de Ruijter D, Smit E S, de Vries H, Hoving C
Department of Health Promotion, Maastricht University, Maastricht, the Netherlands.
Department of Communication Science, University of Amsterdam, Amsterdam, the Netherlands.
Contemp Clin Trials. 2016 May;48:125-32. doi: 10.1016/j.cct.2016.04.007. Epub 2016 Apr 19.
Dutch practice nurses sub-optimally adhere to evidence-based smoking cessation guidelines. Web-based computer-tailoring could be effective in improving their guideline adherence. Therefore, this paper aims to describe the development of a web-based computer-tailored program and the design of a randomized controlled trial testing its (cost-)effectiveness.
Theoretically grounded in the I-Change Model and Self-Determination Theory, and based on the results of a qualitative needs assessment among practice nurses, a web-based computer-tailored program was developed including three modules with tailored advice, an online forum, modules with up-to-date information about smoking cessation, Frequently Asked Questions (FAQs) and project information, and a counseling checklist. The program's effects are assessed by comparing an intervention group (access to all modules) with a control group (access to FAQs, project information and counseling checklist only). Smoking cessation guideline adherence and behavioral predictors (i.e. intention, knowledge, attitude, self-efficacy, social influence, action and coping planning) are measured at baseline and at 6- and 12-month follow-up. Additionally, the program's indirect effects on smokers' quit rates and the number of quit attempts are assessed after 6 and 12months.
This paper describes the development of a web-based computer-tailored adherence support program for practice nurses and the study design of a randomized controlled trial testing its (cost-)effectiveness. This program potentially contributes to improving the quality of smoking cessation care in Dutch general practices. If proven effective, the program could be adapted for use by other healthcare professionals, increasing the public health benefits of improved smoking cessation counseling for smokers.
荷兰的执业护士对循证戒烟指南的遵循情况欠佳。基于网络的计算机定制干预可能有助于提高他们对指南的遵循程度。因此，本文旨在描述一个基于网络的计算机定制项目的开发过程以及一项测试其（成本）效益的随机对照试验的设计。
以行为改变I-Change模型和自我决定理论为理论基础，并基于对执业护士进行的定性需求评估结果，开发了一个基于网络的计算机定制项目，该项目包括三个提供定制建议的模块、一个在线论坛、包含戒烟最新信息的模块、常见问题解答和项目信息，以及一份咨询清单。通过将干预组（可访问所有模块）与对照组（仅可访问常见问题解答、项目信息和咨询清单）进行比较来评估该项目的效果。在基线以及6个月和12个月随访时测量戒烟指南遵循情况和行为预测因素（即意图、知识、态度、自我效能感、社会影响、行动和应对计划）。此外，在6个月和12个月后评估该项目对吸烟者戒烟率和戒烟尝试次数的间接影响。
本文描述了一个为执业护士开发的基于网络的计算机定制依从性支持项目以及一项测试其（成本）效益的随机对照试验的研究设计。该项目可能有助于提高荷兰全科医疗中戒烟护理的质量。如果被证明有效，该项目可进行调整以供其他医疗保健专业人员使用，从而增加改善吸烟者戒烟咨询所带来的公共卫生效益。
