PDF(Pubmed)
Abstract：
BACKGROUND: Behavioral activation (BA) is an evidence-based treatment for depression that fosters engagement in values-based activities to increase access to positive reinforcement. Depressed mood has been shown to hinder smoking cessation.
OBJECTIVE: This study determined the feasibility and preliminary efficacy of a mobile app to motivate smokers to quit by using BA and integrating motivational messages to quit smoking.
METHODS: Adult smokers (N=56; mean age 34.5, SD 9.52 years) who were not ready to quit smoking within 30 days were recruited from advertisements and randomized to either 8 weeks of the BA app (set 2 values-based activities per week+motivational messages+feedback on changes in smoking, mood, and values-based activities) or the control group (no app; received resources for quitting smoking). All participants completed the baseline and end-of-treatment web-based questionnaires. Controls also completed weekly web-based assessments, and BA app participants completed assessments through the app.
RESULTS: There were no dropouts and only 2 participants in each condition did not complete the end-of-treatment questionnaire. The results demonstrated that it is feasible to recruit smokers who are unmotivated to quit into a smoking cessation induction trial: 86% (57/66) of eligible participants were randomized (BA app: n=27; control: n=29). Participants reported high levels of satisfaction: 80% (20/25) of participants said they would recommend the BA app, there were moderate-to-high scores on the Mobile App Rating Scale, and 88% (22/25) of participants rated the app 3 stars or higher (out of 5). There were high levels of BA app engagement: 96% (26/27) of participants planned activities, and 67% (18/27) of participants planned 7 or more activities. High engagement was found even among those who were at the highest risk for continued smoking (low motivation to quit, low confidence to quit, and high negative affect). The results provided support for the hypothesized relationships between BA constructs: greater pleasant activity completion was associated with greater positive affect (b=0.37, SE 0.21; 95% CI -0.05 to 0.79; P=.08), and greater positive affect tended to predict fewer cigarettes smoked the next day (b=-0.19, SE 0.10; 95% CI -0.39 to 0.01; P=.06). Additionally, a greater number of activities planned was associated with lower negative affect (b=-0.26, SE 0.15; 95% CI -0.55 to 0.04; P=.09). Overall, 16% (4/25) of BA app participants set a quit date versus 4% (1/27) among controls, and there were promising (but not significant) trends for motivation and confidence to quit.
CONCLUSIONS: The findings suggest that a mobile app intervention can be made appealing to smokers who are unmotivated to quit by focusing on aspects most important to them, such as mood management. This theory-based intervention has shown some initial support for the underlying theoretical constructs, and further efficacy testing is warranted in a fully powered trial.
OBJECTIVE: This study determined the feasibility and preliminary efficacy of a mobile app to motivate smokers to quit by using BA and integrating motivational messages to quit smoking.
METHODS: Adult smokers (N=56; mean age 34.5, SD 9.52 years) who were not ready to quit smoking within 30 days were recruited from advertisements and randomized to either 8 weeks of the BA app (set 2 values-based activities per week+motivational messages+feedback on changes in smoking, mood, and values-based activities) or the control group (no app; received resources for quitting smoking). All participants completed the baseline and end-of-treatment web-based questionnaires. Controls also completed weekly web-based assessments, and BA app participants completed assessments through the app.
RESULTS: There were no dropouts and only 2 participants in each condition did not complete the end-of-treatment questionnaire. The results demonstrated that it is feasible to recruit smokers who are unmotivated to quit into a smoking cessation induction trial: 86% (57/66) of eligible participants were randomized (BA app: n=27; control: n=29). Participants reported high levels of satisfaction: 80% (20/25) of participants said they would recommend the BA app, there were moderate-to-high scores on the Mobile App Rating Scale, and 88% (22/25) of participants rated the app 3 stars or higher (out of 5). There were high levels of BA app engagement: 96% (26/27) of participants planned activities, and 67% (18/27) of participants planned 7 or more activities. High engagement was found even among those who were at the highest risk for continued smoking (low motivation to quit, low confidence to quit, and high negative affect). The results provided support for the hypothesized relationships between BA constructs: greater pleasant activity completion was associated with greater positive affect (b=0.37, SE 0.21; 95% CI -0.05 to 0.79; P=.08), and greater positive affect tended to predict fewer cigarettes smoked the next day (b=-0.19, SE 0.10; 95% CI -0.39 to 0.01; P=.06). Additionally, a greater number of activities planned was associated with lower negative affect (b=-0.26, SE 0.15; 95% CI -0.55 to 0.04; P=.09). Overall, 16% (4/25) of BA app participants set a quit date versus 4% (1/27) among controls, and there were promising (but not significant) trends for motivation and confidence to quit.
CONCLUSIONS: The findings suggest that a mobile app intervention can be made appealing to smokers who are unmotivated to quit by focusing on aspects most important to them, such as mood management. This theory-based intervention has shown some initial support for the underlying theoretical constructs, and further efficacy testing is warranted in a fully powered trial.
摘要：
背景：行为激活（BA）是一种基于证据的抑郁症治疗方法，可促进参与基于价值观的活动，以增加获得积极强化的机会。抑郁情绪已被证明会阻碍戒烟。
目的：这项研究确定了通过使用BA和整合戒烟动机信息来激励吸烟者戒烟的移动应用程序的可行性和初步功效。
方法：从广告中招募未准备在30天内戒烟的成年吸烟者（N=56；平均年龄34.5，SD9.52岁），并随机分配到BA应用程序的8周（每周设置2次基于价值观的活动+激励信息+关于吸烟变化的反馈，心情,和基于价值观的活动)或对照组(没有应用程序；收到戒烟资源)。所有参与者都完成了基线和基于网络的治疗结束问卷。控制还完成了每周基于网络的评估，和BA应用程序参与者通过应用程序完成评估。
结果：没有辍学，每种情况下只有2名参与者没有完成治疗结束问卷。结果表明，招募无动机戒烟的吸烟者参加戒烟诱导试验是可行的：86％（57/66）的合格参与者被随机分配（BA应用：n=27；对照：n=29）。参与者表示满意度很高：80％（20/25）的参与者表示他们会推荐BA应用程序，在移动应用程序评级量表上有中等到较高的分数，88％（22/25）的参与者将应用程序评为3星或更高（满分5）。有高水平的BA应用程序参与：96％（26/27）的参与者计划活动，67%(18/27)的参与者计划了7项或更多的活动。即使在那些持续吸烟风险最高的人中，也发现了高参与度（戒烟动机低，放弃的信心很低，和高负面影响)。结果为BA构建体之间的假设关系提供了支持：更愉快的活动完成与更大的积极影响相关（b=0.37，SE0.21；95％CI-0.05至0.79；P=.08），和更大的积极影响倾向于预测第二天吸烟减少（b=-0.19，SE0.10；95％CI-0.39至0.01；P=.06）。此外,计划的活动数量越多,负面影响越低(b=-0.26,SE0.15;95%CI-0.55~0.04;P=.09).总的来说,16％（4/25）的BA应用程序参与者设置了退出日期，而控件中的4％（1/27），并且有有希望（但不显著）的动机和信心退出趋势。
结论：研究结果表明，可以通过专注于对他们最重要的方面来吸引没有戒烟动机的吸烟者，比如情绪管理。这种基于理论的干预已经显示出对潜在理论结构的一些初步支持，并且在完全有效的试验中需要进一步的疗效测试.
目的：这项研究确定了通过使用BA和整合戒烟动机信息来激励吸烟者戒烟的移动应用程序的可行性和初步功效。
方法：从广告中招募未准备在30天内戒烟的成年吸烟者（N=56；平均年龄34.5，SD9.52岁），并随机分配到BA应用程序的8周（每周设置2次基于价值观的活动+激励信息+关于吸烟变化的反馈，心情,和基于价值观的活动)或对照组(没有应用程序；收到戒烟资源)。所有参与者都完成了基线和基于网络的治疗结束问卷。控制还完成了每周基于网络的评估，和BA应用程序参与者通过应用程序完成评估。
结果：没有辍学，每种情况下只有2名参与者没有完成治疗结束问卷。结果表明，招募无动机戒烟的吸烟者参加戒烟诱导试验是可行的：86％（57/66）的合格参与者被随机分配（BA应用：n=27；对照：n=29）。参与者表示满意度很高：80％（20/25）的参与者表示他们会推荐BA应用程序，在移动应用程序评级量表上有中等到较高的分数，88％（22/25）的参与者将应用程序评为3星或更高（满分5）。有高水平的BA应用程序参与：96％（26/27）的参与者计划活动，67%(18/27)的参与者计划了7项或更多的活动。即使在那些持续吸烟风险最高的人中，也发现了高参与度（戒烟动机低，放弃的信心很低，和高负面影响)。结果为BA构建体之间的假设关系提供了支持：更愉快的活动完成与更大的积极影响相关（b=0.37，SE0.21；95％CI-0.05至0.79；P=.08），和更大的积极影响倾向于预测第二天吸烟减少（b=-0.19，SE0.10；95％CI-0.39至0.01；P=.06）。此外,计划的活动数量越多,负面影响越低(b=-0.26,SE0.15;95%CI-0.55~0.04;P=.09).总的来说,16％（4/25）的BA应用程序参与者设置了退出日期，而控件中的4％（1/27），并且有有希望（但不显著）的动机和信心退出趋势。
结论：研究结果表明，可以通过专注于对他们最重要的方面来吸引没有戒烟动机的吸烟者，比如情绪管理。这种基于理论的干预已经显示出对潜在理论结构的一些初步支持，并且在完全有效的试验中需要进一步的疗效测试.
