Brunette Mary F, Gunn William, Alvarez Hilary, Finn Patricia C, Geiger Pamela, Ferron Joelle C, McHugo Gregory J
Geisel School of Medicine at Dartmouth, Department of Psychiatry, Psychiatric Research Center, 105 Pleasant St, Concord, NH, 03301, USA.
Concord Hospital Family Health Center, Concord, USA.
Addict Sci Clin Pract. 2015 Feb 1;10(1):3. doi: 10.1186/s13722-015-0026-5.
People with low education and/or income are more likely to smoke, less likely to quit, and experience disparately poor health outcomes compared to those with education and income advantage. Cost-effective strategies are needed to inform and engage this group into effective cessation treatments. We developed a novel, web-based, motivational, decision-support system that was designed to engage disadvantaged smokers into tobacco cessation treatment. We piloted the system among smokers in a primary care safety net clinic.
Thirty-nine eligible subjects were assessed at baseline and used the decision-support system; 38 were assessed 2 months later. Chi-square or Fisher's exact tests were used to assess whether participants who used the program were more likely to use cessation treatment than a randomly selected group of 60 clinic patients.
Thirty-nine percent of smokers initiated cessation treatment after using the decision-support system, compared to 3 percent of the comparison group (Fisher's exact = 21.2; p = 0.000). Over 10 percent achieved continuous abstinence over the 2-month follow-up. Users were satisfied with the program - 100 percent stated they would recommend it to a friend.
Our data indicate that this web-based, motivational, decision-support system is feasible, satisfactory, and promising in its ability to engage smokers into cessation treatment in a primary care safety net clinic. Further evaluation research is warranted.
与具有教育和收入优势的人群相比，受教育程度低和/或收入低的人吸烟可能性更高，戒烟可能性更低，健康状况也明显较差。需要采用具有成本效益的策略，让这一群体了解并参与有效的戒烟治疗。我们开发了一种新型的基于网络的激励性决策支持系统，旨在让处于不利地位的吸烟者参与戒烟治疗。我们在一家初级保健安全网诊所的吸烟者中对该系统进行了试点。
39名符合条件的受试者在基线时接受评估并使用了决策支持系统；2个月后对38名受试者进行了评估。使用卡方检验或费舍尔精确检验来评估使用该项目的参与者是否比随机选择的60名诊所患者更有可能使用戒烟治疗。
使用决策支持系统后，39%的吸烟者开始接受戒烟治疗，而对照组这一比例为3%（费舍尔精确检验=21.2；p=0.000）。在2个月的随访中，超过10%的人实现了持续戒烟。用户对该项目感到满意——100%的人表示会向朋友推荐。
我们的数据表明，这种基于网络的激励性决策支持系统在初级保健安全网诊所中，让吸烟者参与戒烟治疗方面是可行的、令人满意的且前景良好。有必要进行进一步的评估研究。
