StopAdvisor的初步研究：针对各个社会阶层的基于理论并基于网络的交互性戒烟干预措施
2012/11/09
摘要
背景：本试验对新的戒烟网站（’StopAdvisor’）进行初步研究，该网站基于PRIME理论、证据、网页设计专家和使用者测试进行开发。本试验旨在1）评价戒烟率、网站使用度和满意度是否足够高，以便继续进行随机对照试验（RCT）；2）评价社会经济状态是否影响戒烟转归。
方法：本试验为非对照性初步研究。204名每日吸烟、且愿意戒烟的成人吸烟者入选。所有参与者接受来自’StopAdvisor’的戒烟支持，该网站推荐一种结构式戒烟计划和多种循证行为改变技术以帮助戒烟。戒烟前1个月至戒烟后1个月，该网站为受试者提供一系列定制的嵌入式会话和多种交互式菜单（http://www.lifeguideonline.org/player/play/stopadvisordemonstration）。主要转归为自我主诉的至少持续1个月的持续戒断（在入选后2个月采集，通过检测唾液中的可替宁或新烟碱证实）。通过受试者登录和网页浏览来确定网站的使用情况。在入选后2个月，通过在线问卷调查，通过二分法对帮助性、个人相关性、推荐的可能性和未来使用情况进行分级。基于社会经济状态对转归进行评价。
结果：入选后8周，基于主要转归标准，19.6%（40/204）的参与者出现戒断（95% C.I.=14.1%-25.1%）。参与者在6.4次登录（中位数=3）中平均浏览133.5（中位数=71.5）个网页。大部分回复者对网站4个方面的满意度上持积极态度（66.7%-75.3%）。没有证据显示，社会经济状态对戒断（OR=1.01, C.I.=0.50-2.07）、使用（网页浏览：t(202)=0.11, p=.91; 登录：t(202)=0.21, p=.83）和满意度（助人：OR=1.09, C.I.=0.41-2.88；个人相关性：OR=0.55, C.I.=0.20-1.56；推荐：OR=0.98, C.I.=0.34-2.81；未来使用情况：OR=1.45, C.I.=0.49-4.27）有影响。
结论：系统化的理论应用、证据、网页设计专家和使用者测试创建的网站，在帮助吸烟者戒断上具有一定效果，有必要进行RCT进行评价。网站对于各个社会阶层均具有类似的作用，而且使用者可以接受。
（陈欣 审校）
Addict Behav. 2012 Jun 9. [Epub ahead of print]
A pilot study of StopAdvisor: A theory-based interactive internet-based smoking cessation intervention aimed across the social spectrum.
Brown J, Michie S, Geraghty AW, Miller S, Yardley L, Gardner B, Shahab L, Stapleton JA, West R.
Source
Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
Abstract
BACKGROUND: This article reports a pilot study of a new smoking cessation website (’StopAdvisor’), which has been developed on the basis of PRIME theory, evidence, web-design expertise and user-testing. The aims were to i) evaluate whether cessation, website usage and satisfaction were sufficiently high to warrant a randomised controlled trial (RCT) and ii) assess whether outcomes were affected by socio-economic status.
METHODS: This was an uncontrolled pilot study. Two hundred and four adult daily smokers willing to make a serious quit attempt were included. All participants received support from ’StopAdvisor’, which recommends a structured quit plan and a variety of evidence-based behaviour change techniques for smoking cessation. A series of tunnelled sessions and a variety of interactive menus provide tailored support for up to a month before quitting through until one-month post-quit (http://www.lifeguideonline.org/player/play/stopadvisordemonstration). The primary outcome was self-report of at least 1month of continuous abstinence collected at 2months post-enrolment and verified by saliva cotinine or anabasine. Usage was indexed by log-ins and page views. Satisfaction was assessed by dichotomous ratings of helpfulness, personal relevance, likelihood of recommendation and future use, which were collected using an online questionnaire at 2months post-enrolment. Outcomes according to socio-economic status were assessed.
RESULTS: At 8weeks post-enrolment, 19.6% (40/204) of participants were abstinent according to the primary outcome criteria (95% C.I.=14.1% to 25.1%). Participants viewed a mean of 133.5 pages (median=71.5) during 6.4 log-ins (median=3). A majority of respondents rated the website positively on each of the four satisfaction `ratings (range=66.7% to 75.3%). There was no evidence of an effect of socio-economic status on abstinence (OR=1.01, C.I.=0.50-2.07), usage (page-views, t(202)=0.11, p=.91; log-ins, t(202)=0.21, p=.83), or satisfaction (helpfulness, OR=1.09, C.I.=0.41-2.88; personal relevance, OR=0.55, C.I.=0.20-1.56; recommendation, OR=0.98, C.I.=0.34-2.81; use in future, OR=1.45, C.I.=0.49-4.27).
CONCLUSIONS: The systematic application of theory, evidence, web-design expertise, and user-testing has resulted in a website that shows sufficiently promising efficacy and usability to warrant evaluation in a RCT. The website appears to be similarly effective and acceptable to users across the social spectrum.
Addict Behav. 2012 Jun 9. [Epub ahead of print]
背景：本试验对新的戒烟网站（’StopAdvisor’）进行初步研究，该网站基于PRIME理论、证据、网页设计专家和使用者测试进行开发。本试验旨在1）评价戒烟率、网站使用度和满意度是否足够高，以便继续进行随机对照试验（RCT）；2）评价社会经济状态是否影响戒烟转归。
方法：本试验为非对照性初步研究。204名每日吸烟、且愿意戒烟的成人吸烟者入选。所有参与者接受来自’StopAdvisor’的戒烟支持，该网站推荐一种结构式戒烟计划和多种循证行为改变技术以帮助戒烟。戒烟前1个月至戒烟后1个月，该网站为受试者提供一系列定制的嵌入式会话和多种交互式菜单（http://www.lifeguideonline.org/player/play/stopadvisordemonstration）。主要转归为自我主诉的至少持续1个月的持续戒断（在入选后2个月采集，通过检测唾液中的可替宁或新烟碱证实）。通过受试者登录和网页浏览来确定网站的使用情况。在入选后2个月，通过在线问卷调查，通过二分法对帮助性、个人相关性、推荐的可能性和未来使用情况进行分级。基于社会经济状态对转归进行评价。
结果：入选后8周，基于主要转归标准，19.6%（40/204）的参与者出现戒断（95% C.I.=14.1%-25.1%）。参与者在6.4次登录（中位数=3）中平均浏览133.5（中位数=71.5）个网页。大部分回复者对网站4个方面的满意度上持积极态度（66.7%-75.3%）。没有证据显示，社会经济状态对戒断（OR=1.01, C.I.=0.50-2.07）、使用（网页浏览：t(202)=0.11, p=.91; 登录：t(202)=0.21, p=.83）和满意度（助人：OR=1.09, C.I.=0.41-2.88；个人相关性：OR=0.55, C.I.=0.20-1.56；推荐：OR=0.98, C.I.=0.34-2.81；未来使用情况：OR=1.45, C.I.=0.49-4.27）有影响。
结论：系统化的理论应用、证据、网页设计专家和使用者测试创建的网站，在帮助吸烟者戒断上具有一定效果，有必要进行RCT进行评价。网站对于各个社会阶层均具有类似的作用，而且使用者可以接受。
（陈欣 审校）
Addict Behav. 2012 Jun 9. [Epub ahead of print]
A pilot study of StopAdvisor: A theory-based interactive internet-based smoking cessation intervention aimed across the social spectrum.
Brown J, Michie S, Geraghty AW, Miller S, Yardley L, Gardner B, Shahab L, Stapleton JA, West R.
Source
Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK.
Abstract
BACKGROUND: This article reports a pilot study of a new smoking cessation website (’StopAdvisor’), which has been developed on the basis of PRIME theory, evidence, web-design expertise and user-testing. The aims were to i) evaluate whether cessation, website usage and satisfaction were sufficiently high to warrant a randomised controlled trial (RCT) and ii) assess whether outcomes were affected by socio-economic status.
METHODS: This was an uncontrolled pilot study. Two hundred and four adult daily smokers willing to make a serious quit attempt were included. All participants received support from ’StopAdvisor’, which recommends a structured quit plan and a variety of evidence-based behaviour change techniques for smoking cessation. A series of tunnelled sessions and a variety of interactive menus provide tailored support for up to a month before quitting through until one-month post-quit (http://www.lifeguideonline.org/player/play/stopadvisordemonstration). The primary outcome was self-report of at least 1month of continuous abstinence collected at 2months post-enrolment and verified by saliva cotinine or anabasine. Usage was indexed by log-ins and page views. Satisfaction was assessed by dichotomous ratings of helpfulness, personal relevance, likelihood of recommendation and future use, which were collected using an online questionnaire at 2months post-enrolment. Outcomes according to socio-economic status were assessed.
RESULTS: At 8weeks post-enrolment, 19.6% (40/204) of participants were abstinent according to the primary outcome criteria (95% C.I.=14.1% to 25.1%). Participants viewed a mean of 133.5 pages (median=71.5) during 6.4 log-ins (median=3). A majority of respondents rated the website positively on each of the four satisfaction `ratings (range=66.7% to 75.3%). There was no evidence of an effect of socio-economic status on abstinence (OR=1.01, C.I.=0.50-2.07), usage (page-views, t(202)=0.11, p=.91; log-ins, t(202)=0.21, p=.83), or satisfaction (helpfulness, OR=1.09, C.I.=0.41-2.88; personal relevance, OR=0.55, C.I.=0.20-1.56; recommendation, OR=0.98, C.I.=0.34-2.81; use in future, OR=1.45, C.I.=0.49-4.27).
CONCLUSIONS: The systematic application of theory, evidence, web-design expertise, and user-testing has resulted in a website that shows sufficiently promising efficacy and usability to warrant evaluation in a RCT. The website appears to be similarly effective and acceptable to users across the social spectrum.
Addict Behav. 2012 Jun 9. [Epub ahead of print]
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