Smoking Cessation Intervention for American Indian Women Experiencing Intimate Partner Violence

吸烟和亲密伴侣暴力（IPV）是可以预防的，主要的公共卫生问题， 造成严重的生理和心理后果经历过IPV的女性更容易遭受 来自物质使用、抑郁、焦虑和创伤后应激障碍--所有这些都是 smoking.在经历过IPV的女性中，吸烟率高达51%至70%。美国 印度妇女，包括北方平原部落妇女，在妇女中IPV的比例最高 任何种族/民族。此外，北方平原部落妇女的吸烟率是 在美国，特别是在经历过IPV的北方平原部落妇女中， 现在的吸烟者已经为经历过IPV的妇女制定了多种健康干预措施， 包括酗酒和吸毒，因为这些问题同时发生的比例很高。然而， 其中没有戒烟干预措施。基于创伤的正念方法是 显示创造身体，心理和情感安全，同时减轻反应或 通过增加对反应性和自动化的意识来控制成瘾行为（例如，吸烟）行为，允许 更大的灵活性来应对渴望。这些基于实力的方法与 美国印第安人文化，并创造机会，为个人谁已受到创伤，以重建一种感觉 选择和控制。我们的研究团队采用了一种互动的、高度参与的方法来收集和使用 定性数据，为文化定制的创伤知情戒烟的初步发展提供信息 对经历过IPV的北方平原部落妇女进行干预。因此， 本申请旨在最终确定8个疗程的新型干预，并测试其可行性、可接受性和满意度 在一组48名经历过IPV的北方平原部落女性吸烟者中。为了实现这一目标， 我们将致力于实现以下目标：1）与我们的社区一起使用基于社区的参与式方法 咨询委员会，以完善干预材料，并最终确定我们的试点干预方法; 2）进行一次 一项单臂干预试验，招募了48名经历过IPV的北方平原部落女性吸烟者， 检查可行性的主要研究结果，可接受性，和满意度与我们的文化定制， 创伤知情的正念戒烟干预和戒烟尝试的次要研究结果 并在3个月和6个月随访时进行生物化学验证的戒烟率，这将衡量 干预的有效性; 3）作为探索性目标，我们将探索药物和 考虑到拟议的干预措施的中心重点是美国人的个人和历史创伤， 印度妇女是成瘾的贡献者，并与关注多物质与单一物质相一致。

Cigarette smoking and intimate partner violence (IPV) are preventable, major public health concerns that result in severe physical and psychological consequences. Women who have experienced IPV are more likely to suffer from substance use, depression, anxiety, and post-traumatic stress disorder --all of which are risk factors for smoking. Smoking prevalence among women who have experienced IPV is as high as 51% to 70%. American Indian women, including Northern Plains Tribal women, experience the highest proportion of IPV among women from any racial/ethnic group. Furthermore, smoking prevalence among Northern Plains Tribal women is among the highest in the U.S and specifically among Northern Plains Tribal women who experienced IPV, 58% are current smokers. Multiple health interventions have been developed for women who have experienced IPV, including for alcohol and drug use given the high rates of these co-occurring problems. However, there have been no smoking cessation interventions among them. Trauma-informed, mindfulness-based approaches are shown to create physical, psychological, and emotional safety while mitigating habitual patterns of reactive or addictive behaviors by increasing awareness of reactivity and automated (e.g., smoking) behavior, allowing greater flexibility in response to cravings. These strength-based approaches are consistent with the values of American Indian culture and create opportunities for individuals who have been traumatized to rebuild a sense of choice and control. Our research team used an interactive, highly participatory approach to collect and use qualitative data to inform the initial development of a culturally tailored, trauma-informed smoking cessation intervention for Northern Plains Tribal women who have experienced IPV. Therefore, the primary objective of this application is to finalize the 8-session novel intervention and test its feasibility, acceptability, and satisfaction among a group of 48 Northern Plains Tribal women smokers who have experienced IPV. To achieve this goal, the following Aims will be addressed: 1) Use a community-based participatory approach with our Community Advisory Board to refine intervention materials and finalize our pilot intervention methodology; 2) Conduct a single arm intervention trial enrolling 48 Northern Plains Tribal women smokers who have experienced IPV to examine the primary study outcomes of feasibility, acceptability, and satisfaction with our culturally tailored, trauma-informed mindfulness smoking cessation intervention and the secondary study outcome of quit attempts and biochemically verified smoking abstinence prevalence at 3 and 6-months follow-up, which will gauge the effectiveness of the intervention; and 3) As an exploratory aim, we will explore concurrent changes in drug and alcohol use given the proposed intervention’s central focus on personal and historical trauma among American Indian women as contributors to addiction and consistent with a focus on poly- vs. single substance.