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评估一种综合治疗方案对 HIV 感染者戒烟和焦虑/抑郁症状的效果:一项随机对照试验的研究方案。

Evaluation of an integrated treatment to address smoking cessation and anxiety/depressive symptoms among people living with HIV: Study protocol for a randomized controlled trial.

机构信息

Department of Psychology, University of Houston, Houston, TX, United States of America.

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.

出版信息

Contemp Clin Trials. 2021 Jul;106:106420. doi: 10.1016/j.cct.2021.106420. Epub 2021 Apr 30.

Abstract

BACKGROUND

Interventions that target anxiety/depressive symptoms in the context of smoking treatment have shown promise irrespective of psychiatric diagnosis. Yet, these tailored treatments are largely absent for persons who smoke and are living with HIV (SLWH).

OBJECTIVE

To evaluate a novel, smoking cessation intervention that addresses anxiety/depression and HIV-related health (QUIT) against a time-matched control (TMC) and a standard of care (SOC) condition.

METHODS

SLWH (N = 180) will be recruited and enrolled from 3 medical clinics in Boston, MA, and Houston, TX. The trial will consist of a baseline assessment, a 10-week intervention/assessment period, and follow-up assessments, accounting for a total study duration of approximately 8 months. All participants will complete a baseline visit and a pre-randomization standardized psychoeducation visit, and will then be randomized to one of three conditions: QUIT, TMC, or SOC. QUIT and TMC will consist of nine 60-min, cognitive behavioral therapy-based, individual weekly counseling sessions using standard smoking cessation counseling; additionally, QUIT will target anxiety and depressive symptoms by addressing underlying mechanisms related to mood and quit difficulty. SOC participants will complete weekly self-report surveys for nine weeks. All participants will be encouraged to quit at Session 7 and will be offered nicotine replacement therapy to help.

CONCLUSIONS

QUIT is designed to improve smoking cessation in SLWH by addressing anxiety and depression and HIV-related health issues. If successful, the QUIT intervention would be ready for implementation and dissemination into "real-world" behavioral health and social service settings consistent with the four objectives outlined in NIDA's Strategic Plan.

摘要

背景

针对吸烟治疗中焦虑/抑郁症状的干预措施已显示出其有效性,无论患者是否有精神科诊断。然而,针对同时吸烟和感染艾滋病毒(HIV)的人群(HIV 感染者),这些量身定制的治疗方案却基本不存在。

目的

评估一种新的、针对焦虑/抑郁和与 HIV 相关健康问题的戒烟干预措施(QUIT),与时间匹配对照(TMC)和标准护理(SOC)条件进行对比。

方法

将从马萨诸塞州波士顿和德克萨斯州休斯顿的 3 家医疗诊所招募并纳入 HIV 感染者(N=180)。该试验将包括基线评估、10 周的干预/评估期和随访评估,总研究持续时间约为 8 个月。所有参与者都将完成基线访视和预随机化标准化心理教育访视,然后随机分配到三个条件之一:QUIT、TMC 或 SOC。QUIT 和 TMC 将包括 9 次每次 60 分钟的认知行为治疗为基础的个体每周咨询,采用标准的戒烟咨询;此外,QUIT 将通过解决与情绪和戒烟困难相关的潜在机制来针对焦虑和抑郁症状。SOC 参与者将在九周内每周完成自我报告调查。所有参与者将在第 7 次会议时被鼓励戒烟,并提供尼古丁替代疗法来帮助他们。

结论

QUIT 旨在通过解决 HIV 感染者的焦虑和抑郁以及与 HIV 相关的健康问题来提高戒烟率。如果成功,QUIT 干预措施将准备好进行实施和传播到“真实世界”的行为健康和社会服务环境中,符合 NIDA 战略计划中概述的四个目标。

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