FRESH Delivers: An Innovative Approach to Reducing Tobacco Use Among Rural Black/African American Smokers

FRESH 提供：减少农村黑人/非裔美国吸烟者烟草使用的创新方法

• 批准号: 10436493
• 负责人: Pebbles Fagan
• 金额: $ 64.58万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10436493
• 关键词: Abstinence; Acetaldehyde; Acrolein; Address; African American; Arkansas; Benzaldehyde; Biological Markers; Body mass index; COVID-19 pandemic; Cancer Etiology; Carbon Monoxide; Cessation of life; Chronic Disease; Cigarette; Community Trial; Consumption; Cotinine; Counseling; County; Discrimination; Dose; Evidence based intervention; Face; Failure; Food; Food Access; Formaldehyde; Foundations; Goals; Health; Health Food; Healthcare; Home; Income; Intervention; Knowledge; Malignant Neoplasms; Measures; Medical; Modeling; Morbidity - disease rate; Motivation; Nicotine Dependence; Population; Poverty; Prevalence; Preventable cancer cause; Research; Resources; Risk Behaviors; Role; Rural; Science; Smoker; Smoking; Social Change; Social Conditions; Social Justice; Structural Racism; Structure; System; Testing; Time; Tobacco; Transportation; Unemployment; United States; Universities; Withdrawal; arm; attributable mortality; base; cancer health disparity; cancer prevention; cancer risk; cigarette smoking; community partnership; craving; effective intervention; efficacy testing; evidence base; experience; food insecurity; food security; fruits and vegetables; health care availability; health disparity; hydroxycotinine; improved; innovation; mortality; multidisciplinary; novel; programs; randomized controlled design; recruit; reduce tobacco use; rural African American; rural counties; smoking abstinence; smoking cessation; smoking prevalence; social; social disparities; social factors; social interventions; social stressor; social structure; stressor; tobacco exposure; tobacco-free; treatment group; trend; voucher

SUMMARY – PROJECT 2 Blacks/African Americans have the highest cigarette smoking-attributable cancer mortality rates in the United States. Cigarette smoking is nearly double the national average (23%-26%) in Arkansas rural counties where more than 48% of the population is Black/African American. Social structural stressors such as persistent poverty, low educational attainment, high rates of unemployment, the COVID-19 pandemic, poor transportation, poor access to health care, and historical oppression pose tremendous barriers to successful quitting. Quitting smoking can substantially reduce cancer morbidity and mortality among African Americans, but successful quitting as well as the reach of evidence-based interventions to rural African Americans is alarmingly low. Few studies have empirically tested the efficacy of social structural interventions (home-based food delivery) that address the dynamic interplay of cancer risk behaviors, like smoking, and social factors that perpetuate disparities like food insecurity. The long-term goal of this study is to fill a critical gap in knowledge on the role of social structural interventions in the elimination of cancer health disparities in low resource rural Arkansas counties with high proportions of Blacks/African Americans and high smoking prevalence. Our aims are to 1) test the efficacy of a social change intervention (home-based food delivery) on smoking abstinence using a 3-armed randomized controlled design, 2) examine changes in measures of cigarette abuse liability, and 3) examine the extent to which home-based food delivery improves recruitment and retention of Black/African American smokers in the treatment conditions. Our academic-community partnership – the University of Arkansas for Medical Sciences, Coalition for a Tobacco Free Arkansas, and the Arkansas Foodbank – has a strong collaborative foundation and experience in working together to reduce tobacco use in rural Arkansas Delta counties with high proportions of Blacks/African Americans. Multilevel interventions are needed to address persistent social conditions that potentially increase the abuse liability of smoking and impede successful quitting. Smokers who are more food insecure are less likely to quit smoking. Our multidisciplinary team will use the Socioecological Model to test our central hypothesis: smokers who receive evidence-based real-time video-based motivational counseling and a social change intervention (home-based food delivery) will have greater cotinine-verified 7-day point prevalence abstinence than those who receive motivational counseling alone or social change alone. Social structural interventions that meet the immediate social needs of Black/African American smokers hold tremendous promise for improving Black/African American recruitment and retention into helpful cancer prevention community trials, increasing successful quitting, and reducing social disparities that perpetuate tobacco-caused cancer disparities.

摘要-项目2 在美国，黑人/非裔美国人因吸烟而导致的癌症死亡率最高。 States.在阿肯色州的农村县，吸烟率几乎是全国平均水平（23%-26%）的两倍， 超过48%的人口是黑人/非裔美国人。社会结构性压力源，如持续的 贫困、低教育水平、高失业率、COVID-19大流行、交通不便、 难以获得医疗保健和历史压迫对成功戒烟构成了巨大障碍。退出 吸烟可以大大降低非裔美国人的癌症发病率和死亡率， 戒烟以及基于证据的干预措施对农村非洲裔美国人的影响低得惊人。几 一些研究对社会结构性干预措施（家庭食品供应）的有效性进行了实证检验， 解决癌症风险行为的动态相互作用，如吸烟，以及使其永久化的社会因素 比如粮食不安全。这项研究的长期目标是填补关于 社会结构干预在消除低资源农村阿肯色州癌症健康差异中的作用 黑人/非裔美国人比例高和吸烟率高的县。我们的目标是1）测试 社会变革干预（家庭食品配送）对使用3臂 随机对照设计，2）检查香烟滥用倾向措施的变化，3）检查 在何种程度上，以家庭为基础的食品交付改善招聘和保留黑人/非裔美国人吸烟者 在治疗条件下。我们的学术-社区合作伙伴-阿肯色州大学医学 科学、无烟草阿肯色州联盟和阿肯色州食品银行-有着强大的合作关系， 共同努力减少阿肯色州三角洲农村县烟草使用的基础和经验， 黑人/非裔美国人的比例。需要多层次的干预措施来解决持续存在的社会问题 可能增加吸烟滥用倾向并阻碍成功戒烟的条件。的吸烟者 食物不安全的人戒烟的可能性更小。我们的多学科团队将使用社会生态学 模型来测试我们的中心假设：吸烟者接受基于证据的实时视频激励 咨询和社会变革干预（家庭食品配送）将有更大的可替宁验证的7天 单纯接受动机辅导或单纯接受社会改变者的戒断率高于单纯接受动机辅导者。 满足黑人/非裔美国人吸烟者直接社会需求的社会结构性干预措施 改善黑人/非裔美国人招募和保留到有益的癌症的巨大承诺 预防社区试验，增加成功戒烟，减少社会差距， 烟草引起的癌症差异。