针对青少年戒烟的主动式、个性化电话咨询干预的群组随机试验。
Group-randomized trial of a proactive, personalized telephone counseling intervention for adolescent smoking cessation.
作者信息
Peterson Arthur V, Kealey Kathleen A, Mann Sue L, Marek Patrick M, Ludman Evette J, Liu Jingmin, Bricker Jonathan B
机构信息
Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
出版信息
J Natl Cancer Inst. 2009 Oct 21;101(20):1378-92. doi: 10.1093/jnci/djp317. Epub 2009 Oct 12.
BACKGROUND
The Hutchinson Study of High School Smoking randomized trial was designed to rigorously evaluate a proactive, personalized telephone counseling intervention for adolescent smoking cessation.
METHODS
Fifty randomly selected Washington State high schools were randomized to the experimental or control condition. High school junior smokers were proactively identified (N = 2151). Trained counselors delivered the motivational interviewing plus cognitive behavioral skills training telephone intervention to smokers in experimental schools during their senior year of high school. Participants were followed up, with 88.8% participation, to outcome ascertainment more than 1 year after random assignment. The main outcome was 6-months prolonged abstinence from smoking. All statistical tests were two-sided.
RESULTS
The intervention increased the percentage who achieved 6-month prolonged smoking abstinence among all smokers (21.8% in the experimental condition vs 17.7% in the control condition, difference = 4.0%, 95% confidence interval [CI] = -0.2 to 8.1, P = .06) and in particular among daily smokers (10.1% vs 5.9%, difference = 4.1%, 95% CI = 0.8 to 7.1, P = .02). There was also generally strong evidence of intervention impact for 3-month, 1-month, and 7-day abstinence and duration since last cigarette (P = .09, .015, .01, and .03, respectively). The intervention effect was strongest among male daily smokers and among female less-than-daily smokers.
CONCLUSIONS
Proactive identification and recruitment of adolescents via public high schools can produce a high level of intervention reach; a personalized motivational interviewing plus cognitive behavioral skills training counseling intervention delivered by counselor-initiated telephone calls is effective in increasing teen smoking cessation; and both daily and less-than-daily teen smokers participate in and benefit from telephone-based smoking cessation intervention.
背景
哈钦森高中吸烟研究随机试验旨在严格评估一种针对青少年戒烟的积极主动、个性化的电话咨询干预措施。
方法
随机选取50所华盛顿州的高中，随机分为实验组或对照组。主动识别出高中三年级的吸烟者（N = 2151）。经过培训的咨询师在高中四年级时，对实验组学校的吸烟者进行动机访谈加认知行为技能培训的电话干预。对参与者进行随访，随机分组后1年多的结局确定时参与率为88.8%。主要结局是6个月持续戒烟。所有统计检验均为双侧检验。
结果
干预措施提高了所有吸烟者中实现6个月持续戒烟的比例（实验组为21.8%，对照组为17.7%，差异 = 4.0%，95%置信区间[CI] = -0.2至8.1，P = 0.06），尤其是在每日吸烟者中（10.1%对5.9%，差异 = 4.1%，95%CI = 0.8至7.1，P = 0.02）。对于3个月、1个月和7天的戒烟以及自上次吸烟后的持续时间，也普遍有强有力的证据表明干预有效果（P分别为0.09、0.015、0.01和0.03）。干预效果在男性每日吸烟者和女性非每日吸烟者中最为显著。
结论
通过公立高中主动识别和招募青少年能够实现较高的干预覆盖水平；由咨询师发起电话提供的个性化动机访谈加认知行为技能培训咨询干预措施在增加青少年戒烟方面是有效的；每日吸烟和非每日吸烟的青少年都参与基于电话的戒烟干预并从中受益。
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