Development and pilot testing of a culturally-tailored smartphone-delivered intervention for commercial smoking cessation in American Indians

多达三分之二的美国印第安人(AI)成年人位于美国北部平原地区 抽商业香烟。因此，北部平原的人工智能机构患上了与吸烟有关的癌症的几率。 高达其他种族的三倍。与其他机构相比，认可机构戒除商业吸烟的可能性只有大约一半 比赛。与现有戒烟计划的接触和参与度较低被认为是主要原因 用于人工智能吸烟者的低戒烟。我们的长期目标是为人工智能商业吸烟者开发戒烟干预措施 具有广泛性、吸引力和文化适宜性。NCI的QuitGuide是一款公开发售的智能手机 戒烟应用程序，允许立即访问互动治疗内容，如实时 关于如何导航吸烟触发因素的指导，因此在接触和参与人工智能方面具有巨大的潜力 吸烟者。然而，QuitGuide不包括关于人工智能人员特有的触发因素的指导，例如商业 它也不涉及传统烟草，这是一种普遍的精神实践 位于北部平原的人工智能。缺乏关于传统烟草使用的内容尤其成问题，因为 我们团队先前的研究表明，商业戒烟中对传统烟草的文化参考 短信可以提高戒烟的自我效能感。我们目前的目标是开发和试运行一种文化定制的 人工智能商业吸烟者的QuitGuide版本。我们的假设是，根据文化定制的QuitGuide将 与标准QuitGuide相比，人工智能吸烟者对其可行性和可接受性的评价更高。该项目 建立在共济会癌症中心和美国印第安人癌症基金会的研究合作基础上 与人工智能社区合作。我们的多学科团队在人工智能烟草使用、戒烟、裁剪等方面拥有专业知识 对人工智能文化和智能手机应用程序开发的癌症预防干预。我们的社区合作伙伴 代表一个位于乡村的部落和一个为人工智能服务的城市诊所，两者都位于北部平原 美国的一个地区。一个社区咨询委员会将监督所有活动，我们有一项合作协议 正是开发了NCI的QuitGuide应用程序的技术专家。我们的首要目标是进行深入的采访。 在人工智能吸烟者(n=40)和关键告密者(n=10)中，指导QuitGuide的文化定制 产生了一个量身定制的应用程序原型。我们的第二个目标是评估该计划的初步可行性和可接受性 在人工智能吸烟者(两组n=6；N=12)中使用迭代测试的定制应用程序原型，并改进应用程序。 我们的第三个目标是进行一项试点随机对照试验，以测试其可行性、可接受性和初步 在人工智能吸烟者中，定制QuitGuide应用程序(n=40)与标准QuitGuide应用程序(n=40)的疗效。在… 得出的结论是，我们将有一个蓝图来指导临床试验的开发，旨在测试 为人工智能吸烟者量身定做的QuitGuide智能手机应用程序的文化版本。鉴于北部的人工智能 普莱恩斯经历了一些最极端的吸烟差异，这种根据文化量身定做的治疗方法可能 对认可机构中与烟草有关的癌症的负担产生有意义的公共卫生影响。

As many as two out of every three American Indian (AI) adults located in the northern plains region of the US smoke commercial cigarettes. As a result, AIs in the northern plains experience rates of smoking-related cancers as high as three-fold other races. AIs are only about half as likely to quit commercial smoking compared to other races. Poor access and engagement with existing cessation programs has been put forward as a main reason for low quitting in AI smokers. Our long-term goal is to develop cessation interventions for AI commercial smokers that are wide-reaching, engaging, and culturally appropriate. NCI’s QuitGuide is a publicly available smartphone app for smoking cessation that allows for immediate access to interactive treatment content, such as real-time guidance on how to navigate smoking triggers, and therefore has great potential for reaching and engaging AI smokers. However, QuitGuide does not include guidance on triggers unique to AI persons such as commercial cigarette use at pow wows nor does it address traditional tobacco which is a spiritual practice common among AIs in the northern plains. The lack of content on traditional tobacco use is particularly problematic because of our team’s prior research showing that cultural references to traditional tobacco in commercial smoking cessation messages can improve self-efficacy to quit. Our present objective is to develop and pilot test a culturally-tailored version of the QuitGuide in AI commercial smokers. Our hypothesis is that a culturally-tailored QuitGuide will result in greater ratings of feasibility and acceptability in AI smokers versus the standard QuitGuide. The project builds on the Masonic Cancer Center’s and the American Indian Cancer Foundation’s research collaborations with AI communities. Our multidisciplinary team has expertise in AI tobacco use, smoking cessation, tailoring cancer prevention interventions to the cultural of AIs, and smartphone app development. Our community partners represent a rurally located Tribe and an urban clinic serving AIs, both of which are located in the northern plains region of the US. A community advisory board will oversee all activities and we have an agreement to work with the same technology experts who created NCI’s QuitGuide app. Our first aim is to conduct in-depth interviews among AI smokers (n=40) and key-informants (n=10) to guide the cultural tailoring of the QuitGuide that will result in a tailored app prototype. Our second aim is to assess the preliminary feasibility and acceptability of the tailored app prototype using iterative testing among AI smokers (two groups of n=6; N=12) and to refine the app. Our third aim is to conduct a pilot randomized controlled trial to test the feasibility, acceptability, and preliminary efficacy of the tailored QuitGuide app (n=40) versus the standard QuitGuide app (n=40) among AI smokers. At the conclusion, we will have a blueprint to guide the development of a clinical trial intended to test the efficacy of a culturally-tailored version of the QuitGuide smartphone app for AI smokers. Given that AIs in the northern plains experience some of the most extreme smoking disparities, this culturally-tailored treatment approach could have a meaningful public health impact on the burden of tobacco-related cancers among AIs.