Improving Access to Cigarette Cessation Treatment Among African American Smokers: Development and Evaluation of an Integrated mHealth Application

改善非裔美国吸烟者获得戒烟治疗的机会：综合移动医疗应用程序的开发和评估

• 批准号: 10259792
• 负责人: MICHAEL J. ZVOLENSKY
• 金额: $ 45.71万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-08 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10259792
• 关键词: Abstinence; Acculturation; Address; Adult; African American; American; Anxiety; Asthma; Behavior; Biological; COVID-19; Cardiovascular Diseases; Caring; Cellular Phone; Characteristics; Cigarette; Data; Development; Discrimination; Distress; Ecological momentary assessment; Economic Burden; Emotional disorder; Enrollment; European; Evaluation; Exposure to; Feedback; Friends; Health; Improve Access; Intervention; Interview; Latinx; Maintenance; Malignant Neoplasms; Menthol; Methods; Mobile Health Application; National Cancer Institute; Nicotine Withdrawal; Outcome; Participant; Persons; Phase; Prevalence; Randomized; Randomized Clinical Trials; Recording of previous events; Research; Resources; Smoker; Smoking; Smoking Cessation Intervention; Societies; Stress; Testing; Time; Tobacco; Tobacco use; Translating; United States; Withdrawal Symptom; Work; addiction; anxiety sensitivity; anxiety symptoms; base; bodily sensation; cancer prevention; cigarette smoking; comorbidity; craving; depressive symptoms; design; disability; emotional symptom; ethnic discrimination; ethnic identity; experience; follow up assessment; health disparity; improved; interest; intervention effect; mobile computing; mortality; negative mood; nicotine replacement; novel; phase 1 testing; preventable death; programs; racial and ethnic; racial discrimination; racism; remote delivery; smoking cessation; smoking intervention; smoking relapse; stress symptom; success; theories; therapy design; willingness; Abstinence; Acculturation; Address; Adult; African American; American; Anxiety; Asthma; Behavior; Biological; COVID-19; Cardiovascular Diseases; Caring; Cellular Phone; Characteristics; Cigarette; Data; Development; Discrimination; Distress; Ecological momentary assessment; Economic Burden; Emotional disorder; Enrollment; European; Evaluation; Exposure to; Feedback; Friends; Health; Improve Access; Intervention; Interview; Latinx; Maintenance; Malignant Neoplasms; Menthol; Methods; Mobile Health Application; National Cancer Institute; Nicotine Withdrawal; Outcome; Participant; Persons; Phase; Prevalence; Randomized; Randomized Clinical Trials; Recording of previous events; Research; Resources; Smoker; Smoking; Smoking Cessation Intervention; Societies; Stress; Testing; Time; Tobacco; Tobacco use; Translating; United States; Withdrawal Symptom; Work; addiction; anxiety sensitivity; anxiety symptoms; base; bodily sensation; cancer prevention; cigarette smoking; comorbidity; craving; depressive symptoms; design; disability; emotional symptom; ethnic discrimination; ethnic identity; experience; follow up assessment; health disparity; improved; interest; intervention effect; mobile computing; mortality; negative mood; nicotine replacement; novel; phase 1 testing; preventable death; programs; racial and ethnic; racial discrimination; racism; remote delivery; smoking cessation; smoking intervention; smoking relapse; stress symptom; success; theories; therapy design; willingness

ABSTRACT Tobacco use is the leading cause of preventable death and disability and results in substantial economic burden. Estimates suggest that 13.7% of adults in the United States (US) are current smokers. Yet, tobacco use is not equally distributed in society. African American smokers evince elevated smoking rates (14.6%) and are significantly more likely to use menthol cigarettes, which are associated with a host of flavor-specific negative health outcomes. Additionally, African American smokers are less likely to maintain cessation compared to European American and Latinx smokers despite making more quit attempts. A major contributing factor to smoking among African Americans appears to be their increased exposure to interoceptive-stress symptoms. Consequently, cessation interventions directed toward African American smokers might benefit from specific focus on increasing the ability to adaptively respond to interoceptive stress (e.g., anxiety, bodily sensations, stress-related burden due to racism or discrimination during a quit attempt and thereafter). Notably, motives for smoking to cope with negative mood states are central to cigarette use among those with greater sensitivity to stress (i.e., higher anxiety sensitivity [AS]; a well-established malleable, transdiagnostic construct for emotional symptoms and disorders and the maintenance of smoking). Past work has not leveraged the potential of AS to better understand smoking and interoceptive stress relations among this established health disparities group. The present proposal aims to refine and comprehensively culturally adapt an initially tested novel, mobile intervention that targets AS among African American smokers (Mobile Anxiety Sensitivity Program for Smoking: MASP). Our intervention is framed within the cultural context of interoceptive stress among African American smokers, which is supported by theory, empirical evidence, and characteristics of this group. In Phase I, we will further culturally tailor our preliminarily test treatment (MASP 1.0) with African American-smoking content and history to develop MASP 2.0, which will be pilot tested during this phase. In Phase I, 25 African American smokers with elevated AS will be administered MASP 2.0 for 6 weeks. Following completion of Phase I, we will further refine MASP 2.0 based on qualitative and quantitative data from participants and the research team to produce MASP 3.0. In Phase II, 200 African American smokers with elevated AS will be enrolled and randomly assigned to either: (1) the smartphone-based National Cancer Institute (NCI) QuitGuide app for standard mobile smoking cessation treatment (2) MASP 3.0. Participants in Phase I and Phase II will complete an in-person baseline assessment, pre- and post-quit ecological momentary assessments, an end-of-treatment qualitative interview, and follow-up assessments at weeks 1, 2 (quit date), 3, 4, 5, 6, 28, and 54 (52 weeks post-quit) via the app as well as receive nicotine replacement therapy.

抽象的 烟草使用是可预防死亡和残疾的主要原因，并导致了实质性的经济 负担。估计表明，美国（美国）的成年人中有13.7％是目前的吸烟者。但是，烟草使用 不是在社会中平等分布。非裔美国人吸烟者证明吸烟率升高（14.6％），为 使用薄荷香烟的可能性更大，这些香烟与大量特定风味的负相关 健康结果。此外，与非裔美国人吸烟者相比，戒烟的可能性较小 欧美和拉丁裔吸烟者尽管进行了更多的戒烟尝试。一个主要的因素 非洲裔美国人中的吸烟似乎是他们增加了感受性压力症状的暴露。 因此，针对非裔美国人吸烟者的戒烟干预措施可能会受益于特定 专注于提高适应性应激的能力（例如，焦虑，身体感觉， 由于种族主义或歧视而导致的压力相关的负担，此后）。值得注意的是，动机 吸烟以应对消极的情绪状态，这对于具有更高敏感性的人的香烟使用至关重要 压力（即，较高的焦虑敏感性[AS]；一个完善的可延展性，经诊断的结构 情绪症状和疾病以及吸烟的维持）。过去的工作没有利用 在这种既定的健康中更好地了解吸烟和感受性的压力关系的潜力 差异组。目前的建议旨在完善和全面地适应最初测试的 新颖的移动干预措施是非裔美国人吸烟者（移动焦虑敏感性） 吸烟计划：MASP）。我们的干预措施是在互感压力的文化背景下进行的 在非洲裔美国吸烟者中，这是由理论，经验证据和特征所支持的 团体。在第一阶段，我们将在文化上进一步量身定制非洲初步测试治疗（MASP 1.0） 美国吸烟的内容和历史以开发MASP 2.0，这将在此阶段进行试点测试。在 第一阶段，25名非裔美国人吸烟者将升高，并将使用MASP 2.0施用6周。下列的 第一阶段的完成，我们将根据定性和定量数据进一步完善MASP 2.0 参与者和研究团队生产MASP 3.0。在第二阶段，有200名非裔美国人吸烟者 将被招募并随机分配到：（1）基于智能手机的国家癌症 用于标准移动吸烟戒烟处理的Institute（NCI）戒烟应用程序（2）MASP 3.0。参与者 第一阶段和第二阶段将完成面对面的基线评估，前后生态瞬间 评估，定性访谈结束终结以及在第1周第2周（退出日期），第3期的随访评估 通过该应用程序进行4、5、6、28和54（询问后52周），并接受尼古丁替代疗法。