J. Med. Internet Res. - Preventing smoking relapse via Web-based computer-tailored feedback: a randomized controlled trial.

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Resumo

CKGROUND: Web-based computer-tailored approaches have the potential to be successful in supporting smoking cessation. However, the potential effects of such approaches for relapse prevention and the value of incorporating action planning strategies to effectively prevent smoking relapse have not been fully explored. The Stay Quit for You (SQ4U) study compared two Web-based computer-tailored smoking relapse prevention programs with different types of planning strategies versus a control group.OBJECTIVES: To assess the efficacy of two Web-based computer-tailored programs in preventing smoking relapse compared with a control group. The action planning (AP) program provided tailored feedback at baseline and invited respondents to do 6 preparatory and coping planning assignments (the first 3 assignments prior to quit date and the final 3 assignments after quit date). The action planning plus (AP+) program was an extended version of the AP program that also provided tailored feedback at 11 time points after the quit attempt. Respondents in the control group only filled out questionnaires. The study also assessed possible dose-response relationships between abstinence and adherence to the programs.METHODS: The study was a randomized controlled trial with three conditions: the control group, the AP program, and the AP+ program. Respondents were daily smokers (N = 2031), aged 18 to 65 years, who were motivated and willing to quit smoking within 1 month. The primary outcome was self-reported continued abstinence 12 months after baseline. Logistic regression analyses were conducted using three samples: (1) all respondents as randomly assigned, (2) a modified sample that excluded respondents who did not make a quit attempt in conformance with the program protocol, and (3) a minimum dose sample that also excluded respondents who did not adhere to at least one of the intervention elements. Observed case analyses and conservative analyses were conducted.RESULTS: In the observed case analysis of the randomized sample, abstinence rates were 22% (45/202) in the control group versus 33% (63/190) in the AP program and 31% (53/174) in the AP+ program. The AP program (odds ratio 1.95, P = .005) and the AP+ program (odds ratio 1.61, P = .049) were significantly more effective than the control condition. Abstinence rates and effects differed per sample. Finally, the results suggest a dose-response relationship between abstinence and the number of program elements completed by the respondents.CONCLUSION: Despite the differences in results caused by the variation in our analysis approaches, we can conclude that Web-based computer-tailored programs combined with planning strategy assignments and feedback after the quit attempt can be effective in preventing relapse 12 months after baseline. However, adherence to the intervention seems critical for effectiveness. Finally, our results also suggest that more research is needed to assess the optimum intervention dose.TRIAL REGISTRATION: Dutch Trial Register: NTR1892; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1892 (Archived by WebCite at http://www.webcitation.org/693S6uuPM).

Resumo Limpo

ckground webbas computertailor approach potenti success support smoke cessat howev potenti effect approach relaps prevent valu incorpor action plan strategi effect prevent smoke relaps fulli explor stay quit squ studi compar two webbas computertailor smoke relaps prevent program differ type plan strategi versus control groupobject assess efficaci two webbas computertailor program prevent smoke relaps compar control group action plan ap program provid tailor feedback baselin invit respond preparatori cope plan assign first assign prior quit date final assign quit date action plan plus ap program extend version ap program also provid tailor feedback time point quit attempt respond control group fill questionnair studi also assess possibl doserespons relationship abstin adher programsmethod studi random control trial three condit control group ap program ap program respond daili smoker n age year motiv will quit smoke within month primari outcom selfreport continu abstin month baselin logist regress analys conduct use three sampl respond random assign modifi sampl exclud respond make quit attempt conform program protocol minimum dose sampl also exclud respond adher least one intervent element observ case analys conserv analys conductedresult observ case analysi random sampl abstin rate control group versus ap program ap program ap program odd ratio p ap program odd ratio p signific effect control condit abstin rate effect differ per sampl final result suggest doserespons relationship abstin number program element complet respondentsconclus despit differ result caus variat analysi approach can conclud webbas computertailor program combin plan strategi assign feedback quit attempt can effect prevent relaps month baselin howev adher intervent seem critic effect final result also suggest research need assess optimum intervent dosetri registr dutch trial regist ntr httpwwwtrialregisternltrialregadminrctviewasptc archiv webcit httpwwwwebcitationorgsuupm

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