A Multi-Media Approach to Partner Support in Smokeless Tobacco Cessation

描述（由申请人提供）：无烟烟草戒烟的合作伙伴支持无烟烟草（ST）的使用继续以每年至少4%的速度增长，并构成重大的健康风险。需要新的方法来扩大ST停止计划的覆盖范围，以ST用户谁不寻求自己的治疗。该提案的目标是评估一种创新方法，该方法通过争取其妻子/伴侣的支持来鼓励男性性传播感染者戒烟，既引导性传播感染者接受治疗，又帮助他们保持禁欲。我们提出的干预措施是基于响应理论，这表明，支持将收到最好的，如果它传达验证（尊重ST用户的决定和自主权），理解（ST用户的矛盾心理戒烟和戒烟过程的挑战），和关怀（耐心，温暖，关心ST用户的福祉）。干预将通过两种方式提供信息：印刷的指南和互动网站，该网站提供指南信息沿着互动式定制支持计划、支持行为模型视频以及允许参与者相互交流和项目工作人员交流的论坛。这种多媒体方法的目的是吸引妇女，她们可能在学习风格、获取材料的首选模式（即，（在纸上或在网上）和互联网接入。在以前的可行性研究（R21-CA 131461），我们创建了一个初始版本的指南，并建立了妇女可以很容易地招募到一个干预，以帮助他们的合作伙伴退出ST。我们现在建议进行一项双臂随机临床试验，比较干预与延迟治疗控制，让访问干预网站和印刷指南后，最终评估。主要结局是伴侣在7.5个月随访时报告的ST使用者6个月的戒烟情况;次要结局包括ST使用者的戒烟尝试和作为干预功能的伴侣支持行为的变化。我们将测试一个中介模型有关的变化，合作伙伴的支持行为的ST用户的停止。 拟议的研究在两个方面具有创新性：（1）目标人群-通过招募ST使用者的妻子/伴侣，我们将鼓励那些本身不寻求治疗的ST使用者戒烟，包括那些戒烟准备程度较低的人，以及（2）干预的理论基础。如果所提出的AIS得以实现，我们将建立一种方法，可以扩大现有ST停止计划的范围和有效性。这种方法可以推广到戒烟干预和其他健康行为改变干预。 公共卫生相关性：在早期的一项研究中，我们开发了一本指导手册，教导妇女采取支持性行为来帮助她们的丈夫/伴侣戒烟。本研究将使用指南中的信息创建一个网站，沿着互动功能、视频和论坛。然后，我们将进行一项随机试验，将干预组（接受网站访问和印刷的指南）与延迟治疗对照条件进行比较，以了解支持干预是否能有效地教会女性支持性行为，从而提高其伴侣的无烟戒烟率。

DESCRIPTION (provided by applicant): Partner Support in Smokeless Tobacco Cessation Smokeless tobacco (ST) use continues to grow by at least 4% annually, and poses significant health risks. New methods are needed to expand the reach of ST cessation programs to ST users who do not seek treatment on their own. The goal of this proposal is to evaluate an innovative approach that encourages male ST users to quit by enlisting the support of their wives/ partners, both to lead the ST users to engage in treatment and to help them sustain abstinence. Our proposed intervention is based on responsiveness theory, which indicates that support will be received best if it conveys validation (respect for the ST user's decisions and autonomy), understanding (of the ST user's ambivalence about quitting and of the challenges of the cessation process), and caring (patience, warmth, and concern about the ST user's well-being). The intervention will present information via two modalities: a printed guidebook, and an interactive website presenting the guidebook information along with an interactive tailored support plan, videos modeling supportive behavior, and forums allowing participants to interact with each other and project staff. This multi- media approach is intended to appeal to women who may vary in learning styles, preferred mode of access to materials (i.e., in paper or on the web), and Internet access. In a previous feasibility study (R21-CA131461), we created an initial version of the guidebook and established that women can be readily recruited to an intervention to help their partners quit ST. We now propose to conduct a two-armed randomized clinical trial, comparing the intervention with a delayed treatment control giving access to the intervention website and printed guidebook after the final assessment. The primary outcome will be the ST user's 6-month cessation as reported at 7.5-month follow-up by the partner; secondary outcomes include ST users' quit attempts and change in the partner's supportive behaviors as a function of the intervention. We will test a mediating model relating change in partner's supportive behaviors to the ST user's cessation. The proposed study is innovative in two ways: (1) the target population - by recruiting the wives/partners of ST users, we will be encouraging cessation among ST users who are not themselves seeking treatment, including those at lower levels of readiness to quit, and (2) the theoretical basis for the intervention. If the proposed ais are achieved, we will have established a method that can expand the reach and effectiveness of existing ST cessation programs. The approach could be generalized to smoking cessation interventions and to other health behavior change interventions. PUBLIC HEALTH RELEVANCE: In an earlier study, we developed a guidebook that taught women supportive behaviors to help their husbands/partners quit smokeless tobacco. This study will create a website using the information in the guidebook, along with interactive features, videos, and forums. We will then conduct a randomized trial comparing an intervention group (receiving website access and the printed guidebook) with a delayed treatment control condition, to learn if the support intervention can effectively teach women supportive behaviors and thereby increase their partners' smokeless tobacco cessation rates.