1 Center of Competence for Public Management, University of Bern, Bern, Switzerland.
2 Faculty of Medicine, University of Geneva, Geneva, Switzerland.
J Telemed Telecare. 2017 Jun;23(5):521-528. doi: 10.1177/1357633X16655476. Epub 2016 Jun 30.
Introduction Self-help computer-based programs are easily accessible and cost-effective interventions with a great recruitment potential. However, each program is different and results of meta-analyses may not apply to each new program; therefore, evaluations of new programs are warranted. The aim of this study was to assess the marginal efficacy of a computer-based, individually tailored program (the Coach) over and above the use of a comprehensive Internet smoking cessation website. Methods A two-group randomized controlled trial was conducted. The control group only accessed the website, whereas the intervention group received the Coach in addition. Follow-up was conducted by e-mail after three and six months (self-administrated questionnaires). Of 1120 participants, 579 (51.7%) responded after three months and 436 (38.9%) after six months. The primary outcome was self-reported smoking abstinence over four weeks. Results Counting dropouts as smokers, there were no statistically significant differences between intervention and control groups in smoking cessation rates after three months (20.2% vs. 17.5%, p = 0.25, odds ratio (OR) = 1.20) and six months (17% vs. 15.5%, p = 0.52, OR = 1.12). Excluding dropouts from the analysis, there were statistically significant differences after three months (42% vs. 31.6%, p = 0.01, OR = 1.57), but not after six months (46.1% vs. 37.8%, p = 0.081, OR = 1.41). The program also significantly increased motivation to quit after three months and self-efficacy after three and six months. Discussion An individually tailored program delivered via the Internet and by e-mail in addition to a smoking cessation website did not significantly increase smoking cessation rates, but it increased motivation to quit and self-efficacy.
介绍
自助式计算机程序是一种易于获取且具有成本效益的干预措施，具有很大的招募潜力。然而，每个程序都不同，荟萃分析的结果可能不适用于每个新程序；因此，需要对新程序进行评估。本研究旨在评估基于计算机的个体化定制程序（Coach）在使用全面的互联网戒烟网站之上的边际疗效。
方法
采用两臂随机对照试验。对照组仅访问网站，而干预组在此基础上还使用了 Coach。在三个月和六个月后（通过电子邮件进行自我管理的问卷调查）进行随访。在 1120 名参与者中，有 579 名（51.7%）在三个月后做出回应，436 名（38.9%）在六个月后做出回应。主要结局是四周内自我报告的戒烟情况。
结果
将辍学者视为吸烟者，在三个月时，干预组和对照组的戒烟率没有统计学上的显著差异（20.2%比 17.5%，p=0.25，比值比（OR）=1.20），六个月时也没有统计学上的显著差异（17%比 15.5%，p=0.52，OR=1.12）。从分析中排除辍学者后，三个月时有统计学上的显著差异（42%比 31.6%，p=0.01，OR=1.57），但六个月时没有统计学上的显著差异（46.1%比 37.8%，p=0.081，OR=1.41）。该程序还显著提高了三个月时的戒烟动机和三个月及六个月时的自我效能感。
讨论
除了戒烟网站之外，通过互联网和电子邮件提供个体化定制程序并没有显著提高戒烟率，但它提高了戒烟动机和自我效能感。
