Mindfulness-based ecological momentary intervention for smoking cessation among cancer survivors

基于正念的生态瞬时干预对癌症幸存者戒烟的影响

基本信息

批准号：
10590358
负责人：
Min-Jeong Yang
金额：
$ 11.88万
依托单位：
H. LEE MOFFITT CANCER CTR & RES INST
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10590358
关键词：
Acceptance Process Acute Address Affect Affective Attention Awareness Benchmarking Breathing Cancer Center Cancer Prevention Intervention Cancer Survivor Cancer Survivorship Cellular Phone Chronic Client satisfaction Clinical Clinical Trials Cognitive Data Development Distress Ecological momentary assessment Effectiveness Elements Fatigue Feasibility Studies Feedback Fright Future General Population Goals Guilt Health Hour Individual Intervention Interview Knowledge Link Literature Malignant Neoplasms Measures Meditation Methodology Mission Nature Outcome Pain Participant Patient Self-Report Patients Perception Persons Phase Population Preparation Procedures Process Psychometrics Qualitative Methods Quality of life Randomized Randomized, Controlled Trials Recording of previous events Recurrent Malignant Neoplasm Relapse Risk Risk Factors Role Second Primary Cancers Self-Examination Shame Smoke Smoker Smoking Smoking Cessation Intervention Stress Structure Survivors Testing Therapeutic Time Tobacco Tobacco Use Cessation Tobacco use Training Treatment Cost Work acceptability and feasibility anticancer research arm barrier to care cancer diagnosis cancer recurrence cancer therapy career cost effective intervention craving efficacy testing experience feasibility testing follow-up handheld mobile device improved innovation mHealth mindfulness mindfulness intervention mortality negative affect novel patient-level barriers portability primary outcome prototype relapse risk satisfaction secondary analysis smartphone application smoking abstinence smoking cessation smoking prevalence smoking relapse sound standard care temporal measurement tobacco abstinence

项目摘要

PROJECT SUMMARY/ABSTRACT Continued tobacco use among cancer survivors is linked to an increased risk of lowered effectiveness of cancer treatment, greater cancer-related mortality, developing a secondary primary cancer, worse quality of life, and increased cancer treatment costs ($3.4 billion/year). Despite high quit rates at cancer diagnosis, more than half of survivors who quit resume smoking shortly thereafter. Mindfulness-based interventions (MBIs) hold great promise in enhancing smoking abstinence among cancer survivors given its emphasis on purposefully paying attention to immediate experience, thereby reducing reactivity to smoking triggers. The current proposal addresses significant gaps in the extant smoking cessation literature for cancer survivors, which include: (1) A limited understanding of the role of dynamic relations between cancer-specific (e.g., fatigue, pain, fear of cancer recurrence) and general smoking risk factors (e.g., negative affect) contributing to smoking relapse given the known chronic high stress level among cancer survivors, (2) Lack of real-time cessation interventions using portable mobile devices such as smartphones (i.e., mobile health [mHealth]), (3) Little attention given to cancer- specific cessation barriers for cancer survivors (e.g., shame, guilt) and (4) Barriers to treatment accessibility among existing MBIs due to the time-intensiveness and in-person format. To address these gaps, the objective of this proposal is to develop a mindfulness-based ecological momentary intervention (mindEMI) that delivers MBI content in real-time and in the real world where quitting smoking takes place, and, when an elevated level Dr. Yang’s long-term career goal is to develop and evaluate accessible and scalable mHealth smoking cessation interventions for cancer prevention with expertise in real-time measurement of cognitive-affective constructs. As such, training goals address tobacco use and cancer survivorship, mHealth and clinical trials methodology, quantitative and qualitative methods, clinical delivery of MBIs, and professional development. of cancer-specific smoking relapse risk is indicated through ecological momentary assessment (EMA). There are three specific aims. The K99 phase will take place at the Moffitt Cancer Center. The aims during the K99 phase include: (1) To identify the most psychometrically sound EMA items for measuring negative affect, positive affect, and state mindfulness and (2) to develop a mindEMI targeting cancer-specific smoking vulnerabilities through an iterative multi-step process among cancer survivors who smoke. The R00 phase aims to conduct a 2-arm pilot randomized controlled trial (RCT) among cancer survivors to test the feasibility and acceptability of the mindEMI for smoking cessation. Feasibility of RCT procedures in preparation for a larger subsequent study will also be examined. This proposal is highly innovative because the mindEMI will address a crucial gap in the literature by targeting cancer-specific smoking vulnerabilities and deliver an MBI in real-time when relapse risk is high for cancer survivors. This work will inform a future trial to fully test the efficacy of mindEMI and directly addresses the NCI’s mission to conduct and support cancer research to promote longer and healthier lives.

项目概要/摘要癌症幸存者持续使用烟草与癌症疗效降低的风险增加有关治疗、更高的癌症相关死亡率、发展为继发性原发性癌症、生活质量更差，以及癌症治疗费用增加（每年 34 亿美元），尽管癌症诊断后戒烟率很高，但超过一半的人此后不久戒烟的幸存者中基于正念的干预措施（MBI）效果很好。鉴于其强调有目的地付费，有望提高癌症幸存者的戒烟率关注即时经验，从而减少对吸烟触发因素的反应。解决了现有癌症幸存者戒烟文献中的重大空白，其中包括：(1) A 对癌症特异性（例如疲劳、疼痛、对癌症的恐惧）之间的动态关系的作用了解有限复发）和导致吸烟复发的一般吸烟危险因素（例如负面影响）已知癌症幸存者的慢性高压力水平，(2) 缺乏使用实时戒烟干预措施便携式移动设备，例如智能手机（即移动医疗 [mHealth]），(3) 对癌症关注甚少- 癌症幸存者的具体戒烟障碍（例如羞耻、内疚）和 (4) 获得治疗的障碍由于时间密集和面对面的形式，现有的 MBI 之间存在差距。该提案的目的是开发一种基于正念的生态瞬时干预（mindEMI），该干预可以提供实时的 MBI 内容和戒烟发生的现实世界中的内容，以及当水平升高时博士。 Yang 的长期职业目标是开发和评估可访问且可扩展的 mHealth 戒烟方法具有实时测量认知情感结构的专业知识，进行癌症预防干预。例如，培训目标涉及烟草使用和癌症生存、移动医疗和临床试验方法，定量和定性方法、MBI 的临床实施以及专业发展。癌症特异性吸烟复发风险通过生态瞬时评估（EMA）来指示。有三个 K99 阶段将在莫菲特癌症中心进行 K99 阶段的目标包括： (1) 确定心理测量上最合理的 EMA 项目，用于测量负面情绪、正面情绪和陈述正念并 (2) 通过 R00 阶段旨在对吸烟的癌症幸存者进行多步骤迭代过程。在癌症幸存者中进行的随机对照试验（RCT），以测试 MindEMI 的可行性和可接受性为戒烟做准备的随机对照试验程序的可行性也将被确定。该提案具有高度创新性，因为 MindEMI 将通过以下方式解决文献中的一个关键空白。针对癌症特定的吸烟弱点，并在复发风险较高时实时提供 MBI 这项工作将为未来的试验提供信息，以全面测试 MindEMI 的功效并直接解决这一问题。 NCI 的使命是开展和支持癌症研究，以促进更长、更健康的生活。