Advancing Tobacco Research by Integrating Systems Science and Mixture Models

通过整合系统科学和混合模型推进烟草研究

• 批准号: 8537877
• 负责人: STEPHANIE T LANZA
• 金额: $ 15.89万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8537877
• 关键词: Abstinence; Accountability; Address; Adult; Affect; American; Area; Awareness; Centers for Disease Control and Prevention (U.S.); Cessation Research; Cessation of life; Characteristics; Clinical Trials; Collection; Complex; Data; Data Collection; Data Set; Dependence; Disease; Environmental Risk Factor; Etiology; Failure; Future; Goals; Health; Individual; Institute of Medicine (U.S.); Intervention; Malignant Neoplasms; Marital Status; Measurement; Methodology; Methods; Modeling; Morbidity - disease rate; Motivation; Nicotine Dependence; Outcome; Participant; Pharmacotherapy; Population Heterogeneity; Process; Public Health; Recommendation; Relapse; Reporting; Research; Research Personnel; Role; Science; Selection for Treatments; Smoker; Smoking; Smoking Cessation Intervention; Social support; Subgroup; System; Techniques; Testing; Time; Tobacco; Tobacco use; United States; United States Dept. of Health and Human Services; Withdrawal; Withholding Treatment; Work; cigarette smoking; contextual factors; design; disability; experience; improved; innovation; meetings; mortality; novel; novel strategies; population health; prevent; programs; response; smoking cessation; smoking intervention; success; therapy development; treatment effect; uptake; Abstinence; Accountability; Address; Adult; Affect; American; Area; Awareness; Centers for Disease Control and Prevention (U.S.); Cessation Research; Cessation of life; Characteristics; Clinical Trials; Collection; Complex; Data; Data Collection; Data Set; Dependence; Disease; Environmental Risk Factor; Etiology; Failure; Future; Goals; Health; Individual; Institute of Medicine (U.S.); Intervention; Malignant Neoplasms; Marital Status; Measurement; Methodology; Methods; Modeling; Morbidity - disease rate; Motivation; Nicotine Dependence; Outcome; Participant; Pharmacotherapy; Population Heterogeneity; Process; Public Health; Recommendation; Relapse; Reporting; Research; Research Personnel; Role; Science; Selection for Treatments; Smoker; Smoking; Smoking Cessation Intervention; Social support; Subgroup; System; Techniques; Testing; Time; Tobacco; Tobacco use; United States; United States Dept. of Health and Human Services; Withdrawal; Withholding Treatment; Work; cigarette smoking; contextual factors; design; disability; experience; improved; innovation; meetings; mortality; novel; novel strategies; population health; prevent; programs; response; smoking cessation; smoking intervention; success; therapy development; treatment effect; uptake

DESCRIPTION (provided by applicant): Smoking is the leading preventable cause of disease, disability, and death in the United States, but approximately one-fifth of adults smoke cigarettes. Among the approximately 15 million smokers who make a quit attempt every year, the great majority eventually relapse even with smoking cessation aids. While much is known about the etiology of smoking dependence, substantial work remains to effectively help smokers quit and ultimately prevent smoking-related death, most commonly due to cancer, and disease. Smoking cessation occurs within the context of a wide variety of interrelated individual and environmental factors, many of which change rapidly during the first few weeks after quitting. We propose two areas of scientific inquiry to substantially improve smoking cessation outcomes. First, a better understanding of the complex system dynamics that unfold during the smoking cessation process will guide clinicians in the development of interventions that adapt over time to individuals' changing needs and response to particular treatments. Second, a more thorough scientific understanding of differential treatment effects for individuals with different profiles t baseline will guide clinicians in selection of treatments that hold the most promise for different types of individuals. The overall goal of this project is to further the science of smoking cessation by integrating a novel systems-science approach, time-varying effect models, and mixture models, and apply the new approach to analysis of ecological momentary assessment (EMA) data on tobacco use. The specific aims of this project are (1) To establish the relation between the experience of withdrawal over time and survival to smoking cessation milestones (lapse and relapse), and examine the impact of treatment condition, baseline characteristics, and time-varying covariates; (2) To examine differential treatment effects across latent subgroups of individuals reflecting key combinations of baseline factors; (3) To identify latent subgroups characterized by unique dynamic processes occurring during a smoking cessation attempt; and (4) To promote and facilitate uptake of these innovative statistical approaches by tobacco researchers. Results from the proposed project will inform the construction of highly effective smoking cessation interventions that (1) are tailored to the individual and (2) adapt to participant response over time. Importantly, the overall impact of this project extends far beyond the proposed set of analyses; this project will accelerate the pace of smoking cessation research in a sustained, powerful way through rapid, programmatic dissemination of important new analytic methods and design considerations to tobacco researchers.

描述（由申请人提供）：吸烟是美国疾病，残疾和死亡的主要预防原因，但大约五分之一的成年人吸烟。 在每年大约1500万吸烟者中，即使戒烟辅助工具，绝大多数人最终都会复发。尽管对吸烟依赖的病因有很多了解，但仍有大量工作仍有有效地帮助吸烟者戒烟并最终防止与吸烟有关的死亡，这通常是由于癌症和疾病造成的。戒烟发生在各种相互关联的个体和环境因素的背景下，其中许多因素在退出后的头几周迅速变化。我们提出了两个科学探究领域，以大大改善戒烟结果。首先，对在戒烟过程中展开的复杂系统动态的更好理解将指导临床医生开发干预措施，这些干预措施会随着时间的流逝而适应个人的不断变化的需求和对特定治疗的反应。其次，对不同特征基线的个体的差异治疗效应的更彻底的科学理解将指导临床医生选择对不同类型个体的最有望的治疗方法。该项目的总体目标是通过整合一种新型的系统科学方法，随时间变化的效果模型和混合模型来进一步戒烟科学，并将新方法应用于生态瞬时评估（EMA）数据的分析。该项目的具体目的是（1）建立随着时间的推移戒断经验与戒烟里程碑（失效和复发）之间的关系，并检查治疗条件，基线特征和时变协变量的影响； （2）检查反映基线因素的关键组合的个体潜在亚组的差异治疗效应； （3）确定潜在的亚组，其特征是在戒烟期间发生的独特动态过程； （4）促进和促进烟草研究人员采用这些创新的统计方法。拟议项目的结果将告知（1）对个人量身定制的高效戒烟干预措施的构建，并且（2）随着时间的推移适应参与者的反应。重要的是，该项目的总体影响远远超出了拟议的一组分析。该项目将通过对重要的新分析方法和设计考虑到烟草研究人员的快速，程序化传播，以一种持续，有力的方式加速戒烟研究的速度。