Effect of Helpers Program On-line Training on Smoking Relapse and Social Networks

帮助者计划在线培训对吸烟复吸和社交网络的影响

基本信息

批准号：
10515605
负责人：
MYRA L. MURAMOTO
金额：
$ 63.75万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-01 至 2026-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10515605
关键词：
Abstinence Active Listening Address Adult Arizona Behavior Behavior Therapy Behavioral Biochemical Cancer Etiology Cessation of life Characteristics Cigarette Client Communication Complex Counseling Educational Intervention Effectiveness Exposure to Feasibility Studies Feedback Gender Genital Genitalia Hematologic Neoplasms Individual Intervention Intervention Studies Malignant Neoplasms Mediating Methodology Methods Modeling Motivation Outcome Outcome Study Pamphlets Participant Patient Self-Report Pharmaceutical Preparations Pharmacological Treatment Pharmacotherapy Pilot Projects Prevalence Prevention Research Prevention program Process Randomized Randomized Controlled Trials Relapse Reporting Research Research Design Sampling Shapes Smoke Smoker Smoking Smoking Behavior Smoking Cessation Intervention Smoking Status Social Environment Social Network Source Structure System Testing Time Tobacco Use Cessation Tobacco use Training United States Urinary system base behavior change brief intervention care outcomes cigarette smoke cigarette smoking design disorder later incidence prevention effectiveness evaluation evidence base follow-up innovation member multi-component intervention novel strategies preventive intervention primary outcome programs quitline secondary outcome skills smoking abstinence smoking cessation smoking cue smoking relapse systematic review theories tobacco user tobacco-free treatment as usual

项目摘要

Abstract Despite major gains in smoking cessation treatment, over half of recently quit smokers will relapse within the first year. Two systematic reviews of relapse prevention studies came to different conclusions on effectiveness of behavioral interventions. Existing evidence in relapse prevention is limited by study designs, methodology, and conceptual approaches to behavioral interventions. Different approaches to relapse prevention studies, and to the interventions themselves are needed to advance the long-term understanding and outcomes of smoking relapse prevention. To date, relapse prevention interventions have focused on the newly abstinent smoker (“abstainer”), and not attempted to directly or indirectly influence the abstainer’s personal network (PN), e.g. by helping the abstainer influence others in their PN to quit. Personal networks exert powerful effects on initiating and maintaining smoking behavior, and can facilitate maintaining abstinence or trigger relapse. A “help others” intervention that seeks to increase the abstainer’s ability to influence smokers in their PN to quit – thereby creating a PN social environment more supportive of long-term abstinence - may have a beneficial effect on relapse. The Helpers SQ intervention encourages abstainers to reinforce their own abstinence through helping others quit, and to proactively influence their PN to be more conducive to long-term smoking abstinence. Framing relapse as a dynamic and complex process, the Helpers Stay Quit (Helpers SQ) intervention is a conceptually novel approach to relapse prevention that integrates different behavioral theories into a multifaceted intervention model presented as an on-line tobacco cessation brief intervention training. Helpers SQ teaches abstainers how to encourage other tobacco users to quit and avoid relapse through a non- confrontational “helping conversation” (HC) that encourages quitting and use of evidence-based cessation aids (e.g. quitlines, cessation medications) without confrontation and nagging. Our pilot feasibility study of Helpers SQ (N=104) with abstainers from Arizona’s state quitline compared 30-day abstinence at 7-months with a propensity score matched sample from quitline clients not exposed to Helpers SQ. Preliminary results: Helpers SQ participants reported higher 30-day abstinence than non-participants (82% vs. 36%, Difference = 46% [95% CI: 37%, 56%, p<0.0001]). Encouraged by these results, we hypothesize that quitline abstainers exposed to Helpers SQ will have higher 30-day and 7-day point prevalence abstinence than those receiving quitline follow-up usual care, and that the effect of Helpers SQ may be mediated by PN characteristics. To test this hypothesis, we propose a pragmatic randomized controlled trial (N=940) with embedded mixed-methods PN study to assess the effect of Helpers SQ training on proportion and duration of abstainers’ abstinence over time, and on abstainer’s PN interactions related to smoking and smoking cessation. Metrics derived from the PN study will be used for mediational analyses of overall, and gender-based effects of Helpers SQ on smoking relapse.

抽象的尽管戒烟治疗方面有很大的收获，但最近戒烟的一半以上的吸烟者将在内部缓解第一年。关于救济预防研究的两项系统评价得出了有效性的不同结论行为干预措施。现有的预防证据受到研究设计，方法论的限制，和行为干预的概念方法。救济预防研究的不同方法，需要进行干预本身，以提高长期理解和结果预防吸烟。迄今为止，中继预防干预措施集中在新戒烟上吸烟者（“弃权”），而不是直接或间接影响戒酒者的个人网络（PN），例如通过帮助戒酒者在PN中影响他人退出。个人网络发挥强大对启动和维持吸烟行为的影响，并可以促进戒酒或触发复发。一种“帮助他人”的干预措施，旨在增加戒酒者影响吸烟者的能力 PN退出 - 从而创造PN社会环境更支持长期禁欲 - 可能有一个对救济的有益影响。助手SQ干预鼓励弃权者加强自己的通过帮助他人辞职，并主动影响其PN的禁欲，以使其长期导电更具导电性戒烟。框架继电器作为一个动态而复杂的过程，助手保持戒烟（助手SQ）干预是一种预防退休预防的概念性新颖方法，它整合了不同的行为理论作为在线烟草停止简短干预培训的多方面干预模型中。帮助者SQ教授戒酒者如何鼓励其他烟草使用者退出并避免通过非 - 对抗性的“帮助对话”（HC）鼓励安静并使用循证戒烟艾滋病（例如，戒烟，停止药物）而没有对抗和na。我们对助手的飞行员可行性研究 SQ（n = 104）与亚利桑那州的戒烟者的戒酒者相比，将7个月的30天禁欲与一个倾向分数与Quitline客户端的样本匹配，但未暴露于Helpers SQ。初步结果：帮助者 SQ参与者报告的30天节制高于非参与者（82％比36％，差异= 46％ [95％CI：37％，56％，p <0.0001]）。在这些结果的鼓励下，我们假设戒烟者暴露了对于助手，SQ比接受Quitline的人将具有更高的30天和7天的戒酒。后续的通常护理，并且帮助者SQ的效果可能是由PN特征介导的。测试这个假设，我们提出了一项具有嵌入式混合方法PN的务实的随机对照试验（n = 940）研究以评估帮助者SQ培训对戒酒比例和持续时间的影响时间，以及与吸烟和戒烟有关的戒酒中的PN相互作用。源自 PN研究将用于对助手SQ对吸烟的整体和基于性别的影响的中介分析复发。