设计及实施针对青少年戒烟的有效电话咨询干预措施
2009/12/15
背景：现在急需对青少年进行有效的戒烟，但文献中相关研究较少。我们对一项采用主动干预促进青少年戒烟的措施进行评价，该措施含有动机访谈（MI）和认知行为技能培训（CBST）。
方法：采用班级调查的方法选取25个试验中学初中部的1058名吸烟学生。经父母同意后，由经培训的咨询者电话吸烟学生，邀请学生参与本项研究并给予戒烟咨询，其中包括MI和CBST。通过每周监督咨询者并回顾5％的咨询者电话检测咨询者对计划的顺应性以及通过随机选取19.8％的咨询电话采用动机访谈治疗完整性代码正式评价咨询者对MI的忠实性，来评价咨询的完成质量。
结果：基于年龄（≥18岁）和父母知情同意，948（89.6%）名学生入选，其中736（70%）名同意参与电话咨询，691（65％）人完成1次或多次电话咨询，499（47％）人完成所有电话随访。通过电话，对吸烟学生给予个体化的MI 和CBST，其中90％的对象对干预计划的依从性较好。对随机选取的咨询电话样本回顾分析显示，对于6个评价行为中的4个，有超过85％的咨询电话满足或超过基准分：MI精神（99.1%）、同情（96.2%）、对问题的反应比率（97.2%）及MI依从性（85.7%）。
结论：在青少年吸烟者中可采用MI和CBST组成的主动电话咨询干预进行有效的戒烟，此方法具有较好的可操作性和忠实度。
（刘国梁 审校）
J Natl Cancer Inst. 2009 Oct 12.
Design and Implementation of an Effective Telephone Counseling Intervention for Adolescent Smoking Cessation.
Kealey KA, Ludman EJ, Marek PM, Mann SL, Bricker JB, Peterson AV.
Background Effective smoking cessation for youth is urgently needed, but the literature guiding such efforts is nascent. We evaluated the implementation of a proactive intervention for adolescent smoking cessation that incorporated motivational interviewing (MI) and cognitive behavioral skills training (CBST). Methods We proactively identified 1058 smokers via classroom survey of enrolled juniors in 25 experimental high schools. After parental consent was obtained, trained counselors telephoned participants to invite their participation and deliver personalized smoking cessation counseling that combined MI and CBST. Implementation quality was assessed via weekly supervision of counselors, monitoring of counselor adherence to protocol via review of 5% of each counselor’s calls, and formal evaluation of counselor fidelity to MI via review of a random sample of 19.8% of counseling calls using the Motivational Interviewing Treatment Integrity Code. Results Among identified smokers, 948 (89.6%) were eligible for intervention by age (>/=18 years) or parental consent, 736 (70%) agreed to participate in telephone counseling, 691 (65%) completed one or more counseling calls, and 499 (47%) completed all planned calls. Telephone delivery of the personalized MI and CBST counseling intervention to a general population of adolescents was done with greater than 90% adherence to the intervention protocol. Review of the random sample of counselors’ calls demonstrated that more than 85% of counselors’ calls met or exceeded benchmark scores for four of six evaluated behaviors: MI spirit (99.1%), empathy (96.2%), ratio of reflections to questions (97.2%), and MI adherent (85.7%). Conclusion An effective proactive telephone counseling intervention consisting of MI and CBST can be successfully implemented with reach and fidelity in a general population of adolescent smokers.
Kealey KA, Ludman EJ, Marek PM, et al. J Natl Cancer Inst. 2009 Oct 12.
方法：采用班级调查的方法选取25个试验中学初中部的1058名吸烟学生。经父母同意后，由经培训的咨询者电话吸烟学生，邀请学生参与本项研究并给予戒烟咨询，其中包括MI和CBST。通过每周监督咨询者并回顾5％的咨询者电话检测咨询者对计划的顺应性以及通过随机选取19.8％的咨询电话采用动机访谈治疗完整性代码正式评价咨询者对MI的忠实性，来评价咨询的完成质量。
结果：基于年龄（≥18岁）和父母知情同意，948（89.6%）名学生入选，其中736（70%）名同意参与电话咨询，691（65％）人完成1次或多次电话咨询，499（47％）人完成所有电话随访。通过电话，对吸烟学生给予个体化的MI 和CBST，其中90％的对象对干预计划的依从性较好。对随机选取的咨询电话样本回顾分析显示，对于6个评价行为中的4个，有超过85％的咨询电话满足或超过基准分：MI精神（99.1%）、同情（96.2%）、对问题的反应比率（97.2%）及MI依从性（85.7%）。
结论：在青少年吸烟者中可采用MI和CBST组成的主动电话咨询干预进行有效的戒烟，此方法具有较好的可操作性和忠实度。
（刘国梁 审校）
J Natl Cancer Inst. 2009 Oct 12.
Design and Implementation of an Effective Telephone Counseling Intervention for Adolescent Smoking Cessation.
Kealey KA, Ludman EJ, Marek PM, Mann SL, Bricker JB, Peterson AV.
Background Effective smoking cessation for youth is urgently needed, but the literature guiding such efforts is nascent. We evaluated the implementation of a proactive intervention for adolescent smoking cessation that incorporated motivational interviewing (MI) and cognitive behavioral skills training (CBST). Methods We proactively identified 1058 smokers via classroom survey of enrolled juniors in 25 experimental high schools. After parental consent was obtained, trained counselors telephoned participants to invite their participation and deliver personalized smoking cessation counseling that combined MI and CBST. Implementation quality was assessed via weekly supervision of counselors, monitoring of counselor adherence to protocol via review of 5% of each counselor’s calls, and formal evaluation of counselor fidelity to MI via review of a random sample of 19.8% of counseling calls using the Motivational Interviewing Treatment Integrity Code. Results Among identified smokers, 948 (89.6%) were eligible for intervention by age (>/=18 years) or parental consent, 736 (70%) agreed to participate in telephone counseling, 691 (65%) completed one or more counseling calls, and 499 (47%) completed all planned calls. Telephone delivery of the personalized MI and CBST counseling intervention to a general population of adolescents was done with greater than 90% adherence to the intervention protocol. Review of the random sample of counselors’ calls demonstrated that more than 85% of counselors’ calls met or exceeded benchmark scores for four of six evaluated behaviors: MI spirit (99.1%), empathy (96.2%), ratio of reflections to questions (97.2%), and MI adherent (85.7%). Conclusion An effective proactive telephone counseling intervention consisting of MI and CBST can be successfully implemented with reach and fidelity in a general population of adolescent smokers.
Kealey KA, Ludman EJ, Marek PM, et al. J Natl Cancer Inst. 2009 Oct 12.
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在肺癌手术时实施戒烟计划的经济效益
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采用体力活动辅助戒烟：在戒烟门诊的戒烟者中跨理论模型的多种行为变化的应用
