Small Financial Incentives to Promote Smoking Cessation in Safety Net Hospital Patients

促进安全网医院患者戒烟的小额经济激励

• 批准号: 9181235
• 负责人: Darla Elizabeth Kendzor
• 金额: $ 28.19万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-11-16 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9181235
• 关键词: Small; Financial; Incentives; Promote; Smoking

Tobacco use is the leading cause of preventable death in the U.S. Although the prevalence of smoking has declined to 17.8% among U.S. adults, 29.2% of those living in poverty report current smoking. Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. There is mounting evidence that offering incentives for abstinence (i.e., Contingency Management [CM]) may be an effective approach for promoting short-term smoking cessation, though few studies have demonstrated longer-term effectiveness. In addition, little attention has been paid to socioeconomically disadvantaged smokers specifically in CM intervention studies. Our preliminary work indicates that offering small escalating financial incentives for smoking abstinence dramatically increases short-term cessation rates among socioeconomically disadvantaged smokers when incentives are included as an adjunct to standard clinic-based smoking cessation treatment. Additional work is needed to evaluate the influence of this CM approach in the longer- term with a rigorous and adequately powered trial. Thus, the aims of the proposed study are to: 1) evaluate the longer-term impact of an adjunctive, low-cost CM intervention (relative to usual care) on smoking abstinence rates among economically disadvantaged individuals participating in a clinic-based smoking cessation program, and 2) identify treatment mechanisms and contextual factors associated with cessation outcomes among intervention participants using both traditional and ecological momentary assessment approaches. Economically disadvantaged individuals participating in a clinic-based smoking cessation treatment (N = 320) will be randomly assigned to 1) usual care (UC; n = 160) or 2) UC plus financial incentives for biochemically- confirmed abstinence (CM; n = 160). Those randomized to the CM intervention will have the opportunity to earn small gift cards for biochemically-verified abstinence through 12 weeks post-quit. Specifically, participants may earn $20 for abstinence on the quit date, and this amount will increase by $5 with each successive abstinent visit through 4 weeks post-quit ($150 total). Participants may additionally earn $50 gift cards for abstinence at 8 and 12 weeks post-quit. Biochemically-verified 7-day point prevalence abstinence at 26 weeks post-quit (longer-term abstinence) will be the primary outcome variable, though smoking status will be assessed at all visits. We also hope to gain a better understanding of CM treatment mechanisms and to identify other factors that directly influence cessation via traditional questionnaire and smartphone-based ecological momentary assessment approaches. Smartphone technology allows for “real-time” data collection to more accurately capture important cessation-related variables, and will be used to deliver gain-framed messages to support and strengthen the CM intervention. Findings will provide insight about new treatment targets for intervention research, and will demonstrate an effective, inexpensive, and easily implementable means by which to improve longer-term smoking cessation rates among economically disadvantaged smokers.

烟草使用是美国可预防死亡的主要原因，尽管吸烟的流行率已经下降 美国成年人中有 29.2% 的贫困人口目前吸烟。 缺点与戒烟可能性降低有关。越来越多的证据表明。 提供禁欲激励（即应急管理 [CM]）可能是一种有效的方法 促进短期戒烟，尽管很少有研究证明长期有效性。 此外，很少关注社会经济弱势吸烟者，特别是在 CM 中 我们的初步工作表明，为以下群体提供小额逐步升级的经济激励措施。 戒烟会显着提高社会经济人群的短期戒烟率 当激励措施作为标准诊所吸烟的辅助手段时，吸烟者处于不利地位 需要开展额外的工作来评估这种 CM 方法的长期影响。 因此，拟议研究的目的是：1）评估 辅助性低成本 CM 干预（相对于常规护理）对戒烟的长期影响 经济弱势群体参与诊所戒烟的比例 计划，2) 确定与戒烟结果相关的治疗机制和背景因素 使用传统和生态瞬时评估方法的干预参与者。 参加临床戒烟治疗的经济弱势群体 (N = 320) 将被随机分配到 1) 常规护理 (UC；n = 160) 或 2) UC 加上生化治疗的经济激励 确认戒断（CM；n = 160）的人将有机会接受 CM 干预。 具体来说，参与者可以在戒烟后 12 周内获得经过生化验证的戒烟小礼品卡。 在戒烟日戒烟可赚取 20 美元，并且每次连续戒烟该金额将增加 5 美元 戒烟后 4 周内进行戒酒访问（总计 150 美元），参与者还可额外获得 50 美元礼品卡。 戒烟后 8 周和 12 周的戒烟情况，经生化验证的 7 天点流行率戒烟后 26 周的戒烟情况。 戒烟后（长期戒烟）将是主要结果变量，尽管吸烟状况将 我们还希望更好地了解 CM 治疗机制并进行评估。 通过传统问卷调查和基于智能手机的调查确定直接影响戒烟的其他因素 生态瞬时评估方法允许“实时”数据收集 更准确地捕获与戒烟相关的重要变量，并将用于提供增益框架 支持和加强 CM 干预的信息研究结果将为新治疗提供见解。 干预研究的目标，并将展示一种有效、廉价且易于实施的方法 提高经济困难吸烟者长期戒烟率的方法。