Testing Financial Incentive Interventions in Dyadic-Smoker Couples

项目摘要/摘要 吸烟者与其他吸烟者(即双重吸烟者夫妇)的伴侣约占所有吸烟者的2/3。双人- 吸烟者夫妇(DSC)不太可能尝试戒烟，更有可能在戒烟尝试期间复发， 降低总体戒烟率，并代表临床高危人群。尽管他们的高度 持续吸烟的患病率和风险，然而，关于戒烟的数据有限。 DSC中的干预措施。基于之前的研究，建议采取经济激励措施(FITS) 在提高戒烟动机和戒烟率方面是有效的，拟议的试点研究将 系统地探索在DSCs中使用Fit的两个变体。具体地说，我们将测试传统的匹配(即， 以一对夫妇中的一个人为目标)以及Fit的一个二元变体--以一对夫妇的两个成员为目标 同时还提供了经济奖励。确定适用于DSCs的FIT(单一或二元)的有效性 需要随机对照试验(RCT)，拟议的先导研究将产生关键的初步数据 在三个领域。首先，我们将研究一种新的修改的二元版本的FIT用于DSCs的可行性 针对两个二元体成员(二元匹配)，将其与标准匹配和不匹配的主动控制组进行比较。 其次，我们将使用试点研究来生成一系列效果大小估计，以便为未来的RCT提供适合的信息 DSCs。最后，我们将考察可能作为行为机制的个体和二元因素。 改变DSC中的FIT干预措施。 我们在一个三组试点RCT中解决了这些问题。在任何情况下，这对夫妇中的两个人 获得标准化的积极治疗(即尼古丁替代疗法，为期4周 教育计划)。在每对夫妇中，第一个接触戒烟计划的人将被指定 目标。在控制条件下，任何个人都不会获得经济奖励。在单一目标匹配中 条件下，目标将额外获得参加计划和节欲的财政奖励 后续行动。在二元匹配条件下，每对夫妇(目标+伴侣)的两个成员都将获得 对参加计划和戒烟的激励。初步可行性结果为： 完成研究所有阶段的参与者；主要耐受性结果是参与者的百分比 由于学习程序的原因，选择停止参加学习。主要结果是计划完成 3个月时按点流行戒毒。行为改变的潜在机制包括这两种 个人因素(如自我效能感和动机的变化)和二元因素(如联合戒烟、伴侣 支持)。有关行为改变的可行性、有效性和机制的初步数据将使我们能够 确定FIT的二元形式是否适用于DSCs中的戒烟。调查结果将是 直接用于通知未来的RCT测试是否适合在该治疗难治人群中促进戒烟。

Project Summary/Abstract Smokers partnered with other smokers (i.e., dual-smoker couples) represent ~2/3 of all smokers. Dual- smoker couples (DSCs) are less likely to try to quit smoking and more likely to relapse during a quit attempt, reducing overall smoking cessation rates and representing a high-risk clinical population. Despite their high prevalence and risk for persistent smoking, however, there are limited data on the smoking cessation interventions among DSCs. Building on previous research that suggests financial incentive treatments (FITs) are effective at increasing motivation to quit and quit rates in general, the proposed pilot study will systematically explore using two variants of FIT with DSCs. Specifically, we will test a traditional FIT (i.e., targeting one individual of a couple) as well as a dyadic variant of FIT—targeting both members of a couple with simultaneous financial incentives. Determining the efficacy of FIT (single or dyadic) for DSCs would require a randomized controlled trial (RCT) and the proposed pilot study will generate critical preliminary data in three domains. First, we will examine the feasibility of a novel modified dyadic version of FIT for DSCs that targets both members of the dyad (dyadic FIT), comparing it to standard FIT and a no-FIT active control group. Second, we will use the pilot study to generate a range of effect size estimates to inform a future RCT of FIT in DSCs. Finally, we will examine individual and dyadic factors that may serve as mechanisms of behavior change for FIT interventions in DSCs. We address these questions in a three-group pilot RCT. In all conditions, both individuals in the couple will have access to standardized active treatment (i.e., Nicotine Replacement Therapy, a 4-week manualized educational program). In each couple, the person who first contacts the cessation program will be designated the target. In the control condition, no individual will receive financial incentives. In the single-target FIT condition, the target will additionally receive financial incentives for program attendance and abstinence at follow-up. In the dyadic FIT condition, both members of each couple (target + partner) will receive financial incentives for program attendance and smoking abstinence. The primary feasibility outcome is % of participants who complete all sessions of the study; the primary tolerability outcomes are the % of participants opting to discontinue study participation due to study procedures. Primary outcomes are program completion and point-prevalence abstinence at 3 months. Potential mechanisms of behavior change include both individual factors (e.g., change in self-efficacy and motivation) and dyadic factors (e.g., joint quitting, partner support). Preliminary data on feasibility, efficacy, and mechanisms of behavior change will allow us to determine whether the dyadic format for FIT is viable for smoking cessation in DSCs. The findings will be directly used to inform future RCTs testing FIT to promote quitting in this treatment refractory population.