Adjunct for Smoking Cessation: Development and Initial Validation

项目摘要/摘要 2016年，美国成年人的烟草使用率为15.5%。开发有效的 戒烟干预仍然是公共卫生的优先事项，mHealth提供了减少障碍的机会 传播和实施戒毒治疗。这一阶段的治疗开发项目测试 新兴的增强现实(AR)技术作为辅助治疗的基础的潜力 烟草依赖。AR是一项快速发展的技术，可以为 戒烟。AR将数字创建的虚拟对象插入到真实世界环境中，就像在 屏幕(即智能手机或平板电脑)。在健康促进干预方面，AR提供了机会 将治疗元素扩展到用户自己的环境中。因此，AR似乎提供了完美的 在现实世界中进行基于灭绝的治疗的机会。线索暴露疗法已经证明 在实验室或临床上对减少烟草渴求的有效性，但这些效果通常是短暂的，而且确实 似乎并不能超越灭绝的背景来概括。这种灭绝后的“更新效应”一直是 在动物和人体研究中都证明了这一点。随着AR技术的出现，现在有可能 在吸烟者自己的真实吸烟环境中，在多个环境中进行消光试验。 将线索暴露于日常环境的影响扩大的可能性，与 智能手机的广泛使用，为开发创新和可扩展的吸烟提供了机会 戒烟治疗。拟议项目的主要目标是通过以下方式启动一系列系统的研究 创建一组与吸烟相关的、比较中性的AR刺激，然后测试它们产生 线索-实验室中的反应和消亡。这个项目有三个目标。AIM 1将开发AR移动设备 APP和Pilot在一小部分吸烟者身上测试了AR吸烟和中性刺激。然后，我们将修改 根据他们的反馈进行刺激。目标2将包括两个以实验室为基础的会议，以测试AR刺激对 线索--吸烟冲动的反应和消退。提示-反应会话将使用2x2- 受试者析因设计检验AR吸烟刺激与中性刺激和体内刺激对自身的影响 据报道有吸烟的冲动。第二节将重复介绍AR吸烟刺激物 进行物种灭绝测试。如果AR刺激在实验室中表现出足够的线索反应性和消失性， 随后的研究将把这项工作扩展到现实世界，以确定AR影响冲动的能力 和吸烟行为。因此，Aim 3将升级这款应用程序用于治疗，并对AR吸烟进行试点测试 在真实世界环境中进行刺激，为未来更大规模的试验做准备。该项目预计将 验证AR作为进行消退试验的策略，这些试验构成了线索暴露疗法和SET的基础 将AR作为更全面吸烟的一个组成部分进行随机对照试验的阶段 停止干预。

PROJECT SUMMARY/ABSTRACT In 2016, the prevalence of tobacco use was 15.5% among adults in the United States. Developing effective cessation interventions remains a public health priority, and mHealth offers the opportunity to reduce barriers to dissemination and implementation of cessation treatment. This Stage 1 treatment development project tests the potential of the emerging technology of augmented reality (AR) as the basis of an adjunct treatment for tobacco dependence. AR is a rapidly-advancing technology that could provide a novel and exciting aid to smoking cessation. AR inserts virtual, digitally-created objects into the real-world environment as viewed on a screen (i.e., smartphone or tablet). With respect to health promotion interventions, AR provides the opportunity to extend therapeutic elements into the user's own environment. As such, AR seemingly provides the perfect opportunity for extinction-based treatment in the real-world. Cue-exposure treatments have demonstrated efficacy for decreasing tobacco craving in the laboratory or clinic, but these effects are often short-lived, and do not appear to generalize beyond the extinction setting. This post-extinction “renewal effect” has been demonstrated in both animal and human studies. With the emergence of AR technology, it is now possible to conduct extinction trials across multiple environments throughout smokers' own real-world smoking settings. The potential to extend the effects of cue-exposure to the everyday environment, combined with the widespread use of smartphones, presents the opportunity to develop an innovative and scalable smoking cessation treatment. The primary goal of the proposed project is to initiate a systematic line of research by creating a set of smoking-related and comparison neutral AR stimuli, and then testing their ability to produce cue-reactivity and extinction in the laboratory. This project has three aims. Aim 1 will develop an AR mobile app and pilot test the AR smoking and neutral stimuli on a small sample of smokers. We will then modify the stimuli based on their feedback. Aim 2 will comprise two, lab-based sessions to test the impact of AR stimuli on cue-reactivity and extinction of smoking urges, respectively. The cue-reactivity session will utilize a 2x2 within- subjects factorial design to test AR smoking stimuli against both neutral stimuli and in vivo stimuli on self- reported urge to smoke. The second session will involve repeated presentations of the AR smoking stimuli to test for extinction. If AR stimuli demonstrate sufficient cue-reactivity and extinction in the laboratory, subsequent research would extend this work into the real-world to determine the ability of AR to impact urges and smoking behavior. Thus, Aim 3 will upgrade the app for therapeutic use and pilot test the AR smoking stimuli in the real-world environment to prepare for a future, larger-scale trial. This project is expected to validate AR as a strategy for conducting extinction trials that form the basis of cue-exposure therapy and set the stage for a randomized controlled trial to test AR as a component of a more comprehensive smoking cessation intervention.