Mobile Health Technology for Personalized Tobacco Cessation Support in Laos

移动健康技术在老挝提供个性化戒烟支持

• 批准号: 10331790
• 负责人: Thanh C. Bui
• 金额: $ 15.79万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10331790
• 关键词: Abstinence; Address; Adoption; Adult; Applications Grants; Behavior Therapy; Biochemical; Cambodia; Cambodian; Cellular Phone; Cigarette; Clinics and Hospitals; Collaborations; Communication; Confidence Intervals; Control Groups; Country; Data; Developed Countries; Development; Ecological momentary assessment; Educational workshop; Enrollment; Evaluation; Future; Goals; Government Agencies; Health; Health Promotion; Health Technology; Hospitals; Image; Income; Influentials; Institution; Intervention; Language; Laos; Manuscripts; Mobile Health Application; Morbidity - disease rate; Outcome; Participant; Patient Self-Report; Patients; Persons; Phase; Pilot Projects; Preparation; Prevalence; Proliferating; Province; Public Health; Publishing; Randomized; Randomized Controlled Trials; Relative Risks; Reporting; Research; Research Methodology; Research Personnel; Services; Smoker; Smoking Cessation Intervention; Surveys; Technology; Testing; Tobacco; Tobacco Use Cessation; Tobacco smoke; Tobacco use; Training; Wireless Technology; Woman; World Health Organization; base; brief advice; cost effective; efficacy evaluation; follow-up; global health; health care service; insight; knowledge base; low and middle-income countries; mHealth; men; mobile computing; mortality; nicotine replacement; novel; personalized intervention; personalized medicine; programs; randomized trial; recruit; secondary outcome; self help; sex; smoking cessation; smoking prevalence; social culture; standard care; support network; text messaging intervention; tobacco cessation intervention; tobacco control; tool; treatment group; treatment program

PROJECT SUMMARY: Tobacco use remains the leading cause of preventable morbidity and mortality worldwide. Although tobacco use has declined in developed nations in recent decades, smoking prevalence remains strikingly high in many low- and middle-income countries (LMICs). In Lao People's Democratic Republic (Lao PDR), 51% of adult men and 7% of adult women smoke tobacco. The development and evaluation of sustainable tobacco cessation interventions suitable for widespread adoption in nations such as Lao PDR are pressing public health needs. To address this need, we propose a project that adapts our theoretically and empirically based mobile health (mHealth) technology to help people quit smoking cigarettes in Lao PDR. This mHealth approach includes a fully automated, interactive, personalized, smartphone- delivered intervention for behavioral treatment, delivered through our Insight™ platform. mHealth interventions are proliferating in developed countries, but efforts to utilize similar approaches in Lao PDR are extremely limited. The World Health Organization acknowledges that using mHealth for health promotion is cost-effective, scalable, and sustainable, including for the least-developed countries. Additionally, text-messaging interventions for smoking cessation have been shown to be effective, cost-effective, and affordable for tobacco control globally. We have already developed the mHealth platform and intervention approach proposed for this study and pilot tested this technology with a group of Cambodian smokers. Preliminary results demonstrated that our mHealth technology is efficacious, highly feasible, appropriate, and potentially scalable for LMIC settings. This proposed project for Lao PDR includes 2 main phases. In the R21 Phase, we will use formative research methods to adapt our intervention content to the sociocultural context, language, and communication styles of Laotians. In the subsequent R33 Phase, we will conduct a randomized controlled trial (RCT) to evaluate the efficacy of our mHealth intervention and technology. Adult smokers of both sexes will be recruited through 2 large hospitals: Setthathirath Hospital in Vientiane and Champasak Hospital in Champasak Province. Participants (n=500) will be randomized to 1 of 2 treatment groups: Standard Care (SC; n=250) or Automated Treatment (AT; n=250). SC consists of brief advice to quit smoking delivered by research staff, self- help written materials, and a 2-week supply of NRT (transdermal patches). AT consists of all SC components plus a fully automated smartphone-based treatment program that involves interactive and personalized proactive messages, images, or videos. The primary health outcome of the trial is biochemically confirmed self- reported 7-day point prevalence abstinence 12 months post study enrollment. The project also aims to advance mHealth research capacity in Lao PDR and sustain the US-Lao PDR research network. The project has the potential to transform healthcare services for tobacco cessation treatment throughout the country and, ultimately, to significantly reduce tobacco-induced morbidity and mortality.

项目摘要：烟草使用仍然是可预防的发病率和死亡率的主要原因 尽管近几十年来发达国家的烟草使用量有所下降，但吸烟率仍然很高。 老挝人民民主共和国的许多低收入和中等收入国家 (LMIC) 仍然非常高。 共和国（老挝人民民主共和国），51%的成年男性和7%的成年女性吸烟。 对适合在以下国家广泛采用的可持续戒烟干预措施进行评估： 老挝人民民主共和国面临着紧迫的公共卫生需求，为了满足这一需求，我们提出了一个适应我们的项目。 基于理论和经验的移动健康（mHealth）技术帮助人们戒烟 在老挝人民民主共和国，这种移动医疗方法包括完全自动化、交互式、个性化的智能手机- 通过我们的 Insight™ 平台提供行为治疗干预。 发达国家正在激增，但在老挝人民民主共和国利用类似方法的努力却极其有限 世界卫生组织承认，利用移动医疗促进健康具有成本效益。 可扩展、可持续，包括对最不发达国家而言。 戒烟干预措施已被证明是有效的、具有成本效益的，并且对烟草来说是负担得起的 我们已经为此开发了移动医疗平台和干预方法。 对一组柬埔寨吸烟者进行的研究和试点测试显示了初步结果。 我们的移动医疗技术对于中低收入国家来说是有效的、高度可行的、合适的并且具有可扩展性 老挝人民民主共和国的拟议项目包括两个主要阶段。在 R21 阶段，我们将采用形成阶段。 使我们的干预内容适应社会文化背景、语言和交流的研究方法 在接下来的R33阶段，我们将进行一项随机对照试验（RCT）来了解老挝人的风格。 将招募男女成年吸烟者来评估我们的移动健康干预和技术的功效。 通过2家大型医院：万象的Setthathirath医院和占巴塞的占巴塞医院 参与者 (n=500) 将被随机分配到 2 个治疗组中的 1 个：标准护理 (SC；n=250) 或 自动治疗（AT；n=250）包括研究人员自我戒烟的简短建议。 帮助书面材料，以及 2 周供应的 NRT（透皮贴剂 AT）包含所有 SC 成分。 加上基于智能手机的全自动治疗程序，涉及互动和个性化 试验的主要健康结果是通过生化方法自我确认的。 报告研究入组后 12 个月的 7 天点戒断率 该项目还旨在 老挝人民民主共和国的移动医疗研究能力并维持美国-老挝人民民主共和国研究网络。 有潜力改变全国戒烟治疗的医疗保健服务，并且， 最终，显着降低烟草引起的发病率和死亡率。