Computer-based MI to engage smokers living with HIV in tobacco quitline treatment

基于计算机的 MI 让感染艾滋病毒的吸烟者参与戒烟热线治疗

• 批准号: 8467102
• 负责人: RICHARD A BROWN
• 金额: $ 32.85万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8467102
• 关键词: Abstinence; Accounting; Cardiovascular Diseases; Cardiovascular system; Caring; Cessation of life; Cigarette Smoker; Clinical Research; Communities; Computers; Counseling; Data; Development; Dietary Intervention; Disease; Effectiveness; Feedback; General Population; Geographic state; Goals; HIV; Health; Health Benefit; Health Personnel; Highly Active Antiretroviral Therapy; Hour; Individual; Intervention; Interview; Knowledge; Life; Link; Lung; Lung diseases; Meta-Analysis; Modification; Morbidity - disease rate; Outcome; Participant; Patient Self-Report; Patients; Prevalence; Process; Public Health; Publishing; Randomized Controlled Trials; Readiness; Relative (related person); Reporting; Research; Research Personnel; Resources; Risk; Risk Behaviors; Scientific Advances and Accomplishments; Self Efficacy; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Smoking and Health Research; Telephone; Testing; Time; Tobacco; Tobacco use; Training; Treatment Efficacy; Withholding Treatment; Work; base; brief intervention; cigarette smoking; cohort; cost; cost effective; follow-up; health related quality of life; innovation; interest; mortality; motivational intervention; nicotine patch; non-smoking; nutrition; nutrition education; post intervention; programs; prototype; public health relevance; quitline; satisfaction; smoking cessation

DESCRIPTION (provided by applicant): The prevalence of cigarette smoking among people living with HIV (PLWH) in the U.S. is estimated at 40-70%, as the smoking rate in the general population has declined to 20.6%. Tobacco use has significant health consequences for PLWH, accounting for nearly 25% of all deaths in a multinational cohort of PLWH who used highly active antiretroviral therapy (HAART). Interactions among tobacco, the HIV virus, and HAART render PLWH who smoke even more susceptible than smokers without HIV to cardiovascular and lung diseases, and also increases their risk for a multitude of HIV-related illnesses. Against this backdrop, very little research on smoking cessation interventions for PLWH has been published, and none has evaluated approaches that could be easily disseminated and integrated into standard HIV care. The long-term goal of this program of research is to disseminate an effective, brief computer-based intervention that can be readily integrated into HIV treatment settings to motivate tobacco quitline use among smokers living with HIV. The overall objective of this application is to develop this computer intervention, modify it based on initial piloting and feedback, and obtain preliminary data supporting the efficacy of the intervention. This will be accomplished by pursuing three specific aims: 1) to develop and conduct preliminary pilot testing (n=16) of a brief, computer- based intervention intended to motivate tobacco quitline use among cigarette smokers living with HIV (CI- METQ; Computer Intervention to Motivate Engagement in Tobacco Quitline treatment) and to develop and pilot (n=4) a computer-based, time matched nutrition education for PLWH control intervention (NC) equated for the offer of a tobacco quitline referral and 8 weeks of free nicotine patch for those who engage in quitline treatment, 2) to conduct a preliminary smoking cessation RCT with 100 PLWH, comparing CI-METQ vs. NC, with predictions that CI-METQ relative to NC will result in increased readiness, higher rates of tobacco treatment engagement, more quit smoking attempts and higher rates of 7-day point prevalence abstinence rates at 1-, 3- and 6-month follow-ups. Health-related quality of life over this period will also be examined, and 3) to examine CI-METQ's effects on key mechanisms during the computer session and their associations with tobacco treatment engagement and smoking outcomes at 1-, 3- and 6-month follow-ups. The research proposed is innovative in that: 1) no previous studies have implemented a computer-based motivational intervention targeting tobacco use in PLWH, 2) the CI-METQ proposed in this application is focused on promoting tobacco treatment engagement rather than smoking cessation, per se, and 3) no previous studies have attempted to link PLWH smokers with free tobacco quitlines, an efficacious and readily available resource. The CI-METQ will have potential for broad reach within HIV treatment settings and if effective, will have significant overall impact in reducing smoking-related morbidity and mortality and in advancing scientific knowledge regarding the use of brief, computer interventions to change health risk behaviors in PLWH.

描述（由申请人提供）：美国艾滋病毒感染者 (PLWH) 的吸烟率估计为 40-70%，而总人口的吸烟率已下降至 20.6%。烟草使用对 PLWH 造成严重的健康影响，在使用高效抗逆转录病毒疗法 (HAART) 的跨国 PLWH 队列中，烟草使用占所有死亡人数的近 25%。烟草、HIV 病毒和高效抗逆转录病毒治疗 (HAART) 之间的相互作用使吸烟的感染者比未感染 HIV 的吸烟者更容易患心血管和肺部疾病，并且还增加了他们患多种 HIV 相关疾病的风险。在此背景下，关于艾滋病毒感染者戒烟干预措施的研究很少，也没有评估可以轻松传播并纳入标准艾滋病毒护理的方法。该研究计划的长期目标是传播一种有效、简短的基于计算机的干预措施，该干预措施可以很容易地融入艾滋病毒治疗环境中，以激励感染艾滋病毒的吸烟者使用戒烟热线。该应用程序的总体目标是开发这种计算机干预措施，根据初步试验和反馈对其进行修改，并获得支持干预措施有效性的初步数据。这将通过追求三个具体目标来实现：1) 制定并进行初步试点测试（n=16）一项简短的、基于计算机的干预措施，旨在激励感染艾滋病毒的吸烟者使用戒烟热线（CI-METQ；计算机鼓励参与戒烟热线治疗的干预措施），并为 PLWH 控制干预 (NC) 开发和试点 (n=4) 基于计算机、时间匹配的营养教育，相当于提供戒烟热线转介以及为那些参与戒烟线治疗的人提供 8 周的免费尼古丁贴片，2) 对 100 名 PLWH 进行初步戒烟随机对照试验，比较 CI-METQ 与 NC，并预测 CI-METQ 相对于 NC 将导致戒烟准备度提高、更高的烟草治疗参与率、更多的戒烟尝试以及 1、3 和 6 个月随访中的 7 天点流行率戒烟率更高。还将检查此期间与健康相关的生活质量，以及 3) 检查 CI-METQ 在计算机会话期间对关键机制的影响及其与 1、3 和 6 个月时烟草治疗参与度和吸烟结果的关联后续行动。拟议的研究具有创新性，因为：1）以前没有研究针对 PLWH 中的烟草使用实施基于计算机的动机干预，2）本申请中提出的 CI-METQ 侧重于促进烟草治疗参与而不是戒烟，根据se，以及 3) 之前没有研究试图将 PLWH 吸烟者与免费戒烟热线联系起来，免费戒烟热线是一种有效且随时可用的资源。 CI-METQ 将具有在艾滋病毒治疗环境中广泛影响的潜力，如果有效，将在降低与吸烟相关的发病率和死亡率方面产生重大的总体影响，并提高有关使用简短的计算机干预措施改变健康风险行为的科学知识。艾滋病病毒感染者。