The PRIME Theory of motivation and its application to smoking - Quit主要的激励理论和应用戒烟吸烟.pptVIP

* Psychological principles underpinning behavioural support University College London January 2009 Robert West * Sources Cochrane reviews West R (2006) Theory of Addiction. Oxford: Blackwells (see also ) Shahab et al (2009) Report to Department of Health * Why behavioural support is often needed After the start of the ‘quit attempt’ smokers: can experience powerful, frequent and/or persistent feelings of desire (want or need) to smoke (PRIME Theory) reductions in desire to remain abstinent reduced capacity to exercise self-control Medication can reduce the desire to smoke But there are limits to how much smokers often need behavioural support to optimise usage and benefits behavioural support may be needed to address sources of desire to smoke that medication does not behavioural support may be needed to maximise desire not to smoke and capacity for self control * Does behavioural support work? Systematic reviews show clear benefit from: Individual face-to-face group face-to-face telephone-based internet-based delivered to smokers in general hospital inpatients pregnant smokers On average approx 1 in 20 smokers are helped at each quit attempt Benefit appears to accumulate with successive quit attempts But there is little evidence on what elements and combinations of elements of behavioural support are important * Five key principles From PRIME Theory: Maximise continued desire to maintain engagement with behavioural support Minimise strength and frequency of desire to smoke Maximise strength of desire not to smoke when needed Maximise capacity for self-control when needed Maximise effective use of supporting behaviours (e.g. medication usage) * Ideas for motivating engagement Create an image of the next appointment that meets wants and needs Be appropriately friendly and warm Establish credibility as someone who can help Make specific arrangements for next contact and set up feeling of positive expectation Use reminders where appropriate Create sense of ‘iden