基于MAPR模型构建分期个体化移动戒烟干预理论框架  

Development of a theoretical framework based on the MAPR model for stage-based,individualized mobile smoking cessation interventions through systematic literature review and expert consultation

作　　者：褚水莲 景行 梁立荣 李君[2] CHU Shuilian;JING Hang;LIANG Lirong;LI Jun(Beijing Institute of Respiratory Diseases,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;State Key Laboratory of Cognitive Neuroscience and Learning,Beijing Normal University,Beijing 100875,China)

机构地区：[1]首都医科大学附属北京朝阳医院,北京市呼吸疾病研究所,北京100020 [2]北京师范大学认知神经科学与学习国家重点实验室,北京100875

出　　处：《中国公共卫生》2024年第10期1249-1253,共5页Chinese Journal of Public Health

基　　金：首都卫生发展科研专项(首发2024-1G-1062);2022年度北京市重大疫情防治重点专科建设项目(流行病学)。

摘　　要：目的构建用于指导戒烟应用程序(APPs)设计的分期个体化移动戒烟干预理论框架。方法于2023年12月—2024年1月针对戒烟APPs进行系统文献回顾,通过文献研究对现有戒烟APPs应用的经典行为改变理论进行改编,建立MAPR模型,以该模型为基础构建适用于移动戒烟干预的分期个体化移动戒烟干预理论框架,由2名专家使用该框架对2个戒烟APPs的功能模块进行干预策略分类,计算分类的一致性比例,评估框架的可靠性。结果构建的理论框架分为3层。第1层包括5个核心干预要素:动机(motivation)、能力(ability)、提示(prompt)、反馈(reflect)与奖赏(reward);第2层定义了吸烟者经历的5个戒烟阶段:思考期、准备期、行动期、维持期和复吸期;第3层包括可引发戒烟行为改变的9个干预策略:共情、教育、培训、激励、环境重建、树立榜样、提醒、反馈、资源与工具,他们在5个戒烟阶段中可穿插使用。该框架对2个戒烟APPs功能模块的干预策略分类一致性比例分别为88%和90%。结论本研究构建的分期个体化移动戒烟干预框架为开发专业的戒烟APPs提供了一个简明扼要的科学理论框架。Objective To develop a theoretical framework for stage-based,individualized mobile smoking cessation interventions to guide the design of smoking cessation applications(APPs).Methods A systematic literature review of studies of smoking cessation APPs was conducted from December 2023 to January 2024.Classic behavior change theories applied in existing smoking cessation APPs were adapted through literature review and expert consultation to establish a motivation-ability-prompt-reflect/reward(MAPR)model.Based on the established MAPR model,theoretical framework for a stage-based,individualized mobile smoking cessation interventions was constructed.Using the constructed theoretical framework,two experts classified intervention strategies within the functional modules of two smoking cessation APPs,and a consistency ratio was calculated to assess the reliability of the framework.Results The theoretical framework constructed is divided into three layers.The first layer includes five core intervention elements:motivation,capability,prompting,reflection,and reward.The second layer defines five stages of cessation experienced by smokers:contemplation,preparation,action,maintenance,and relapse.The third layer consists of nine intervention strategies that can induce behavioral change in smoking cessation:empathy,education,training,incentives,environmental restructuring,modeling,reminders,feedback,and resources and tools that can be used interchangeably across the five stages of smoking cessation.The agreement rates of the intervention strategy classification for two smoking cessation APPs were 88%and 90%,respectively.Conclusion The stage-based,individualized mobile smoking cessation intervention framework developed in this study provides a concise theoretical framework for the development of professional smoking cessation APPs.

关 键 词：移动医疗 分期 个体化 戒烟干预 行为改变理论 理论框架 

分 类 号：R163[医药卫生—公共卫生与预防医学]