Tobacco Cessation Treatment for Pregnant Alaska Natives

描述（由申请人提供）： 烟草使用是美国过早和可预防死亡的最大单一原因，成年人烟草使用的流行率目前在阿拉斯加原住民中最高。居住在阿拉斯加西部Yukon-Kuskokwim（Y-K）三角洲的阿拉斯加土著妇女中，有50%以上在怀孕期间使用无烟烟草或吸烟。该地区的阿拉斯加原住民是Yup'ik或Cup'ik爱斯基摩人，或阿萨巴斯卡印第安人。没有以前的工作评估烟草使用干预怀孕阿拉斯加土著妇女。该提案建立在我们与Y-K Delta Alaska Natives成功合作的基础上。这项R21提案的目的是开发和试点测试一种新的，文化定制的行为方法，为阿拉斯加土著孕妇戒烟。我们希望，作为这个项目的结果，我们将开发出一个可复制的，可行的，可接受的咨询干预，其疗效可以在未来的大规模随机临床试验进行测试。社会认知（学习）理论是所提出的干预措施的概念基础。该项目将分两个阶段进行。在第一阶段，我们将开发一个多组件，文化定制，烟草使用干预与阿拉斯加土著孕妇，包括录像带和简短的电话咨询。这项工作将包括编写一本辅导员手册，并与重点小组一起制定干预措施。在此阶段，10名孕妇将完成该方案，该方案将根据参与者和顾问的反馈进行修改和完善。第2阶段包括一项初步临床试验，将采用随机、两组设计，在首次产前访视（基线）和妊娠约36周的末次产前访视时进行评估。将招募孕妇并随机分配至标准（N=30）或增强（N=30）烟草使用干预组。这项研究的总体健康相关目标是为阿拉斯加土著孕妇制定有效的治疗方案，最终降低烟草相关疾病的风险。

DESCRIPTION (provided by applicant): Tobacco use is the single largest cause of premature and preventable death in the U.S. The prevalence of tobacco use among adults is currently highest among Alaska Natives. Over 50% of Alaska Native women residing in the Yukon-Kuskokwim (Y-K) Delta of western Alaska use smokeless tobacco or smoke cigarettes during pregnancy. Alaska Natives of this region are of Yup'ik or Cup'ik Eskimo, or Athabascan Indian ethnicity. No prior work has evaluated tobacco use interventions for pregnant Alaska Native women. This proposal builds on our successful partnership and track record of collaboration with Y-K Delta Alaska Natives. The objective of this R21 proposal is to develop and pilot test a novel, culturally-tailored behavioral approach to tobacco cessation for pregnant Alaska Native women. We expect that as a result of this project, we will have developed a replicable, feasible, and acceptable counseling intervention, the efficacy of which can be tested in future larger-scale randomized clinical trials. Social cognitive (learning) theory is the conceptual basis for the proposed intervention. This project will take place in two phases. In Phase 1, we will develop a multi-component, culturally-tailored, tobacco use intervention with and for Alaska Native pregnant women, including a videotape and brief telephone counseling. This work will include development of a counselor manual and development of the intervention with focus groups. During this phase, 10 pregnant women will complete the protocol, which will be modified and refined based on feedback from participants and counselors. Phase 2, consisting of a pilot clinical trial, will apply a randomized, two group design with assessments at the first prenatal visit (baseline) and at the last prenatal visit approximately 36 weeks gestation. Pregnant women will be recruited and randomized to either a standard (N=30) or enhanced (N=30) tobacco use intervention. The overall health related objective of this line of research is to develop effective treatment programs with and for Alaska Native pregnant women that will ultimately reduce the risk of tobacco-related disease.