Financial incentives to help people with cognitive impairment quit smoking

帮助认知障碍患者戒烟的经济激励措施

• 批准号: 10119946
• 负责人: Joseph Abiodun Ladapo
• 金额: $ 38.37万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-15 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10119946
• 关键词: Abstinence; Accidents; Administrative Supplement; Affect; American; Atherosclerosis; Atrial Fibrillation; Biochemical; Cardiovascular Diseases; Caring; Cause of Death; Cerebrovascular Disorders; Client satisfaction; Consult; Coronary heart disease; Cotinine; Counseling; Dementia; Development; Disease Progression; Effectiveness; Fire - disasters; Goals; Government Agencies; Habits; Health; Health behavior; Healthcare Systems; Hour; Hypertension; Impaired cognition; Injury; Insurance Carriers; Intervention; Link; Measures; Outcome; Parents; Patient Self-Report; Patients; Population; Prevalence; Pulmonary Emphysema; Randomized; Relapse; Resources; Risk; Risk Factors; Salivary; Sampling; Smoker; Smoking; Smoking Cessation Intervention; Stroke; Structure; Telephone; Testing; Tobacco use; United States; Validation; World Health Organization; arm; base; cigarette smoking; cost; dementia care; dementia risk; effectiveness evaluation; experience; financial incentive; follow-up; high risk; high risk population; incentive program; mild cognitive impairment; mortality; outreach; patient population; primary outcome; programs; randomized controlled study; recruit; screening; secondary outcome; smoking abstinence; smoking cessation; treatment as usual

PROJECT SUMMARY/ABSTRACT Currently, among Americans 65 years and older, about 20-25% have mild cognitive impairment and about 10% have dementia. Smoking has been linked with an increased risk of dementia development and progression. Quitting smoking can slow the progression of dementia by decreasing many of the risk factors for dementia progression such as cardiovascular disease, hypertension, atherosclerosis, atrial fibrillation, and stroke. In addition to the risk factors of disease progression, smokers with dementia represent a particularly high risk smoking population due to an elevated risk of accidents, residential fires and injury. Unfortunately, cognitive impairment often precludes smokers with dementia from participating in trials of most cessation treatments. While most people with dementia do not smoke, there are a significant number that still do. Interventions are needed in this challenging but high-risk population, particularly since smoking cessation is one of the few interventions that actually affects the rate of dementia progression. However, no smoking cessation programs currently exist for people with dementia. Financial incentives for motivating changes in health behavior, particularly for smoking and other morbid habits, are increasingly being tested by health insurers, employers, and government agencies. However, a key unanswered question is how to structure these incentive programs to maximize their effectiveness in patients with dementia. The goal of this supplement is to leverage the resources of an ongoing financial incentive smoking cessation trial in hospitalized patients to adapt and test the financial incentive smoking cessation interventions for smokers with dementia. We propose a 1-year administrative supplement to use the financial incentive smoking cessation interventions from the Financial Incentives for Smoking Cessation Treatment II (FIESTA II) trial and adapt it for patients with dementia (Aim 1). The intervention will be adapted for dementia patients by consulting with people living with cognitive impairment and care partners and pilot tested. The effectiveness of the dementia-specific financial incentive interventions will then be tested in a 3-arm randomized controlled study comparing 1) goal-directed financial incentives and 2) outcome-based financial incentives versus 3) enhanced usual care for achieving smoking cessation (Aim 2). For this supplement, we will focus on hospitalized smokers that screen positive for cognitive impairment, but would normally be excluded from FIESTA II study of financial incentives for hospitalized smokers.

项目摘要/摘要 目前，在65岁以上的美国人中，约有20-25％的认知障碍和约10％ 有痴呆症。吸烟与痴呆症发育和进展的风险增加有关。 戒烟可以减少痴呆症的许多危险因素，从而减慢痴呆症的进展 进展，例如心血管疾病，高血压，动脉粥样硬化，房颤和中风。在 除了疾病进展的危险因素外，患有痴呆症的吸烟者代表着特别高的风险 吸烟人口由于发生事故，住宅火灾和伤害的风险增加而引起的吸烟人群。不幸的是，认知 损害通常会阻止吸烟者患有痴呆症的吸烟者参加大多数停止治疗的试验。 虽然大多数痴呆症患者不吸烟，但仍然有很多人。干预是 在这个具有挑战性但高风险的人群中需要，特别是因为戒烟是少数几个 实际影响痴呆进展率的干预措施。但是，没有吸烟计划 目前存在于患有痴呆症患者的情况下。激励健康行为变化的经济激励措施， 特别是对于吸烟和其他病态习惯，越来越多地受到健康保险公司，雇主， 和政府机构。但是，一个关键的未解决问题是如何构建这些激励计划 为了最大化其在痴呆症患者中的有效性。该补充的目的是利用 住院患者正在进行的经济奖励戒烟试验的资源，以适应和测试 对痴呆症吸烟者的经济激励戒烟干预措施。 我们提出了1年的行政补品，以使用经济激励戒烟干预措施 从戒烟治疗II（嘉年华II）试验的经济激励措施中，并适应患者 痴呆症（目标1）。干预措施将通过咨询痴呆症患者进行调整 认知障碍和护理伙伴和飞行员进行了测试。痴呆症特异性财务的有效性 然后，将在3臂随机对照研究中对激励干预措施进行比较1）指导。 财务激励措施和2）基于结果的经济激励措施与3）增强了实现的常规护理 戒烟（目标2）。对于这种补充，我们将专注于筛查阳性的住院吸烟者 认知障碍，但通常会被排除在嘉年华II研究中 住院的吸烟者。