尼古丁贴片使用者中基于网络的计算机定制戒烟计划的调节因素和中介因素
Moderators and mediators of a web-based computer-tailored smoking cessation program among nicotine patch users.
作者信息
Strecher Victor J, Shiffman Saul, West Robert
机构信息
University of Michigan Comprehensive Cancer Center, 300 N. Ingalls-Room 5D-04 (0471), Ann Arbor, MI 48109-0471, USA.
出版信息
Nicotine Tob Res. 2006 Dec;8 Suppl 1:S95-101. doi: 10.1080/14622200601039444.
The aim of this study was to examine moderating and mediating factors of the efficacy of World Wide Web-based tailored behavioral smoking cessation materials. The design was a two-group randomized controlled trial in England and the Republic of Ireland. Participants were 3971 subjects who purchased a particular brand of nicotine patch and logged on to use a free Web-based behavioral support program. The intervention was Web-based tailored behavioral smoking cessation materials or Web-based nontailored materials. The 10-week continuous abstinence rate was assessed by Internet-based survey at 12-week follow-up. Potential treatment moderators were examined using subgroups of established or possible predictors of smoking cessation. Treatment mediators examined included 6-week follow-up measures of program relevance and amount of the Web-based materials read. Within all subgroups examined, subjects in the Web-based tailored intervention were more likely to report 10-week continuous abstinence at 12-week follow-up. Significant moderators, indicating a significant difference in program efficacy between subgroups, included presence of a tobacco-related illness (larger treatment-control differences among subjects with a tobacco-related illness), presence of nonsmoking children in the household (larger treatment-control differences among subjects with nonsmoking children in the household), and frequent alcohol consumption (larger treatment-control differences among subjects with higher alcohol consumption). Perceived program relevance at 6-week follow-up was a mediator of cessation at 12-week follow-up. Robust results of the tailored program may be explained by the tailoring strategies utilized in the treatment conditions. Moderating variables may be particularly useful to address in tailored messaging. The mediating factor of perceived message relevance may provide a partial mechanism of effective program tailoring.
本研究的目的是检验基于万维网的个性化行为戒烟材料效果的调节因素和中介因素。研究设计为在英格兰和爱尔兰共和国进行的两组随机对照试验。参与者为3971名购买了某一特定品牌尼古丁贴片并登录使用免费网络行为支持项目的受试者。干预措施为基于网络的个性化行为戒烟材料或基于网络的非个性化材料。在12周随访时通过基于互联网的调查评估10周持续戒烟率。使用已确定的或可能的戒烟预测因素亚组来检验潜在的治疗调节因素。所检验的治疗中介因素包括对项目相关性的6周随访测量以及所阅读的网络材料数量。在所有检验的亚组中,接受基于网络的个性化干预的受试者在12周随访时更有可能报告10周持续戒烟。显著的调节因素表明亚组间项目效果存在显著差异,包括患有烟草相关疾病(患有烟草相关疾病的受试者中治疗组与对照组差异更大)、家中有不吸烟儿童(家中有不吸烟儿童的受试者中治疗组与对照组差异更大)以及频繁饮酒(饮酒量较高的受试者中治疗组与对照组差异更大)。6周随访时感知到的项目相关性是12周随访时戒烟的中介因素。个性化项目的稳健结果可能由治疗条件中所采用的个性化策略来解释。在个性化信息传递中,调节变量可能特别有助于解决问题。感知到的信息相关性这一中介因素可能为有效的项目个性化提供部分机制。