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Randomized Controlled Trial
. 2016 Sep:50:157-65.
doi: 10.1016/j.cct.2016.08.008. Epub 2016 Aug 10.

Abstinence Reinforcement Therapy (ART) for rural veterans: Methodology for an mHealth smoking cessation intervention

Sarah M Wilson  1 , Lauren P Hair  2 , Jeffrey S Hertzberg  2 , Angela C Kirby  3 , Maren K Olsen  4 , Jennifer H Lindquist  4 , Matthew L Maciejewski  4 , Jean C Beckham  5 , Patrick S Calhoun  6
Affiliations
Randomized Controlled Trial

Abstinence Reinforcement Therapy (ART) for rural veterans: Methodology for an mHealth smoking cessation intervention

Sarah M Wilson et al. Contemp Clin Trials. 2016 Sep.

Abstract

Introduction: Smoking is the most preventable cause of morbidity and mortality in U.S. veterans. Rural veterans in particular have elevated risk for smoking and smoking-related illness. However, these veterans underutilize smoking cessation treatment, which suggests that interventions for rural veterans should optimize efficacy and reach.

Objective: The primary goal of the current study is to evaluate the effectiveness of an intervention that combines evidenced based treatment for smoking cessation with smart-phone based, portable contingency management on smoking rates compared to a contact control intervention in a randomized controlled trial among rural Veteran smokers. Specifically, Veterans will be randomized to receive Abstinence Reinforcement Therapy (ART) which combines evidenced based cognitive-behavioral telephone counseling (TC), a tele-medicine clinic for access to nicotine replacement (NRT), and mobile contingency management (mCM) or a control condition (i.e., TC and NRT alone) that will provide controls for therapist, medication, time and attention effects.

Methods: Smokers were identified using VHA electronic medical records and recruited proactively via telephone. Participants (N=310) are randomized to either ART or a best practice control consisting of telephone counseling and telemedicine. Participating patients will be surveyed at 3-months, 6-months and 12-months post-randomization. The primary outcome measure is self-reported and biochemically validated prolonged abstinence at 6-month follow-up.

Discussion: This trial is designed to test the relative effectiveness of ART compared to a telehealth-only comparison group. Dissemination of this mHealth intervention for veterans in a variety of settings would be warranted if ART improves smoking outcomes for rural veterans and is cost-effective.

Keywords: Clinical trial; Financial incentives; Mobile health=mHealth; Smoking cessation; Telehealth; eHealth.

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Conflict of interest statement

The authors have no conflicts of interest to report.

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