ARAB AMERICAN YOUTH: TOBACCO USE AND INTERVENTION

描述(改编自申请人的摘要)：研究研究有 显示中东青少年的吸烟率在33%至33%之间 58%。这项以社区为基础、以理论为导向的研究的目的是：(A) 考察文化、个人、社会和环境力量在 阿拉伯裔美国青年习惯性吸烟的风险和(B)测试效果 在3岁、6岁和12岁时对吸烟行为进行戒烟干预 干预后几个月。吸烟是可以避免的主要原因。 美国和密歇根州的死亡和疾病。1996年，25.9% 在密歇根州成年人口中，吸烟者占比为10% 全国吸烟率最高(密歇根州临界健康指标，1996年)。 年，可归因于吸烟的直接医疗费用接近9.4亿美元 1994年。对密歇根州烟草使用统计的贡献是快速增长的 阿拉伯裔美国移民人口。阿拉伯人最集中的地方 估计有30万人口的美国人生活在密歇根州；超过 36%的人出生在美国以外。飞行员数据显示25% 14-18岁阿拉伯裔美国青年的吸烟率。阿拉伯裔美国人是 美国增长最快的文化少数群体及其对健康的影响 在这一人群中继续使用烟草对人类造成的痛苦 与烟草相关的疾病和医疗保健费用可能非常高。这个 这项研究的背景是阿拉伯共同体经济和社会中心 服务(无障碍)青少年健康中心，为近2500名青少年提供服务(访问 每年)。该诊所服务的大多数人都是穷人， 受教育程度低，生活在3-5个成年人的大家庭中，是移民，以及 把阿拉伯语作为第一语言。总共2900名13岁以上的青少年 将被要求提供有关人口和文化变量的信息， 自尊、压力、家庭和同龄人吸烟、吸烟意图、 烟草使用史、改变的初始阶段和感知健康结束 三年了。习惯性吸烟风险最高的青少年将是 随机分配到走向无烟草使用的项目(TNT项目)干预 或等待列表控制。将获得有关压力的进一步信息， 自我效能感、戒烟障碍和社会支持。样本量N=450 将寻求对研究假设进行检验。TNT项目的目标是 青少年使用烟草的主要原因已被证明是 在不同的文化群体中有效。它将以一个小组的形式交付 由一名双语健康教育者提供。一位阿拉伯裔美国医生将提供 健康教育内容。后续数据将在第一次和第二次会议上收集 4、干预后3、6、12个月。分层线性模型， 将使用有序Logistic回归和配对t检验来分析 数据。

DESCRIPTION (Adapted from the Applicant's Abstract): Research studies have shown cigarette-smoking rates in middle-eastern adolescents to range from 33 to 58 percent. The aims of this community-based, theory-driven research are (a) to examine cultural, personal, social, and environmental forces operating in at risk for habitual tobacco use Arab American youths and (b) to test the effects of a cessation intervention on smoking behavior at three, six, and twelve months post intervention. Cigarette smoking is the chief avoidable cause of death and disease in the United States and in Michigan. In 1996, 25.9 percent of the Michigan adult population smoked cigarettes; Michigan has the 10th highest smoking rate in the nation (Michigan Critical Health Indicators, 1996). Direct medical care costs attributable to smoking were nearly $940 million in 1994. Contributing to tobacco use statistics in Michigan is a rapidly growing Arab American immigrant population. The highest concentration of Arab Americans, with an estimated population of 300,000, live in Michigan; more than 36 percent were born outside the United States. Pilot data showed a 25 percent smoking rate in Arab American youths ages 14-18. Arab Americans are one of the fastest growing cultural minorities in the U.S. and the health consequences of continued tobacco use in this population in terms of human suffering from tobacco-related illnesses and health care dollars is potentially very high. The setting for this study is the Arab Community Center for Economic and Social Services (ACCESS) Teen Health Center which services almost 2500 youth (visits each year). The majority of the people the clinic serves are poor, under-educated, live in extended families of 3-5 adults, are immigrants, and speak Arabic as a first language. A total of 2900 adolescents over 13 years will be asked to provide information on demographic and cultural variables, self-esteem, stress, family and peer tobacco use, intention to use tobacco, history of tobacco use, initial stage of change, and perceived health over three years. Youths with the highest risk for habitual tobacco use will be randomly assigned to Project Toward No Tobacco Use (Project TNT) intervention or Wait List Control. Further information will be obtained on stress, self-efficacy, barrier to cessation, and social support. A sample size of N=450 will be sought to test the study hypotheses. Project TNT was designed to target the primary causes of tobacco use among adolescents and has been shown to be effective in diverse cultural groups. It will be delivered in a small group basis by a bilingual health educator. An Arab American physician will provide the health education content. Follow up data will be collected at Sessions 1 & 4 and at 3, 6, and 12 months post-intervention. The hierarchical linear model, ordinal logistic regression and paired t-tests will be used to analyze the data.