Examining a Text Message Intervention for Smoking Cessation

描述（由申请人提供）：大多数吸烟者希望戒烟，每年有近一半的人试图戒烟。然而，很少有人真正成功。这个问题在年轻的成年吸烟者中尤为严重，他们往往没有充分利用现有的戒烟服务，并且获得健康保险和医疗保健的机会有限。需要新的创新方法来接触年轻的成年吸烟者并帮助他们戒烟。干预提供模式，可以便宜地提供一个有吸引力的格式与广泛的范围是特别引人注目的治疗年轻吸烟者。对于这个项目，我们将开发和测试一个理论驱动的，以证据为基础的戒烟咨询干预，可以通过短信传递。短信在年轻人（<35岁）中很受欢迎，其中一半以上的人使用短信，通常每周发送50条或更多消息。短信可用于提供建议和互动支持，这些建议和支持是根据戒烟的循证干预措施改编的。然而，到目前为止，短信是一种尚未开发的媒介，很少被作为干预措施提供工具进行研究。现有的研究有很大的局限性，拟议的研究将试图纠正这些局限性。该项目包括三个子研究：初始验收测试、原型评估和初始功效测试。我们将首先详细介绍拟议的干预系统，并使用一系列3-4个焦点小组对该计划的潜在可行性和可接受性进行初步测试，其中24名吸烟者来自我们的目标人群，并与主要利益相关者进行半结构化访谈。从这些访谈和焦点小组中获得的信息将用于为原型开发提供信息。干预方案的编制和干预信息的内容将在项目期的第9个月完成。然后，我们将招募24名成年吸烟者的第二个样本，使用该计划作为戒烟干预7周，然后参加焦点小组，以评估他们对该系统的体验。我们亦会向主要持份者展示工作原型，并进行面谈以获取他们的意见。根据这些评估，我们将改进干预措施。在第二年，我们将从目标人群中招募40名成年吸烟者，并随机分配他们接受短信干预（TXT）或接触控制自助干预（TXC）。治疗结束和6个月随访的结果将用于获得更大规模试验所需的效应量估计值。公共卫生相关性：年轻的成年吸烟者通常获得医疗保健的机会有限，并且没有充分利用戒烟服务。该项目将开发一个基于证据的，理论驱动的戒烟计划，通过短信提供，这是大多数年轻人使用的一种流行的沟通形式。该项目具有重大的公共卫生意义，因为成功地传播干预措施每年可使多达680万吸烟者受益。

DESCRIPTION (provided by applicant): Most smokers want to quit and nearly half attempt to quit each year. However, few actually succeed. The problem is particularly acute among young adult smokers who tend to under-utilize existing smoking cessation services, and have limited access to health insurance and healthcare. New, innovative approaches are needed that can reach out to younger adult smokers and help them quit. Intervention delivery modalities that can be inexpensively delivered in an appealing format with wide reach are particularly compelling for treating younger smokers. For this project we will develop and test a theoretically driven, evidence-based smoking cessation counseling intervention that can be delivered through SMS text messages. Text messaging is popular with younger adults (<35 years), over half of whom use text messaging, often sending 50 or more messages per week. Text messaging can be used to provide advice and interactive support adapted from evidence-based interventions for smoking cessation. However, thus far text messaging is an untapped medium and has been only rarely studied as an intervention delivery tool. Existing studies have significant limitations which the proposed study will attempt to redress. This project consists of three sub-studies: Initial Acceptance Testing, Prototype Evaluation, and initial Efficacy Testing. We will first develop a detailed presentation of the proposed intervention system and conduct an initial test of the program's potential feasibility and acceptability using a series of 3-4 focus groups with 24 smokers from our targeted demographic and conduct semi-structured interviews with key stakeholders. Information obtained from these interviews and focus groups will be used to inform prototype development. Intervention programming and the content of intervention messages will be completed in month 9 of the project period. We will then recruit a second sample of 24 adult smokers to use the program as a smoking cessation intervention for 7 weeks, and then participate in focus groups to evaluate their experience with the system. We will also demonstrate the working prototype to key stakeholders and conduct interviews to obtain their feedback. Based on these evaluations, we will refine the intervention. In year 2 we will recruit a sample of 40 adult smokers from the target group and randomly assign them to receive either the text-message intervention (TXT) or a self- help intervention with contact control (TXC). Outcomes at end-of-treatment and six-month follow up will be used to obtain effect size estimates needed for a larger trial. PUBLIC HEALTH RELEVANCE: Younger adult smokers typically have limited access to healthcare and under-utilize smoking cessation services. This project will develop an evidence-based, theoretically driven smoking cessation program delivered through text messaging, which is a popular form of communication used by the majority of younger adults. This project has substantial public health significance in that successful dissemination of the intervention could reach as many as 6.8 million smokers annually.