Randomized Trial of Lay Health Worker Smoking Cessation Intervention for Latinos

描述（由申请人提供）：肺癌是拉丁美洲人癌症死亡的主要原因，吸烟几乎占这些死亡人数的90%。拉丁美洲人特有的文化因素可能会增加（如家庭）或减少（如男子气概）戒烟成功。在社区需求评估中，LACRC社区诊所合作伙伴指出，戒烟服务是一个高度优先事项。在我们之前在LACRC的工作中，我们也发现吸烟者对戒烟感兴趣，并同意参加吸烟研究。值得注意的是，这项研究还表明，抑郁和饮酒与吸烟行为有关。其他人的研究表明，电话咨询在非拉丁裔群体中是有效且具有成本效益的，我们的合作伙伴也表示，这种方法在他们的诊所是可行的。在本试验中，我们使用社会网络模型来评估一项随机临床试验（n=175），该试验由一名非专业卫生工作者（LHW）提供的文化定制电话咨询干预，与常规护理（转介到非定制的西班牙戒烟热线）相比。我们还将提供抑郁症和酒精使用的筛查和转诊，并告知参与者尼古丁戒断的药物支持。我们的首要目标是评估与使用现有材料的简单语言翻译相比，来自参与者社会网络的同伴进行文化定制和交付的影响。相关的目的是：1)验证干预组在6周和3个月时比对照组有更高的戒烟尝试率和戒断率的假设；2)探索文化信仰是否会调节干预的效果；3)探索共病酒精使用和抑郁是否介导干预的效果。如果有效，训练有素的LHWs将能够继续在诊所进行咨询项目。研究结果还将用于扩大这一试验并开展更多的戒烟研究。项目负责人斯珀纳克博士还可以利用这个试点项目获得烟草控制方面的指导，并在拉丁文化方面打下基础，这样她就可以成为研究癌症差异的独立研究员。

DESCRIPTION (provided by applicant): Lung cancer is the leading cause of cancer death in Latinos and smoking is responsible for almost 90% of these deaths. Cultural factors unique to Latinos may act to either increase (e.g., family) or decrease (e.g., machismo) success of smoking cessation. In a community needs assessment, LACRC community clinic partners indicated that tobacco cessation services were a high priority. In our prior work in the LACRC, we also found that smokers were interested in cessation and would agree to participate in smoking studies. Of note, this work also demonstrated that depression and alcohol use were associated with smoking behavior. Research by others has shown that telephone counseling is effective and cost-effective in non-Latino groups and our partners have indicated that this approach was feasible in their clinics. In this pilot, we use the Social Networks Model to evaluate a randomized clinical trial (n=175) of a 6-session (and one 3 month booster), culturally-tailored telephone counseling intervention delivered by a lay health worker (LHW) compared to usual care (referral to a non-tailored Spanish tobacco quit line). We will also provide screening and referral for depression and alcohol use and inform participants about pharmaceutical support for nicotine withdrawal. Our overarching goal is to assess the impact of cultural tailoring and delivery by a peer from the participant's social network compared to use of simple language translation of existing materials. The associated aims are to: 1) test the hypothesis that the intervention group will have higher rates of quit attempts and abstinence than the control group at 6 weeks and 3 months, 2) explore whether cultural beliefs moderate the effects of the intervention, and 3) explore whether co-morbid alcohol use and depression mediate the effects of the intervention. If effective, the trained LHWs will be able to continue the counseling program at the clinics. The results will also be used to extend this trial and develop additional tobacco cessation research. Dr. Spernak, the project leader, will also be able to use this pilot to gain mentoring in tobacco control and grounding in Latino culture so that she can become an independent researcher in cancer disparities.