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儿科医生为家长提供戒烟信息:一种行为表型分析的潜在类别方法。

Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping.

作者信息

Jenssen Brian P, Kelly Mary Kate, Faerber Jennifer, Hannan Chloe, Asch David A, Shults Justine, Schnoll Robert A, Fiks Alexander G

机构信息

Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (BP Jenssen, J Faerber, and AG Fiks), Philadelphia, Pa; PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia (BP Jenssen, MK Kelly, C Hannan, and AG Fiks), Philadelphia, Pa.

PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia (BP Jenssen, MK Kelly, C Hannan, and AG Fiks), Philadelphia, Pa.

出版信息

Acad Pediatr. 2021 Jan-Feb;21(1):129-138. doi: 10.1016/j.acap.2020.07.018. Epub 2020 Jul 27.

Abstract

OBJECTIVE

Message framing can be leveraged to motivate adult smokers to quit, but its value for parents in pediatric settings is unknown. Understanding parents' preferences for smoking cessation messages may help clinicians tailor interventions to increase quitting.

METHODS

We conducted a discrete choice experiment in which parent smokers of pediatric patients rated the relative importance of 26 messages designed to increase smoking cessation treatment. Messages varied on who the message featured (child, parent, and family), whether the message was gain- or loss-framed (emphasizing benefits of engaging or costs of failing to engage in treatment), and the specific outcome included (eg, general health, cancer, respiratory illnesses, and financial impact). Participants included 180 parent smokers at 4 pediatric primary care sites. We used latent class analysis of message ratings to identify groups of parents with similar preferences. Multinomial logistic regression described child and parent characteristics associated with group membership.

RESULTS

We identified 3 groups of parents with similar preferences for messages: Group 1 prioritized the impact of smoking on the child (n = 92, 51%), Group 2 favored gain-framed messages (n = 63, 35%), and Group 3 preferred messages emphasizing the financial impact of smoking (n = 25, 14%). Parents in Group 2 were more likely to have limited health literacy and have a child over age 6 and with asthma, compared to Group 1.

CONCLUSIONS

We identified 3 groups of parent smokers with different message preferences. This work may inform testing of tailored smoking cessation messages to different parent groups, a form of behavioral phenotyping supporting motivational precision medicine.

摘要

目的

信息框架可用于激励成年吸烟者戒烟,但其在儿科环境中对家长的价值尚不清楚。了解家长对戒烟信息的偏好可能有助于临床医生调整干预措施以增加戒烟成功率。

方法

我们进行了一项离散选择实验,让儿科患者的家长吸烟者对26条旨在增加戒烟治疗的信息的相对重要性进行评分。这些信息在其呈现对象(孩子、家长和家庭)、是收益框架还是损失框架(强调参与的好处或不参与治疗的代价)以及具体结果(如总体健康、癌症、呼吸道疾病和经济影响)方面存在差异。参与者包括4个儿科初级保健机构的180名家长吸烟者。我们对信息评分进行潜在类别分析,以识别具有相似偏好的家长群体。多项逻辑回归描述了与群体成员身份相关的儿童和家长特征。

结果

我们识别出3组对信息有相似偏好的家长:第1组优先考虑吸烟对孩子的影响(n = 92,51%),第2组青睐收益框架的信息(n = 63,35%),第3组更喜欢强调吸烟经济影响的信息(n = 25,14%)。与第1组相比,第2组的家长健康素养有限的可能性更大,且孩子年龄超过6岁且患有哮喘。

结论

我们识别出3组有不同信息偏好的家长吸烟者。这项工作可能为针对不同家长群体定制戒烟信息的测试提供参考,这是一种支持动机精准医学的行为表型分析形式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/357e/7785572/12ddd043c00c/nihms-1625014-f0001.jpg

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