Implementing Tobacco Use Treatment in HIV Clinics In Viet Nam

在越南艾滋病毒诊所实施烟草使用治疗

• 批准号: 10357093
• 负责人: Nam Truong Nguyen
• 金额: $ 9.76万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10357093
• 关键词: Address; Ambulatory Care Facilities; Biochemical; Carbon; Caring; Chronic Disease; Cigarette; Clinic; Clinical Trials; Communicable Diseases; Counseling; Data; Enrollment; Food; Fostering; Funding; Goals; Grant; HIV; Health; Health Status; High Prevalence; Household; Income; Individual; Institutes; Interdisciplinary Study; Intervention; Link; Longitudinal Studies; Matched Group; Measures; Medical; Minority; Modeling; Outcome; Outpatients; Parents; Patient Self-Report; Patients; Policies; Population; Postdoctoral Fellow; Prevalence; Randomized; Randomized Controlled Trials; Research; Research Personnel; Resources; Risk Factors; Science; Smoke; Smoker; Smoking; Students; Surveys; Testing; Tobacco; Tobacco Use Cessation; Tobacco smoking behavior; Tobacco use; Training; Vietnam; Vulnerable Populations; arm; cancer prevention; career; cigarette smoke; compare effectiveness; cost effectiveness; evidence base; experience; follow-up; food insecurity; health care settings; health disparity; longitudinal design; low and middle-income countries; nicotine replacement; non-smoker; parent grant; post intervention; programs; quitline; recruit; reduce tobacco use; research study; screening; skills; smoking abstinence; smoking cessation; smoking prevalence; social; social determinants; standard care; supportive environment; three-arm study; tobacco cessation intervention; treatment program

Project Summary This supplement proposes a longitudinal study that will extend the parent’s grant current portfolio to examine the difference in household food insecurity among people living with HIV (PLWH) and the relationship between food insecurity and tobacco use in Vietnam. The supplement focuses on how decreased food insecurity may have significant impact in the health disparities experienced on PLWH as chronic and infectious diseases intersect; and the study is powered to assess the potential impact of smoking cessation on food insecurity. The study aims are 1) to estimate the difference in household food insecurity among PLWH who smoke compared with PLWH who are non-smokers at baseline, and 2) to examine mechanisms linking smoking and household food insecurity among PLWH at baseline and 6-months follow-up, and 3) to assess the impact of a reduction in tobacco use and tobacco cessation on measures of food Insecurity at 6-month follow-up. Using a longitudinal design with a matched comparison population we will assess and compare the prevalence of food insecurity at the household level among individual HIV+ smokers and non-smokers and explore mechanisms associated with food insecurity among PLWH (smokers and non-smokers); and assess the potential impact of smoking cessation on food insecurity. We hypothesize that HIV+ smokers who have quit smoking or reduced cigarettes smoked per day by more than 50% will on average experience lower food insecurity than HIV+ smokers who continued to smoke. Findings from this study will help to better understand how screening for food insecurity may be incorporated in multipronged treatment programs in a resource poor setting, thereby identifying food insecure patients, which may help to alleviate the negative impact of co-occurring conditions and to inform policies and programs that address cessation interventions. The supplement builds on the parent grant which addresses the high prevalence of smoking in Viet Nam among PLWH. The long-term goal of the grant is to develop a scalable model for implementing evidence-based tobacco use treatment in health care settings treating PLWH in LMICs. The objective the grant is to conduct a 3-arm randomized controlled trial that compares the effectiveness and cost-effectiveness of three practical multilevel, multicomponent tobacco cessation interventions in outpatient clinics (OPC). The three arms are: 1) 3As+R (Standard Care): Ask (screen all patients), Advise (advice to quit), Assist (brief counseling), and Refer to Viet Nam’s national Quitline; 2) SC+Counsel: Counsel= 6-session onsite cessation counseling intervention tailored to PLWH and delivered by trained, onsite clinic staff; and 3) SC+Counsel+N: N= 4 weeks of nicotine replacement therapy. Patients (n=672) will be recruited at 14 HIV OPCs in Viet Nam and randomized into one of the three study arms. The study will compare the 3As+R (standard care (SC) with Quitline referral) to SC plus two tobacco treatment model enhancements. Both the parent grant and supplement makes use of a well- established partnership between NYU and the Institute for Social Medical Sciences.

项目摘要 这一补充提出了一项纵向研究，将扩大家长的赠款目前的投资组合，以检查 艾滋病毒感染者（PLWH）家庭粮食不安全的差异以及 越南的粮食不安全和烟草使用。该增刊重点关注如何减少粮食不安全可能 对作为慢性传染病的艾滋病毒携带者的健康差异有重大影响 交叉;该研究旨在评估戒烟对粮食不安全的潜在影响。的 研究的目的是：1）估计吸烟的PLWH与吸烟的PLWH相比， 与PLWH谁是非吸烟者在基线，和2）检查机制连接吸烟和家庭 基线和6个月随访时艾滋病毒携带者的粮食不安全，以及3）评估减少 6个月随访时，烟草使用和戒烟对粮食不安全的影响。使用纵向 设计与匹配的比较人口，我们将评估和比较粮食不安全的普遍性， 艾滋病毒阳性吸烟者和非吸烟者的家庭水平，并探讨相关机制 艾滋病毒/艾滋病感染者（吸烟者和非吸烟者）的粮食不安全;并评估吸烟的潜在影响 停止粮食不安全。我们假设已经戒烟或减少吸烟的HIV+吸烟者 每天吸烟超过50%的人平均粮食不安全程度低于艾滋病毒+吸烟者， 继续抽烟。这项研究的结果将有助于更好地了解食品不安全筛查 在资源匮乏的环境中，可以将其纳入多管齐下的治疗方案，从而确定食物 不安全的患者，这可能有助于减轻同时发生的疾病的负面影响并提供信息 解决戒烟干预的政策和方案。补助金以父母补助金为基础 该方案解决了越南艾滋病毒携带者吸烟率高的问题。赠款的长期目标是 开发一个可扩展的模式，在卫生保健环境中实施循证烟草使用治疗 治疗中低收入国家的艾滋病病毒携带者。该补助金的目的是进行一项3组随机对照试验， 比较了三种实用的多层次、多组分烟草的有效性和成本效益 门诊部的戒烟干预（OPC）。三个臂是：1）3As+R（标准护理）：询问 （筛查所有患者）、建议（戒烟建议）、协助（简短咨询）和转诊至越南国家 戒烟热线; 2）SC+法律顾问：法律顾问=为艾滋病毒携带者量身定制的6次现场戒烟咨询干预 并由经过培训的现场诊所工作人员提供;以及3）SC+法律顾问+N：N= 4周尼古丁替代治疗 疗法患者（n=672）将在越南的14个HIV OPC中招募，并随机分配至三个 研究武器。本研究将比较3As+R（标准治疗（SC）和Quitline转诊）与SC +2 烟草治疗模式的改进。父母补助金和补助金都利用了一个很好的- 纽约大学与社会医学科学研究所建立了伙伴关系。