Twelve-Month Outcomes of a Group-Randomized Community Health Advocate-Led Smoking Cessation Intervention in Public Housing
Twelve-Month Outcomes of a Group-Randomized Community Health Advocate-Led Smoking Cessation Intervention in Public Housing
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DOI：
10.1093/ntr/ntx193
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发表时间：
2018-12-01
影响因子：
4.7
通讯作者：
Geller, Alan C.
中科院分区：
文献类型：
--
作者：
Brooks, Daniel R.;Burtner, Joanna L.;Geller, Alan C.
背景：较低的戒烟率是社会经济弱势成年人吸烟率较高的主要原因。由于戒烟的障碍既多又严重，社会经济上处于不利地位的吸烟者可能会从更密集的干预中受益。我们试图确定是否戒烟干预提供培训的公共住房居民烟草治疗倡导者（TTAs）可以增加利用戒烟资源，增加abstinence.Methods：我们进行了一组随机试验，波士顿公共住房居民谁有兴趣戒烟。对照组的参与者接受标准的戒烟材料和TTA的一次性访问，TTA提供有关戒烟资源的基本咨询和信息。干预中心的参与者有资格接受TTA的多次访问，TTA采用动机访谈，戒烟咨询和导航来鼓励吸烟者使用戒烟治疗（吸烟者戒烟热线和基于诊所的计划）。在12个月时评估了利用率和7天和30天的点戒烟率。结果：干预组（n = 121）比对照组（n = 129）更有可能同时利用治疗方案（校正比值比[aOR]：2.15; 95%置信区间[CI]：0.93-4.91）和7天和30天时点戒烟率aOR分别为2.60（1.72-3.94）、2.98（1.56-5.68）。中介分析表明，更高的利用水平并不能解释干预effects.Conclusions：干预提供同伴健康倡导者能够提高利用公共住房居民的治疗方案和戒烟。未来对类似干预措施的研究应确定成功的关键机制。
Background: Lower rates of smoking cessation are a major reason for the higher prevalence of smoking among socioeconomically disadvantaged adults. Because barriers to quitting are both more numerous and severe, socioeconomically disadvantaged smokers may benefit from more intensive intervention. We sought to determine whether a smoking cessation intervention delivered by public housing residents trained as Tobacco Treatment Advocates (TTAs) could increase utilization of cessation resources and increase abstinence.Methods: We conducted a group-randomized trial among Boston public housing residents who were interested in quitting smoking. Participants at control sites received standard cessation materials and a one-time visit from a TTA who provided basic counseling and information about cessation resources. Participants at intervention sites were eligible for multiple visits by a TTA who employed motivational interviewing, cessation counseling, and navigation to encourage smokers to utilize cessation treatment (Smokers' Quitline and clinic-based programs). Utilization and 7-day and 30-day point prevalence abstinence were assessed at 12 months. Self-reported abstinence was biochemically verified.Results: Intervention participants (n = 121) were more likely than control participants (n = 129) to both utilize treatment programs (adjusted odds ratio [aOR]: 2.15; 95% confidence interval [CI]: 0.93-4.91) and 7-day and 30-day point prevalence abstinence (aOR: 2.60 (1.72-3.94); 2.98 (1.56-5.68), respectively). Mediation analysis indicated that the higher level of utilization did not explain the intervention effect.Conclusions: An intervention delivered by peer health advocates was able to increase utilization of treatment programs and smoking abstinence among public housing residents. Future studies of similar types of interventions should identify the key mechanisms responsible for success.