吸烟仍然是一个非常重要的可预防的全球公共卫生问题。在这种情况下,数字干预在缺乏生物副作用方面提供了巨大的优势,自动交付的可能性,相对于传统干预措施,也节省了人力资源。此类干预措施已在随机对照试验(RCT)中进行了研究,但尚未进行系统审查,包括基于文本和基于多平台的干预措施。此外,这一领域还没有从心理干预理论基础的角度进行评价。
本文的目的是评估数字干预在戒烟的RCT研究中的效率,并评估用于数字干预的策略的有效性。
使用PubMed对RCT进行了电子搜索,Embase,和Cochrane图书馆到2021年6月30日。符合条件的研究必须将自动数字干预(ADI)与使用自助指南或无干预进行比较。参与者是目前的吸烟者(16岁或以上)。作为主要结果,从研究中提取终点后的禁欲。进行了系统评价和荟萃分析以评估ADI的效率。进行了Meta分析以评估干预理论与有效性之间的关系。
共有19项试验(15,472名参与者)纳入分析。终点时的总禁欲率(95%CI)为17.8%(17.0-18.7)。干预组与终点对照组相比的总体风险比为17.8%(17.0-18.7)。用于随机试验的Cochrane偏倚风险工具(ROB2)表明,大多数研究的偏倚风险较低(56.3%)。与心理学理论相关的结构或预测因子,指的是其他基于理论的概念(而不仅仅是行为理论),例如渴望或焦虑,与有效性有关。
这项研究发现,与自助指南或无干预相比,ADI具有明显的积极作用,有效性与理论相关的结构或预测因子相关。决策者和临床从业人员应促进ADI,以解决戒烟需求与传统治疗资源之间的巨大差距。通过最佳整合心理治疗理论和技术,可以实现ADI效率的可能提高。
PROSPEROCRD42021256593;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=256593。
Smoking remains a highly significant preventable global public health problem. In this context, digital interventions offer great advantages in terms of a lack of biological side effects, possibility of automatic delivery, and consequent human resource savings relative to traditional interventions. Such interventions have been studied in randomized controlled trials (RCTs) but have not been systematically reviewed with the inclusion of text-based and multiplatform-based interventions. In addition, this area has not been evaluated from the perspective of the psychological theoretical basis of intervention.
The aim of this paper is to assess the efficiency of digital interventions in RCT studies of smoking cessation and to evaluate the effectiveness of the strategies used for digital interventions.
An electronic search of RCTs was conducted using PubMed, Embase, and the Cochrane Library by June 30, 2021. Eligible studies had to compare
automated digital intervention (ADI) to the use of a self-help guideline or no intervention. Participants were current smokers (aged 16 years or older). As the main outcome, abstinence after endpoint was extracted from the studies. Systematic review and meta-analysis were conducted to assess the efficiency of ADIs. Metaregressions were conducted to assess the relationship between intervention theory and effectiveness.
A total of 19 trials (15,472 participants) were included in the analysis. The overall abstinence rate (95% CI) at the endpoint was 17.8% (17.0-18.7). The overall risk ratio of the intervention group compared to the controls at the endpoint was 17.8% (17.0-18.7). Cochrane risk-of-bias tool for randomized trials (ROB 2) suggested that most of the studies had a low risk of bias (56.3%). Psychological theory-related constructs or predictors, which refer to other theory-based concepts (rather than only behavioral theory) such as craving or anxiety, are associated with effectiveness.
This study found that ADI had a clear positive effect compared to self-help guidelines or to no intervention, and effectiveness was associated with theory-related constructs or predictors. ADIs should be promoted by policy makers and clinical practitioners to address the huge gap between the need for smoking cessation and availability of traditional treatment resources. Possible increases in ADI efficiency may be achieved by optimally integrating psychotherapeutic theories and techniques.
PROSPERO CRD42021256593; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256593.