Nair Uma S, Collins Bradley N, Patterson Freda, Rodriguez Daniel
College of Public Health, Temple University, Philadelphia, United States.
College of Public Health, Temple University, Philadelphia, United States; Department of Pediatrics, School of Medicine, Temple University, Philadelphia, United States.
Contemp Clin Trials. 2015 May;42:158-66. doi: 10.1016/j.cct.2015.03.002. Epub 2015 Mar 17.
Smoking and lack of physical activity (PA) contribute to disproportionate rates of disease among low-income adults. Interventions that simultaneously address both risk behaviors have strong potential to reduce health disparities. Existing smoking-PA studies indicate promising results but have limited generalizability to low-income populations. The goal of this study is to assess the effects of an integrated behavioral counseling approach to promote low-to-moderate intensity PA (LMPA) and reduce short-term smoking cue reactivity among low-income sedentary smokers.
This study uses a randomized, 2-group design with 4 measurement time points: baseline, quit day (week 4), 1-week and 1-month follow-up. Participants (sedentary, smoke>6 cigs/day) receive 4 weeks of either (a) standard smoking cessation counseling (SCC control) or (b) our Step-Up to Quit (SUTQ) intervention that integrates advice for LMPA with SCC. SUTQ counseling focuses on increasing daily steps (walking) to reach 7500-10,000/day by week 4 (quit day) and explicitly links short bouts of LMPA with smoking urge management. Potential for SUTQ to facilitate urge management will be assessed by comparing between-group differences in the reduction (extinction) of quit day cue reactivity. We will explore group differences in quit rates at 1-week and 1-month follow-up.
This novel approach overcomes gaps in the PA-smoking intervention literature by promoting a more realistic PA approach for sedentary populations, using an ecologically valid strategy, integrating LMPA with evidence-based SCC during a 4-week pre-quit period, and testing the SUTQ counseling model in a high-risk sample. Results will guide future efficacy and dissemination studies.
吸烟和缺乏体育活动导致低收入成年人中疾病发生率过高。同时解决这两种风险行为的干预措施具有显著潜力来减少健康差距。现有的吸烟与体育活动研究显示出有前景的结果，但对低收入人群的普遍适用性有限。本研究的目的是评估一种综合行为咨询方法的效果，该方法旨在促进低收入久坐吸烟者进行低至中等强度的体育活动（LMPA）并降低短期吸烟提示反应性。
本研究采用随机两组设计，有4个测量时间点：基线、戒烟日（第4周）、1周和1个月随访。参与者（久坐、每天吸烟>6支）接受4周的以下两种干预之一：（a）标准戒烟咨询（SCC对照组）或（b）我们的逐步戒烟（SUTQ）干预，该干预将LMPA建议与SCC相结合。SUTQ咨询侧重于在第4周（戒烟日）前增加每日步数（步行）至7500 - 10000步/天，并明确将短时间的LMPA与吸烟冲动管理联系起来。将通过比较两组在戒烟日提示反应性降低（消退）方面的差异来评估SUTQ促进冲动管理的潜力。我们将探索1周和1个月随访时两组在戒烟率上的差异。
这种新方法通过为久坐人群推广更现实的体育活动方法、采用生态有效策略、在4周的戒烟前期将LMPA与循证SCC相结合以及在高风险样本中测试SUTQ咨询模型，克服了体育活动与吸烟干预文献中的空白。结果将指导未来的疗效和传播研究。
