Brief mindfulness cessation training with EMA for post-hospital depressed smokers

使用 EMA 对出院后抑郁的吸烟者进行简短的正念戒烟训练

• 批准号: 8828913
• 负责人: RICHARD A BROWN
• 金额: $ 34.27万
• 依托单位: FORDHAM UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8828913
• 关键词: Abstinence; Affect; Association Learning; Cellular Phone; Charge; Cues; Data; Depressed mood; Development; Ecological momentary assessment; Environment; Exercise; Exposure to; General Population; Goals; Home environment; Hospitalization; Hospitals; Incentives; Individual; Inpatients; Intervention; Interview; Learning; Life; Maintenance; Major Depressive Disorder; Mediator of activation protein; Mental Depression; Mental disorders; Modification; Morbidity - disease rate; Outcome; Patient Discharge; Patient Self-Report; Patients; Population; Populations at Risk; Prevalence; Psychiatric Hospitals; Psychological reinforcement; Public Health; Randomized Controlled Trials; Recruitment Activity; Relapse; Relative (related person); Research; Risk; Schedule; Series; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Specific qualifier value; Testing; Time; Tobacco; Tobacco use; Training; Treatment Efficacy; Withdrawal; behavior change; brief advice; contingency management; cost; cost effective; craving; depressed patient; depressive symptoms; effective intervention; experience; high risk; improved; innovation; inpatient psychiatric treatment; interest; mindfulness; mortality; neglect; programs; prototype; public health priorities; public health relevance; response; smoking cessation; stress reactivity; success; theories; Abstinence; Affect; Association Learning; Cellular Phone; Charge; Cues; Data; Depressed mood; Development; Ecological momentary assessment; Environment; Exercise; Exposure to; General Population; Goals; Home environment; Hospitalization; Hospitals; Incentives; Individual; Inpatients; Intervention; Interview; Learning; Life; Maintenance; Major Depressive Disorder; Mediator of activation protein; Mental Depression; Mental disorders; Modification; Morbidity - disease rate; Outcome; Patient Discharge; Patient Self-Report; Patients; Population; Populations at Risk; Prevalence; Psychiatric Hospitals; Psychological reinforcement; Public Health; Randomized Controlled Trials; Recruitment Activity; Relapse; Relative (related person); Research; Risk; Schedule; Series; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Specific qualifier value; Testing; Time; Tobacco; Tobacco use; Training; Treatment Efficacy; Withdrawal; behavior change; brief advice; contingency management; cost; cost effective; craving; depressed patient; depressive symptoms; effective intervention; experience; high risk; improved; innovation; inpatient psychiatric treatment; interest; mindfulness; mortality; neglect; programs; prototype; public health priorities; public health relevance; response; smoking cessation; stress reactivity; success; theories

DESCRIPTION (provided by applicant): Smoking rates among individuals with depression are disproportionately higher than the general population, as are their rates of tobacco-related morbidity and mortality. The majority of psychiatric hospitals ban smoking on hospital grounds, thus providing an opportunity for inpatients to experience abstinence. Yet, smokers in inpatient psychiatric settings are rarely encouraged to quit and the vast majority return to smoking immediately after discharge. An effective intervention that targets this transition, capitalizing o this valuable experience of abstinence, is needed to increase smoking cessation in this at-risk population. The goal of the proposed study is to develop a mindfulness smartphone intervention with contingency management (MSI-CM) for smoking cessation that can be readily available to depressed smokers transitioning to their natural environment following psychiatric hospitalization. The goal will be accomplished by pursuing three specific aims: 1) to develop and conduct a preliminary pilot test (n=10) of the MSI-CM receiving inpatient psychiatric treatment, 2) to conduct a preliminary randomized controlled trial (RCT) with 60 depressed smokers recruited during inpatient psychiatric treatment, comparing MSI-CM and enhanced brief advice (E-BA), with a prediction that MS-CM relative to E-BA will result in higher rates of smoking cessation at 2-week, 4-week, and 3-month post-discharge follow-ups and have longer periods of continuous abstinence after hospital discharge, and 3) to examine MSI-CM's effects on key mechanisms (hypothesized mediators) and their associations with smoking outcomes at 2-week, 4-week, and 3-month follow-ups. The research proposed is innovative in that: 1) no previous studies have implemented a mindfulness intervention targeting tobacco use among depressed smokers in a psychiatric inpatient setting or have utilized smartphones to facilitate implementation, 2) the proposed intervention targets a neglected period of inpatient-home transition, with intervention components delivered in the context of both the inpatient setting and the patient's own environment, 3) the proposed intervention differs from existing mindfulness interventions in that smokers will practice mindfulness while abstinent and experiencing withdrawal, craving and negative affect, both in the hospital and in their own environment, incentivized by contingency management, 4) the use of contingency management (to reinforce abstinence) in conjunction with mindfulness training, in order to enhance the efficacy of mindfulness intervention for smoking cessation is innovative, and 5) no previous study has collected ecological momentary assessment data on constructs related to smoking and mindfulness in this high-risk population, in both an inpatient setting and after hospital discharge If this intervention is found to be efficacious, the potential impact of this program of research wll be considerable, not only in its innovation, but because its objectives are consistent with a significant public health priority: the ready dissemination of effective, low-cost interventions to reduce morbidity and mortality among individuals with psychiatric disorders.

描述（由申请人提供）：抑郁症患者的吸烟率不成比例地高于一般人群，与烟草相关的发病率和死亡率也一样。大多数精神病医院在医院的理由禁止吸烟，从而为住院患者提供了戒酒的机会。然而，很少鼓励在住院精神病患者中吸烟者退出，绝大多数出院后立即恢复吸烟。需要一种有效的干预措施，它可以利用这种禁欲的宝贵经验来增加这种高危人群的戒烟。拟议的研究的目的是通过使用应急管理（MSI-CM）开发正念智能手机干预，以便戒烟，可以轻易地抑郁吸烟者在精神病院住院后过渡到其自然环境。 The goal will be accomplished by pursuing three specific aims: 1) to develop and conduct a preliminary pilot test (n=10) of the MSI-CM receiving inpatient psychiatric treatment, 2) to conduct a preliminary randomized controlled trial (RCT) with 60 depressed smokers recruited during inpatient psychiatric treatment, comparing MSI-CM and enhanced brief advice (E-BA), with a prediction that MS-CM relative to E-BA将导致在2周，4周和3个月分期后的戒烟速度较高的戒烟发生率，并在出院后具有较长的连续禁欲，以及3）检查MSI-CM对关键机制的影响（假设的介体）及其与2周，4周，4周和3-ew and TACLESS的影响（假设的介体）。提出的研究具有创新性：1）以前没有研究在精神病患者住院期间针对吸烟者中使用烟草使用的正念干预措施，或者利用智能手机来实施实施，2）拟议的干预措施目标是忽视的，忽视了忽视的家庭内部过渡时期，并在干预中均提供了干预措施。 患者自身的环境，3）拟议的干预措施与现有的正念干预措施有所不同，因为吸烟者将练习正念，同时在医院和在自己的环境中戒酒，渴望和负面影响，并在医院和自身环境中受到激励，四），4）4）在纠纷中的使用（强化了纠纷），以增强了对纠纷的训练，以增强了纠纷的训练，以使注意力训练，以使注意力训练，以使注意力训练，从而使您的紧张性训练（以纠正性训练）戒烟是创新的，5）先前没有研究收集有关与吸烟和正念相关的建筑物的生态瞬时评估数据，无论是在住院和住院时，出院后是否有效出院后，如果发现这项干预是有效的，则该计划的潜在影响不仅是对这项研究的潜在影响。干预措施 降低精神疾病患者的发病率和死亡率。