A Web-Based Intervention with Adolescent Smokers of Appalachian Ohio

描述（由申请人提供）：对于戒烟努力来说，青春期可能是一个具有独特挑战性但重要的生命时期。对于生活在该国阿巴拉契亚农村地区的青少年来说，与青少年吸烟者打交道的许多挑战更加复杂。与这一观点相一致的是，阿巴拉契亚地区成人和青少年的吸烟率远高于全国平均水平。此外，阿巴拉契亚地区的青少年开始吸烟的年龄似乎更小，这与以后戒烟的难度更大有关。为了满足阿巴拉契亚农村青少年吸烟者的治疗需求，本研究（采用两组随机对照设计，每组35人）将评估一项新的、创新的基于网络的应急管理（CM）计划对生活在俄亥俄州阿巴拉契亚地区的青少年吸烟者戒烟的有效性和疗效。因为这个CM项目是基于网络的，它可以在家里完成，作为农村青少年吸烟者的治疗选择，这比其他需要频繁前往临床机构的治疗更可行。从对成人和青少年吸烟者的初步工作来看，预计该计划将在俄亥俄州阿巴拉契亚地区的青少年吸烟者中促进戒烟非常有效。这项研究还将包括六周的治疗后随访，以确定治疗后吸烟行为的一致性或变化。本研究的第二个目的是探讨冲动行为不同维度的治疗前评估作为治疗结果的预测因子。我们将使用移动行为研究实验室完成这方面的研究。这些行为评估将提供有关青少年吸烟者在治疗期间无法有效改变其吸烟行为的具体行为风格的详细信息。这些信息应该为项目修改提供新的重点，以改进这些项目，使其对阿巴拉契亚青少年戒烟或减少吸烟的努力更有效。在美国，吸烟是最主要的可预防的死亡原因，在阿巴拉契亚地区，成年人和青少年的吸烟率一直高于全国平均水平。本研究将评估一种新的行为治疗戒烟与阿巴拉契亚青少年吸烟者。此外，这项研究将促进我们对不同行为方式与这些青少年戒烟或在戒烟治疗项目中减少吸烟能力的关系的理解。后一目标有望指导吸烟治疗的修改，使这些治疗对试图戒烟或减少吸烟的青少年更有效。

DESCRIPTION (provided by applicant): Adolescence may represent a uniquely challenging but important life period for smoking-cessation efforts. Many of the challenges in working with adolescent smokers are compounded for adolescents living in rural Appalachian regions of the country. Consistent with this notion are findings that smoking rates for adults and adolescents are considerably higher in Appalachia than national averages. Also, adolescents in Appalachia appear to start smoking at younger ages, which has been associated with greater difficulties quitting smoking later in life. In response to the need for treatments appropriate for adolescent smokers in rural Appalachia, this research (utilizing a two-group randomized-control design, n = 35 per group) will evaluate the effectiveness and efficacy of a new and innovative Web-based contingency management (CM) program for smoking abstinence with adolescent smokers living in Appalachian Ohio. Because this CM program is Web-based it can be completed from home, which stands to be more viable as a treatment option for rural adolescent smokers than other treatments requiring frequent trips to a clinical facility. From preliminary work with adult and adolescent smokers, it is expected this program will be highly effective in promoting smoking abstinence among adolescent smokers in Appalachian Ohio. This research also will involve six weekly post-treatment follow-up sessions to determine consistencies or changes in smoking behavior following treatment. A secondary goal of this research is to explore pre-treatment assessments of different dimensions of impulsive behavior as predictors of treatment outcome. We will complete this aspect of the research using a Mobile Behavioral Research Lab. These behavioral assessments will provide highly detailed information about the specific behavioral styles of adolescent smokers who are unable to effectively change their smoking behavior during treatment. This information should provide new points of emphasis for program modifications to improve these programs to be more effective for Appalachian adolescents most challenged in their efforts to quit or reduce smoking. Cigarette smoking is the top preventable cause of death in the United States, and rates of smoking for adults and adolescents are consistently higher in Appalachian regions than national averages. This study will evaluate a novel behavioral treatment for cigarette smoking cessation with Appalachian adolescent smokers. Further, this study will advance our understanding of the different behavioral styles associated with these adolescents' ability to quit or reduce smoking during a treatment program for smoking cessation. This latter aim is expected to guide smoking treatment modifications to make these treatments more effective for adolescents who are trying to quit or reduce smoking.