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生物标志物反馈干预对阿拉斯加原住民孕妇戒烟的影响:随机试点研究。

Biomarker feedback intervention for smoking cessation among Alaska Native pregnant women: Randomized pilot study.

机构信息

Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.

Clinical and Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr., Anchorage, AK, 99508, USA.

出版信息

Patient Educ Couns. 2019 Mar;102(3):528-535. doi: 10.1016/j.pec.2018.10.009. Epub 2018 Oct 12.

Abstract

OBJECTIVE

There is some evidence for biomarker feedback when combined with cessation counseling for reducing smoking in pregnancy. This randomized controlled pilot study evaluated feasibility and potential efficacy of a social-cognitive theory (SCT)-based biomarker feedback intervention among pregnant Alaska Native (AN) smokers.

METHODS

Participants were randomly assigned to receive three study calls (10-20 min each): (1) biomarker feedback intervention (n = 30) including personalized cotinine results and feedback on their baby's likely exposure to carcinogen metabolite NNAL, or (2) contact control usual care condition based on the 5As (n = 30). Assessments were conducted at baseline, post-treatment, and delivery.

RESULTS

High rates of treatment compliance, study retention, and treatment acceptability were observed in both groups. 7-day point prevalence smoking abstinence rates at delivery verified with urinary cotinine were the same in both study groups (20% intent-to-treat analysis, 26% per-protocol). SCT-based measures did not change differentially from baseline by study group.

CONCLUSION

This trial supports the feasibility and acceptability of providing biomarker feedback within the clinical care delivery system, but the intervention did not promote increased smoking cessation during pregnancy compared to usual care.

PRACTICE IMPLICATIONS

Efforts are needed to promote the usual care and to develop alternative biomarker feedback messaging for pregnant AN women.

摘要

目的

有证据表明,生物标志物反馈与戒烟咨询相结合,可以减少孕妇吸烟。本随机对照初步研究评估了基于社会认知理论(SCT)的生物标志物反馈干预在阿拉斯加原住民(AN)孕妇吸烟者中的可行性和潜在疗效。

方法

参与者被随机分配接受三次研究电话(每次 10-20 分钟):(1)生物标志物反馈干预(n=30),包括个性化可替宁结果和他们的婴儿可能接触致癌代谢物 NNAL 的反馈,或(2)基于 5A 的联系控制常规护理条件(n=30)。在基线、治疗后和分娩时进行评估。

结果

两组均观察到治疗依从性、研究保留率和治疗可接受性的高比率。通过尿液可替宁验证的分娩时 7 天点流行率吸烟禁欲率在两组研究中相同(意向治疗分析 20%,方案分析 26%)。基于 SCT 的措施在研究组之间没有差异。

结论

这项试验支持在临床护理提供系统中提供生物标志物反馈的可行性和可接受性,但与常规护理相比,该干预并未促进怀孕期间吸烟的增加。

实践意义

需要努力促进常规护理,并为孕妇 AN 妇女开发替代生物标志物反馈信息。

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