IVR Technology to Mobilize Contingency Management for Smoking Cessation

IVR 技术动员戒烟应急管理

基本信息

批准号：
8114384
负责人：
SHEILA MARIE ALESSI
金额：
$ 22.4万
依托单位：
UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-05-15 至 2013-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8114384
关键词：
10p Abstinence Address Adoption Application procedure Attention Back Behavior Carbon Monoxide Cellular Phone Clinical Communities Counseling Equipment Frequencies Guidelines Half-Life Hour Incentives Individual Intake Intervention Long-Term Effects Mails Measures Monitor Morbidity - disease rate Motivation Nicotine Nicotine Withdrawal Outcome Participant Pharmaceutical Preparations Pharmacotherapy Phase Population Preparation Prize Procedures Process Public Health Randomized Relapse Reporting Research Resources Schedule Smoke Smoker Smoking Smoking Status Source Substance Use Disorder System Technology Telephone Testing Time Training Treatment outcome United States Use Effectiveness Video Recording Voice base cigarette smoking contingency management economic cost eligible participant follow-up improved mortality primary outcome programs response smoking cessation smoking prevalence smoking relapse substance abuse treatment tool

项目摘要

DESCRIPTION (provided by applicant): Cigarette smoking remains the most common source of preventable morbidity and mortality in the United States, with in excess of $167 billion in economic costs per year. Contingency management (CM), in which tangible incentives are provided contingent on a target behavior like abstinence, is highly efficacious in improving substance abuse treatment outcomes and is receiving increased attention for smoking cessation. Expired carbon monoxide (CO) is the most common objective smoking status test used in smoking research and treatment. Unfortunately, multiple CO tests/day are typically required to detect all smoking and reinforce sustained abstinence. The resulting logistical and resource limitations greatly limit the application of this potentially powerful quit smoking toolset. This study addresses these limitations by examining the effectiveness of using interactive voice response technology (IVR) to implement CM. Smokers who want to quit (N = 90 randomized) will receive 2 quit preparation sessions based on public health guidelines for smoking cessation and set a target quit date (TQD). Participants will be randomly assigned to 1 of 2 treatment conditions: (a) IVR- S consisting of objective smoking status monitoring using IVR, telephone counseling and transdermal nicotine and (b) IVR-CM, consisting of the same monitoring, telephone counseling and transdermal nicotine plus IVR- based CM for smoking abstinence (CO d 6ppm). All participants will (1) objectively monitor and report smoking status 1-3x/day via cell phone and IVR (weeks 1-4), (2) receive biweekly telephone counseling (weeks 1-4), and (3) receive transdermal nicotine (weeks 1-8), starting on the TQD. All participants will receive CO testing equipment and a study cell phone and training on how to self-test CO and use the IVR system. CO self-tests will be 1-3 times/day at pseudo-random times prompted by the IVR system. CO self-tests will be video-taped using the cell phone video capture function, results reported to the IVR system, and video records e-mailed to research staff via the study cell phone daily. In the IVR-CM condition, participants will also have the opportunity to win prizes ($1, $20, and $100 in value) for negative tests. The IVR system will generate preliminary values of incentives earned for negative tests and report the values to IVR-CM participants daily. Incentive values will be finalized after comparison of IVR reports and video records and delivered to participants at least once weekly. Nicotine withdrawal, motivation to change, urges to smoke, and substance/medication use will be assessed at Intake, Week 4 (end of counseling and daily monitoring), Week 8, Week 12 and Week 24 (follow- up). Primary outcomes will be 7-day objectively verified point-prevalence smoking abstinence rates at Week 4 (short-term) and Weeks 8, 12, and 24 (longer-term), and longest duration of sustained smoking abstinence (during treatment). Counseling and CO testing compliance will also be examined. It is hypothesized that abstinence rates will be higher in the IVR-CM condition compared to the IVR-S, supporting a combined IVR CM approach, and thereby greatly increasing the applicability of these powerful smoking cessation tools. PUBLIC HEALTH RELEVANCE: Cigarette smoking is the leading cause of preventable morbidity and mortality in the U.S., with economic costs exceeding $167 billion annually. Contingency management procedures that reinforce smoking abstinence based on the most common objective test of smoking status - expired carbon monoxide (CO) levels - have the potential to improve smoking abstinence rates when applied alone or in conjunction with pharmacotherapy, but technological limitations severely limit the application of these procedures. If results of this study suggest that using interactive voice technology (IVR) to remotely conduct CM and CO testing procedures is effective, the public health impact could be the more widespread applicability of this potentially powerful intervention to promote smoking cessation.

描述（由申请人提供）：吸烟仍然是美国最常见的可预防发病率和死亡率的来源，每年的经济成本超过1670亿美元。应急管理（CM），其中在戒酒等目标行为上提供了有形的激励措施，在改善药物滥用治疗结果方面具有高效，并且正在受到越来越关注戒烟的关注。过期的一氧化碳（CO）是吸烟研究和治疗中使用的最常见的客观吸烟状态测试。不幸的是，通常需要多次CO测试来检测所有吸烟并加强持续的戒酒。由此产生的后勤和资源限制极大地限制了这种潜在强大的戒烟工具集的应用。这项研究通过检查使用交互式语音响应技术（IVR）实施CM的有效性来解决这些局限性。想要退出的吸烟者（n = 90个随机分组）将根据公共卫生戒烟指南进行2次退出准备会议，并设定目标退出日期（TQD）。参与者将被随机分配到2个治疗条件中的1个：（a）IVRS包括使用IVR，电话咨询和透皮尼古丁的客观吸烟状态监测以及（b）IVR-CM，包括相同的监测，电话咨询和基于跨烟液的nicotine plus IVR IVR IVR-ivr基于IVR的CM，用于吸烟戒烟（CO d 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 66）。所有参与者将通过手机和IVR（第1-4周）客观地监控和报告吸烟状况为1-3倍/天，（2）双周电话咨询（第1-4周），（3）从TQD开始，接收经透经尼古丁（第1-8周）。所有参与者将收到CO测试设备以及研究手机以及有关如何进行自我测试并使用IVR系统的培训。在IVR系统提示的伪随机时，CO自我测试将为每天1-3次。 CO自我测试将使用手机视频捕获功能，报告给IVR系统的结果以及通过研究手机每天发送给研究人员的视频记录来进行视频划分。在IVR-CM条件下，参与者还将有机会赢得负面测试的奖品（价值1美元，20美元和100美元）。 IVR系统将产生为负测试获得的激励措施的初步值，并每天向IVR-CM参与者报告这些值。在对IVR报告和视频记录进行比较后，将最终确定激励价值，并至少每周一次交付给参与者。尼古丁提取，改变动力，吸烟的敦促以及使用物质/药物的使用将在入学，第4周（咨询和每日监测结束），第8周，第12周和第24周（随访）。主要结果将在第4周（短期）和第8、12和24周（长期）和最长的持续吸烟戒烟持续时间（治疗期间）时（短期）和第8、12和24周（短期）和第8周，第12和24周（短期）和最长的持续时间（在治疗期间）进行原始结果。还将检查咨询和CO测试合规性。假设与IVR-S相比，IVR-CM条件下的节制率将更高，支持联合IVR CM方法，从而大大提高了这些强大的戒烟工具的适用性。公共卫生相关性：吸烟是美国可预防发病率和死亡率的主要原因，经济成本每年超过1670亿美元。根据最常见的吸烟状态客观测试（过期的一氧化碳（CO）水平），应加强戒烟的应急管理程序有可能单独应用或与药物治疗结合使用时提高吸烟率，但技术局限性严重限制了这些程序的应用。如果这项研究的结果表明，使用交互式语音技术（IVR）进行CM和CO测试程序是有效的，那么公共卫生的影响可能是这种潜在强大的干预措施的普遍适用性，以促进戒烟。