Lenert Leslie, Muñoz Ricardo F, Perez John E, Bansod Aditya
Department of Medicine, University of California, La Jolla, CA, USA.
J Am Med Inform Assoc. 2004 Jul-Aug;11(4):235-40. doi: 10.1197/jamia.M1464. Epub 2004 Apr 2.
The aim of this study was to determine whether an automated e-mail messaging system that sent individually timed educational messages (ITEMs) increased the effectiveness of an Internet smoking cessation intervention.
Using two consecutive series of participants, the authors compared two Web-based self-help style smoking cessation interventions: a single-point-in-time educational intervention and an enhanced intervention that also sent ITEMs timed to participants' quit efforts. Outcomes were compared in 199 participants receiving the one-time intervention and 286 receiving ITEMs.
Demographic factors, number of cigarettes smoked, nicotine addiction, depressive symptoms, and confidence in ability to quit were measured at entry. Twenty-four-hour quit attempts and seven-day point-prevalence of abstinence (nonrespondents assumed to smoke) were measured 30 days after each subject's self-selected quit date.
The one-time and ITEMs groups differed in some demographics and some relapse risk factors but not in factors associated with 30-day quit rates. ITEMs appeared to increase the rate at which individuals set quit dates (97% vs. 91%, p = 0.005) and, among the respondents to follow-up questionnaires (n = 145), the rate of reported 24-hour quit efforts (83% vs. 54%, p = 0.001). The 30-day intent-to-treat quit rates were higher in the ITEMs group: 7.5% vs. 13.6%, p = 0.035. In multivariate analyses controlling for differences between groups, receiving ITEMs was associated with an increase in the odds ratio for quitting of 2.6 (95% confidence interval = 1.3-5.3).
ITEMs sent on strategic days in smokers' quit efforts enhanced early success with smoking cessation relative to a single-point-in-time Web intervention. The effect appears to be mediated by ITEMs' causing smokers to plan and undertake quit efforts more frequently.
本研究旨在确定发送个性化定时教育信息（ITEMs）的自动电子邮件系统是否能提高网络戒烟干预的效果。
作者使用连续的两组参与者，比较了两种基于网络的自助式戒烟干预措施：一次性教育干预和增强干预，后者还会根据参与者的戒烟努力发送定时的ITEMs。对199名接受一次性干预的参与者和286名接受ITEMs的参与者的结果进行了比较。
在入组时测量人口统计学因素、吸烟数量、尼古丁成瘾、抑郁症状以及戒烟能力信心。在每个受试者自行选择的戒烟日期30天后，测量24小时戒烟尝试情况和七天的禁欲点患病率（未回复者假定仍在吸烟）。
一次性干预组和ITEMs组在一些人口统计学特征和一些复发风险因素上存在差异，但在与30天戒烟率相关的因素上没有差异。ITEMs似乎提高了个体设定戒烟日期的比例（97%对91%，p = 0.005），并且在后续问卷调查的回复者中（n = 145），报告的24小时戒烟努力的比例也更高（83%对54%，p = 0.001）。ITEMs组的30天意向性治疗戒烟率更高：7.5%对13.6%，p = 0.035。在控制组间差异的多变量分析中，接受ITEMs与戒烟优势比增加2.6相关（95%置信区间 = 1.3 - 5.3）。
相对于一次性网络干预，在吸烟者戒烟努力的关键日子发送ITEMs可提高早期戒烟成功率。这种效果似乎是由ITEMs促使吸烟者更频繁地计划和进行戒烟努力所介导的。
