Treatment Engagement Intervention for Smokers with Psychiatric Disorders

患有精神疾病的吸烟者的治疗参与干预

• 批准号: 8859426
• 负责人: MARK G MYERS
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8859426
• 关键词: Accounting; Address; Area; Awareness; Behavior Therapy; Behavioral; Callback; Caring; Cessation of life; Cigarette; Clinic; Clinical; Clinical Trials; Consultations; Data; Development; Disease; Effectiveness; Enrollment; Feedback; Focus Groups; Funding; Future; General Population; Goals; Group Interviews; Health Priorities; Health Services Accessibility; Healthcare; Healthcare Systems; Hybrids; Individual; Intervention; Interview; Literature; Manuals; Medical; Mental Depression; Mental Health; Mental disorders; Methodology; Methods; Mission; Morbidity - disease rate; Outpatients; Participant; Patients; Persons; Pharmacological Treatment; Phase; Pilot Projects; Population; Procedures; Process; Protocols documentation; Qualitative Evaluations; Recruitment Activity; Research; Research Project Grants; Sales; Sampling; Services; Smoke; Smoker; Smoking Cessation Intervention; Structure; Subgroup; Telephone; Testing; Tobacco; Tobacco Use Cessation; Tobacco use; Treatment Protocols; Veterans; Withholding Treatment; Work; behavioral health; brief intervention; burden of illness; chronic care model; cigarette smoking; design; efficacy trial; evidence base; health administration; health disparity; implementation trial; improved; innovation; mortality; premature; programs; randomized trial; service utilization; smoking cessation; smoking prevalence; success; therapy development; tobacco control; treatment program

 DESCRIPTION (provided by applicant): Background: Research consistently indicates that individuals with psychiatric disorders smoke at rates substantially higher than those of the general population. Despite awareness of the high rates of tobacco use and disproportionate burden of tobacco related disease burden borne by individuals with psychiatric disorders, limited research has addressed this health disparity. In accord with evidence that the majority of smokers with psychiatric disorders express a desire to quit smoking, the VHA has been a national leader for integration of smoking-cessation services in health care settings, and increasingly is addressing tobacco use among veterans with psychiatric disorders. However, rates of treatment utilization by smokers with psychiatric disorders are low; a review of referrals to VA San Diego Healthcare System (VASDHS) tobacco cessation program for veterans with psychiatric disorders indicated that only 16.2% (113 of 638) of patients referred for treatment between August 1, 2012 and July 31, 2013 engaged in smoking cessation treatment within 30 days of referral completion. This is of particular concern as existing research with psychiatric populations indicates that treatment approaches found effective for the general population, including both behavioral and pharmacologic intervention, are also effective for smokers with psychiatric disorders. While a majority of motivated smokers may attempt to quit on their own, putting smokers in contact with structured treatments will likely improve odds of success. As such, engaging smokers with psychiatric disorders in formal treatment for tobacco cessation is an issue of particular importance and relevance to VA. Objectives: The objective of this research project is to develop a brief intervention delivered by telephone to facilitate engagement in outpatient tobacco cessation treatment. Treatment development will be informed by adaptation of an existing, in-person, protocol and qualitative evaluation of facilitators and barriers to participation in tobacco cessation treatment by veterans with psychiatric disorders. The resulting intervention will be utilized in future clinical trials. Primary Aim:The primary aim of this pilot project is to employ a sequential qualitative treatment development procedure in order to adapt for telephone delivery an existing in-person intervention for enhancing tobacco use treatment participation. The aim is to produce a manualized treatment protocol and telephone script for intervention delivery. Secondary Aim: to establish participant recruitment and enrollment procedures for a subsequent randomized trial and to obtain preliminary treatment engagement data. Methods: This is a qualitative treatment development project utilizing a sequential design where information from successive phases will be used to refine intervention content and delivery. Participants will include 50 veteran tobacco users with a psychiatric disorder. Participants will be recruited from mental health clinics and from individuals who are referred for outpatient tobacco cessation treatment in the VA San Diego Healthcare System (VASDHS). We will adapt a treatment engagement intervention developed for tobacco users hospitalized for depression. Adaptation of the treatment engagement intervention for telephone delivery will be informed by qualitative study including focus groups and pilot implementation of the intervention along with telephone "callback" interviews. Focus group interviews will be carried out to explore what veterans consider to be potential barriers and facilitators to participating in an tobacco cessation treatment programs. Callback interviews will be used to refine the final treatment protocol.

 描述（由申请人提供）： 背景：研究始终表明，患有精神疾病的个体以高于一般人群的速度烟雾烟雾。尽管意识到烟草使用率很高，并且伯恩（Burnen）对烟草相关疾病的伯恩（Burnen）伯恩（Burnen）受到精神疾病患者的负担，但有限的研究仍解决了这种健康差异。根据证据表明，大多数精神疾病的吸烟者表达了戒烟的愿望，VHA一直是在卫生保健环境中融入吸烟服务的国家领导者，并且越来越多地解决了退伍军人与精神病患者的烟草使用。但是，患有精神疾病的吸烟者的治疗率很低。对VA San Diego Healthcare系统（VASDHS）戒烟计划的转诊审查，针对患有精神疾病的退伍军人表明，在2012年8月1日至2013年7月31日之间，在2013年8月1日至2013年7月31日之间，只有16.2％（638）的患者在参考完成的30天内接受治疗。这是特别关注的，因为现有的精神病学人群的现有研究表明，发现对普通人群有效的治疗方法，包括行为和药理学干预措施，对患有精神疾病的吸烟者也有效。虽然大多数成熟的吸烟者可能会自行戒烟，但可能会使吸烟者与结构化治疗接触 提高成功的几率。因此，吸烟者患有精神疾病的烟草戒烟是一个与VA特别重要和相关的问题。目的：该研究项目的目的是制定电话通过电话提供的简短干预措施，以促进参与门诊烟草戒烟治疗。治疗开发将通过适应现有的，面对面的，协议和定性评估的促进者和参与烟草戒烟治疗的障碍来获取。 患有精神疾病。最终的干预措施将在以后的临床试验中使用。 主要目的：该试点项目的主要目的是采用连续定性治疗开发程序，以适应电话传送现有的面对面干预措施，以增强烟草使用治疗的参与。目的是制作手动处理方案和电话脚本以进行干预。次要目的：建立参与者的招聘和入学程序，以进行随后的随机试验，并获得初步的治疗参与数据。方法：这是一个定性治疗开发项目，利用连续设计，其中将使用成功阶段的信息来完善干预内容和交付。参与者将包括50种精神疾病的老将烟草使用者。参与者将从精神卫生诊所和在VA San Diego Healthcare System（VASDHS）中被转诊为门诊戒烟治疗的个人。我们将适应为烟草用户开发的治疗参与干预措施。定性研究将对电话交付的治疗参与干预进行调整，包括焦点小组和试点干预措施以及电话“回调”访谈。将进行焦点小组访谈，以探讨退伍军人认为是参加烟草戒烟治疗计划的潜在障碍和促进者。回调访谈将用于完善最终治疗方案。