Electronic Decision Support Systems for Smokers With Severe Mental Illness
| Status: | Completed |
|---|---|
| Conditions: | Schizophrenia, Smoking Cessation, Psychiatric, Tobacco Consumers |
| Therapuetic Areas: | Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 12/14/2018 |
| Start Date: | May 2011 |
| End Date: | May 2012 |
This randomized clinical trial among SMI smokers assessed whether the EDSS with carbon
monoxide monitor and health-checklist feedback lead to higher rates of initiation of smoking
cessation treatment, days of smoking abstinence and Fagerstrom Dependence scores, compared to
use of the EDSS with checklist feedback alone.
monoxide monitor and health-checklist feedback lead to higher rates of initiation of smoking
cessation treatment, days of smoking abstinence and Fagerstrom Dependence scores, compared to
use of the EDSS with checklist feedback alone.
Up to 80% of Americans with serious mental illnesses (SMI; schizophrenia and severe mood
disorders) smoke cigarettes, and most suffer related health consequences. Although combined
treatment with medication and psychosocial therapy can help people with SMI to quit smoking,
it is rarely used. Motivational interventions can enhance the use of combined treatment, but
motivational interventions are expensive and unavailable. To fill this gap, Dartmouth and
Thresholds investigators have developed an easy-to-use, web-based electronic decision support
system (EDSS) that aims to educate and motivate smokers with SMI. Preliminary testing has
demonstrated excellent usability and increased engagement in smoking cessation treatments.
One critical issue is the use of personalized health feedback. Motivational interventions for
smoking cessation for smokers with SMI, including our EDSS, have included personal feedback
from a breath monitor that measures carbon monoxide, a toxic component of cigarette smoke.
Feedback regarding carbon monoxide is thought to motivate the user by personalizing the
health risks of smoking. The carbon monoxide monitor is, however, expensive, difficult to
implement, and largely unavailable in public mental health and primary care clinics. Further,
research on use of carbon monoxide monitoring in the general population is equivocal. Another
motivational strategy to personalize the negative health effects of smoking is a health
checklist with feedback. Health checklists have been shown to be effective, are easy to use,
have no expense, but have not been assessed separately from carbon monoxide monitor feedback
among SMI smokers. Testing the effect of feedback from the health checklist compared to
feedback from the carbon monoxide monitor is an essential next step in the development of
this tool.
Aim 1. The investigators propose a randomized clinical trial among SMI smokers to assess
whether the EDSS with carbon monoxide monitor and health-checklist feedback will lead to
higher rates of initiation of smoking cessation treatment than the EDSS with health-checklist
feedback alone.
Aim 1.a. To explore whether use of the EDSS with carbon monoxide monitor and health-checklist
feedback leads to higher rates of the distal outcomes, days of smoking abstinence and
Fagerstrom Dependence scores, than use of the EDSS with checklist feedback alone.
disorders) smoke cigarettes, and most suffer related health consequences. Although combined
treatment with medication and psychosocial therapy can help people with SMI to quit smoking,
it is rarely used. Motivational interventions can enhance the use of combined treatment, but
motivational interventions are expensive and unavailable. To fill this gap, Dartmouth and
Thresholds investigators have developed an easy-to-use, web-based electronic decision support
system (EDSS) that aims to educate and motivate smokers with SMI. Preliminary testing has
demonstrated excellent usability and increased engagement in smoking cessation treatments.
One critical issue is the use of personalized health feedback. Motivational interventions for
smoking cessation for smokers with SMI, including our EDSS, have included personal feedback
from a breath monitor that measures carbon monoxide, a toxic component of cigarette smoke.
Feedback regarding carbon monoxide is thought to motivate the user by personalizing the
health risks of smoking. The carbon monoxide monitor is, however, expensive, difficult to
implement, and largely unavailable in public mental health and primary care clinics. Further,
research on use of carbon monoxide monitoring in the general population is equivocal. Another
motivational strategy to personalize the negative health effects of smoking is a health
checklist with feedback. Health checklists have been shown to be effective, are easy to use,
have no expense, but have not been assessed separately from carbon monoxide monitor feedback
among SMI smokers. Testing the effect of feedback from the health checklist compared to
feedback from the carbon monoxide monitor is an essential next step in the development of
this tool.
Aim 1. The investigators propose a randomized clinical trial among SMI smokers to assess
whether the EDSS with carbon monoxide monitor and health-checklist feedback will lead to
higher rates of initiation of smoking cessation treatment than the EDSS with health-checklist
feedback alone.
Aim 1.a. To explore whether use of the EDSS with carbon monoxide monitor and health-checklist
feedback leads to higher rates of the distal outcomes, days of smoking abstinence and
Fagerstrom Dependence scores, than use of the EDSS with checklist feedback alone.
Inclusion Criteria:
- adult age 18-75
- in treatment for severe mental illness,
- current smoker,
- physically able to use a computer
Exclusion Criteria:
- Using smoking cessation treatment in past month,
- substance dependence with current use
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