Smoking Treatment and Exercise Program for Underserved Populations (STEP UP)
Condition: Smoking
Study type: Interventional

Summary: 
      This project proposes to evaluate the feasibility, acceptability, and efficacy of a mobile
      intervention to target smoking-cessation and increase physical activity among low-income
      persons. The intervention is called Smoking Treatment and Exercise Program for Underserved
      Populations (STEP UP).
    

Detailed description: 
      This pilot project proposes to evaluate the feasibility, acceptability, and efficacy of a
      mobile intervention to target smoking-cessation and physical activity among low-income
      persons. The intervention, named Smoking Treatment and Exercise Program for Underserved
      Populations (STEP UP), combines a smartphone-based contingency-management application (app),
      which provides monetary reinforcement for smoking abstinence and physical activity, 5 weeks
      of telephone-based cognitive-behavioral therapy (CBT) to prevent relapse, nicotine
      replacement pharmacotherapy, and text-messaging to support physical-activity goals.
      Participants are given a smartphone, a compact carbon-monoxide (CO) monitor, with which
      recency of smoking can by determined, and a Garmin Vivosmart wristband step-tracker. Twice a
      day at semi-random intervals, participants are prompted by the app to submit a video of
      themselves blowing into the CO monitor. Monetary reinforcement is then immediately provided
      contingent upon a below-threshold CO reading. The app also continuously syncs with the Garmin
      step-tracker, providing supportive messaging and bonus incentives-namely doubled
      reinforcement for smoking abstinence among participants who meet personalized daily step
      goals. The expected outcome of the project is to provide information to evaluate the efficacy
      of an innovative approach in preparation for a subsequent larger clinical trial that builds
      upon the capabilities of mHealth technology to reduce the prevalence of smoking among low
      income smokers.
    

Intervention name(s): Cognitive Behavioral Counseling; Mobile Contingency Management; Bupropion; Transdermal nicotine patch; Nicotine polacrilex; Nicotine lozenge
Intervention type(s): Behavioral; Behavioral; Drug; Drug; Drug; Drug
Intervention description(s): Participants will receive five cognitive-behavioral counseling sessions designed to improve rates of smoking cessation, enhance relapse prevention, and increase physical activity.; Participants will be asked to provide video recordings of themselves taking carbon monoxide readings in order to confirm smoking abstinence. They will also be asked to wear a fitness tracker to monitor physical activity (i.e., steps walked). Participants are provided monetary reward for videos that suggest smoking abstinence, and for fitness tracker readings that suggest increased physical activity.; All participants who are medically eligible will be prescribed bupropion, which they will start two weeks prior to their quit day. Dosage will be 150 mg/daily for days 1-7 and 300 mg/daily (administered in two daily doses) until the 6-month follow-up.; Initiated at smoking quit date; 7 mg to 21 mg patch depending on amount smoked by participant; Nicotine gum will be initiated at smoking quit date; 4 mg dose administered as needed; Nicotine lozenge will be initiated at smoking quit date; 4 mg dose administered as needed
Other intervention name(s): Zyban; Nicotine gum; nicorette
Intervention MeSH terms: Bupropion; Nicotine
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment