Elective Surgery as a Teachable Moment for Smoking Cessation

择期手术作为戒烟的教学时机

• 批准号: 7226537
• 负责人: David O. Warner
• 金额: $ 7.4万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-29 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7226537
• 关键词: artificial intelligence; behavior; clinical research; health; model; smoking; smoking cessation; surgery

DESCRIPTION (provided by applicant): The term "teachable moment" refers to an event that motivates individuals to spontaneously adopt risk- reducing health behaviors. Events such as the diagnosis of smoking-related illnesses (e.g. cancer) and the scheduling of surgery spontaneously (i.e., in the absence of interventions) increase the rate of quitting. However, as recently discussed in an important conceptual paper by McBride et al, little is known about factors that make certain cueing events "teachable". They proposed a heuristic in which an event is a "teachable moment" for smoking cessation to the extent that it impacts 3 key constructs. Although appealing in concept, its validity has not been evaluated. The scheduling of surgery provides a unique opportunity to test the McBride model. This study will evaluate the McBride heuristic as applied to smoking behavior following elective surgical procedures. Two specific aims will be pursued. In the first we will develop measures of the Me Bride model specific to the surgical setting, and perform an initial evaluation of their stability and internal consistency in a group of surgical patients. In the second, we will perform a pilot study to explore the hypothesis that in patients scheduled for elective surgery: 1) higher perceptions of risks or greater negative expectancies regarding health outcomes related to smoking, 2) higher levels of positive or negative affective responses, and 3) self-concept or role expectations related to smoking will correlate with measures of self-efficacy and intent, and predict postoperative abstinence from smoking. Measures of the McBride constructs will be administered to smokers scheduled for elective surgery, whose smoking behavior will be evaluated for up to 30 days postoperatively. Structural equation modeling will be utilized both to validate the measurement model established in Aim 1 and to test the fit of the structural model associated with the McBride heuristic to postoperative smoking behavior. Relevance to public health: Evaluation of the McBride heuristic is of interest not only from a theoretical standpoint, but may have practical implications regarding the design of behavioral interventions to exploit the "teachable moment. For example, if the constructs predict behavior, interventions can attempt to specifically influence these constructs. Our overall goal is to develop effective tobacco use interventions for surgical patients; this project will be an important step in this process.

描述（由申请人提供）：“可教时刻”一词是指促使个人自发采用风险降低健康行为的事件。诸如诊断与吸烟有关的疾病（例如癌症）和手术安排（即在没有干预措施的情况下）等事件会增加戒烟率。但是，正如McBride等人最近在一份重要的概念论文中讨论的那样，关于使某些提示事件“可教”的因素知之甚少。他们提出了一种启发式，其中一个事件是戒烟的“可教时刻”，以至于它影响了3个关键结构。尽管概念上有吸引力，但尚未评估其有效性。手术的安排为测试McBride模型提供了独特的机会。这项研究将评估MCBRIDE启发式方法，因为选修手术程序适用于吸烟行为。将追求两个具体的目标。首先，我们将制定特定于手术环境的ME新娘模型的度量，并对一组手术患者的稳定性和内部一致性进行初步评估。在第二个中，我们将进行一项试点研究，以探讨以下假设：在计划进行选修手术的患者中：1）对与吸烟相关的健康结果的风险或负面期望的更高的看法，2）较高水平的正面或负面情感反应，3）与吸烟相关的自我概念或角色期望与吸烟相关的态度将与自我吸烟相关的态度和预测，并预测自我态度和预测。 MCBRIDE结构的度量将针对计划进行选修手术的吸烟者进行，其吸烟行为将在术后30天进行评估。结构方程建模将既可以验证AIM 1中建立的测量模型，又要测试与McBride启发式相关的结构模型与术后吸烟行为相关的拟合。与公共卫生的相关性：对MCBRIDE启发式的评估不仅是从理论的角度来看，而且对行为干预措施的设计可能具有实际意义，以利用“可教的时刻。