Mobile App for Behavioral Activation in Smoking Cessation with Elevated Depressive Symptom Smokers

用于激活抑郁症状严重吸烟者戒烟行为的移动应用程序

基本信息

批准号：
9202688
负责人：
RICHARD A BROWN
金额：
$ 22.5万
依托单位：
HEALTH BEHAVIOR SOLUTIONS, INC.
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-19 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9202688
关键词：
Abstinence Address Adult Behavior Behavioral Bladder Breathing Cancer Etiology Car Phone Cessation of life Client Clinical Practice Guideline Colon Companions Counseling Data Depressed mood Depressive disorder Development Evaluation Failure Funding Future Geographic state Guidelines Health Insurance Individual Intervention Kidney Larynx Liver Major Depressive Disorder Malignant Neoplasms Malignant neoplasm of lung Marketing Mental Depression Methodology Methods Modality Moods Names Nicotine Dependence Oral cavity Outcome Participant Phase Primary Health Care Process Provider Randomized Controlled Trials Rectum Relaxation Reporting Research Personnel Resources Rewards Risk Factors Services Small Business Innovation Research Grant Small Business Technology Transfer Research Smoker Smoking Software Design Symptoms Testing Texas Tobacco Wellness Program Withdrawal Withholding Treatment Work Workplace behavioral study cigarette smoking clinical efficacy comorbid depression comparison group cost depressive symptoms design evidence base experience follow-up health application improved mHealth meetings mobile application mobile computing mood symptom mortality product development productivity loss prototype psychologic psychological distress psychosocial quitline satisfaction self help smoking cessation success symptomatology usability user centered design

项目摘要

Cigarette smoking is the leading cause of mortality in the U.S., resulting in over 480,000 deaths every year and costing $278 billion in loss of productivity. Smoking is also the leading cause of cancer and of deaths from cancer. Smoking causes cancers of the lung, larynx, mouth, bladder, liver, kidney, colon, rectum and others. While smoking rates in the U.S. have declined over recent years, continued smoking is strongly associated with both depressive disorders and depressive symptoms, with smoking rates remaining at 30-50% among individuals with depressive disorders. Depressive symptoms have also been shown to predict smoking cessation failure. While clinical practice guidelines for nicotine dependence treatment suggest the need to address psychological issues such as elevated depressive symptoms, empirically validated interventions to address this important risk factor are lacking. Tobacco quitlines are the major vehicle through which smoking cessation services are delivered in the U.S and are available in every U.S. state via a national quitline portal, 1-800-QUIT-NOW. However tobacco quitlines, as they currently exist, deliver standard behavioral smoking cessation treatment and are not well equipped to effectively help smokers with conditions such as comorbid depression. Indeed, a recent study reported that 24% of smokers calling a state tobacco quitline had a significantly elevated level of depressive symptoms and that these smokers with depressive symptoms, compared to those without, were significantly less likely to successfully quit smoking. Tobacco quitlines would derive significant benefit from an adjunctive psychosocial approach to address the depressive symptoms experienced by many of their clients. While issues of feasibility limit the use of such approaches in a standard delivery method, their use in the form of a mobile application (app) holds significant promise. Behavioral Activation is an empirically supported treatment that is straightforward, easily understood, and as such is particularly amenable to a mobile platform and to systematic integration with tobacco quitline counseling. Across studies, Behavioral Activation is effective for reducing depressive symptoms among individuals with sub threshold depression as well as individuals with major depressive disorder (MDD) and it meets the criteria to be established as an empirically supported treatment. The aims of this Phase I application are to employ user centered design processes to develop and test the acceptability and efficacy of a mobile health app, Act2BSmokeFree, which will incorporate brief Behavioral Activation vs. a relaxation app, Breathe2Relax in a small randomized controlled trial of smokers with elevated depressive symptoms. All participants will receive tobacco quitline counseling. The expected outcome of this project is the development of a prototype of Act2BSmokeFree, which can readied for Phase II testing of clinical efficacy in a future randomized controlled trial in conjunction with tobacco quitline counseling.

吸烟是美国死亡率的主要原因，每年导致超过480,000人死亡，生产率损失损失2780亿美元。吸烟也是癌症和癌症死亡的主要原因。吸烟原因的肺，喉，嘴，膀胱，肝脏，肾脏，结肠，直肠等的癌症。尽管近年来美国的吸烟率下降，但持续吸烟与抑郁症和抑郁症状密切相关，抑郁症患者的吸烟率仍为30-50％。还显示抑郁症状可以预测戒烟失败。虽然尼古丁依赖治疗的临床实践指南表明需要解决诸如抑郁症状升高的心理问题，但缺乏经验验证的干预措施以解决这一重要危险因素。烟草戒烟是在美国提供戒烟服务的主要工具，并在美国每个州都可以通过国家戒烟线门户网站（1-800 QUIT-NOW）提供。然而，烟草戒烟目前存在，可以提供标准的行为戒烟治疗，并且没有能力有效地帮助吸烟者，例如合并症抑郁症。实际上，最近的一项研究报告说，有24％的吸烟者称为州烟草的抑郁症状水平明显升高，与没有抑郁症状的吸烟者相比，这些吸烟者与没有抑郁症状的症状相比，成功戒烟的可能性大大较小。烟草戒烟将从辅助的社会心理方法中获得可观的好处，以解决许多客户所经历的抑郁症状。尽管可行性的问题限制了在标准交付方法中使用此类方法，但它们以移动应用程序（APP）形式的使用具有巨大的希望。行为激活是一种经验支持的治疗方法，很简单，易于理解，因此特别适合移动平台以及与烟草Quitline咨询的系统整合。在整个研究中，行为激活对于减少子阈值抑郁症患者以及重度抑郁症（MDD）的个体的抑郁症状有效，并且符合该标准以确立为经验支持的治疗方法。该阶段应用程序的目的是采用以用户为中心的设计过程来开发和测试移动健康应用程序ACT2BSMOKEFREE的可接受性和功效，该应用程序将在一个小型的抑郁症状吸烟者的小型随机对照试验中纳入简短的行为激活与放松应用程序，Hearthe2relax。所有参与者都将获得烟草戒烟咨询。该项目的预期结果是开发了ACT2BSMOKEFREE的原型，该原型可以在未来的随机对照试验中与烟草戒烟咨询一起在未来的随机对照试验中对II期临床疗效进行测试。