Spirometry to Motivate Quit-Smoking Attempts: Message Development and Testing

肺活量测定法激励戒烟尝试：消息开发和测试

• 批准号: 7484223
• 负责人: David A Kaminsky
• 金额: $ 3.76万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-15 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7484223
• 关键词: Affect; Age; Area; Behavior Therapy; Behavioral; Cancer Control; Cancer Etiology; Cardiovascular system; Cessation of life; Characteristics; Clinical; Clinical Practice Guideline; Data; Dependence; Developed Countries; Development; Disease; Effectiveness; Future; Guidelines; International Agency for Research on Cancer; Intervention; Interview; Knowledge; Laboratories; Language; Letters; Logistics; Lung; Malignant Neoplasms; Measurement; Measures; Motivation; Nicotine Dependence; Numbers; Patients; Persons; Physicians; Primary Health Care; Published Comment; Pulmonary function tests; Randomized Clinical Trials; Randomized Controlled Trials; Rate; Recording of previous events; Regression Analysis; Reporting; Research; Respiratory physiology; Risk; Role; Smoke; Smoker; Smoking; Spirometry; Standards of Weights and Measures; Structure; Telephone; Testing; Time; Tobacco smoke; Tobacco use; United States Agency for Healthcare Research and Quality; United States Dept. of Health and Human Services; University Hospitals; base; cigarette smoking; communication theory; design; effectiveness clinical trial; follow-up; improved; mortality; pulmonary function; respiratory; sex; smoking cessation; tool

DESCRIPTION (provided by applicant): Smoking is a leading cause of preventable disease in industrialized countries, especially cardiovascular and respiratory illness, and cancer. In 2000, the US Department of Health and Human Services issued an evidenced-based Clinical Practice Guideline on Treating Tobacco Use and Dependence that states that patients who smoke, but are unwilling to quit, should receive an intervention that increases their motivation to quit. Among the motivations listed is highlighting the risks of cigarette smoking. One of these risks is decreased lung function as measured by spirometry. However, the evidence that spirometry enhances smoking cessation is limited. The Agency for Healthcare Research and Quality (AHRQ) recently concluded that the available evidence does not support the use of spirometry in the primary care setting in order to improve smoking cessation rates. Nonetheless, in recognition of the potential importance of this tool, the AHRQ lists the need for randomized controlled trials to determine the role of spirometry in smoking cessation as a priority of future research. Before such controlled trials can take place, we need to understand why spirometry has not been shown to convincingly enhance smoking cessation. We believe that the primary reason spirometry has failed in this regard is because the meaning of the measurement in the context of the importance of smoking cessation is not effectively communicated to the patient who smokes. To test this hypothesis, we have designed this proposal to develop an enhanced [spirometry intervention, to include a motivational message and follow-up letter], and then test the impact of this [intevention] on the quit attempt rate. We hypothesize that providing knowledge of lung function to current smokers through an enhanced [spirometry intervention] will increase the quit attempt rate compared to delivery of these results through a standard [intervention]. Our 3 Specific Aims are: 1) To develop an enhanced motivational message about spirometry using principles of behavioral and communication theory; 2) To determine the effect of delivering spirometry results to current smokers through an enhanced [spirometry intervention] on the quit attempt rate; 3) To determine which clinical characteristics are associated with quit attempts, and identify barriers to the effectiveness of spirometry in enhancing the quit attempt rate. These data will provide the framework for developing a future large clinical trial of the effectiveness of spirometry on smoking cessation. Cigarette smoking is the leading cause cancer-related death in the world. Therefore, quitting smoking is the most important behavioral intervention in cancer control. This project will determine whether measuring lung function in smokers and delivering the results to them using a strong motivational strategy will increase the likelihood that they will try to stop smoking. If so, then this strategy can be used in a large scale study to determine whether lung function results are effective in getting people to quit smoking.

描述（由申请人提供）：吸烟是工业化国家可预防疾病的主要原因，尤其是心血管和呼吸系统疾病以及癌症。 2000年，美国卫生与公共服务部发布了一项基于证据的临床实践指南，以治疗烟草使用和依赖性，指出吸烟但不愿戒烟的患者应接受一项干预措施，以增加他们戒烟的动机。列出的动机包括强调吸烟的风险。这些风险之一是通过肺活量测定法测量的肺功能降低。但是，肺活量法可以增强戒烟的证据是有限的。医疗保健研究与质量机构（AHRQ）最近得出结论，可用的证据不支持在初级保健环境中使用肺活量测量，以提高戒烟率。尽管如此，为了认识到该工具的潜在重要性，AHRQ列出了需要随机对照试验来确定肺活量测定法在戒烟中的作用，作为未来研究的优先级。在进行此类对照试验之前，我们需要了解为什么尚未证明肺活量测量会令人信服地增强戒烟。我们认为，在这方面，肺活量测定法失败的主要原因是因为在戒烟重要性的背景下测量的含义没有有效地传达给吸烟的患者。为了检验这一假设，我们设计了这项建议，以开发增强的[肺活量测定学干预，包括动机信息和后续信]，然后测试该[无知]对退出尝试率的影响。我们假设，与通过标准[干预措施]相比，通过增强的[肺活量测定法]向当前吸烟者提供肺功能知识将提高戒烟尝试率。我们的3个具体目标是：1）使用行为和沟通理论原理发展有关肺活量法的增强动机信息； 2）通过增强的[肺活量测定法]对退出尝试率确定向当前吸烟者传递肺活量测量结果的影响； 3）确定哪些临床特征与退出尝试有关，并确定肺活量测定法在提高戒烟尝试率方面的有效性的障碍。这些数据将提供一个框架，以开发未来的大型临床试验，以了解肺活量测定法对戒烟的有效性。吸烟是世界上与癌症有关的主要死亡。因此，戒烟是癌症控制中最重要的行为干预。该项目将确定使用强大的动机策略来测量吸烟者中的肺功能并为他们提供结果，这会增加他们试图停止吸烟的可能性。如果是这样，那么可以在大规模研究中使用该策略来确定肺功能结果是否有效地吸引了吸烟。