Health Advocates as a Vehicle to Improve Treatment for Smokers in Public Housing

健康倡导者作为改善公共住房吸烟者待遇的工具

基本信息

批准号：
8324761
负责人：
DANIEL R BROOKS
金额：
$ 5.71万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-11 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8324761
关键词：
Abstinence Address Adherence Advocate Affect Aftercare Age Attitude Behavior Therapy Boston Cessation of life Clinic Clinical Practice Guideline Communities Community Health Comorbidity Control Groups Counseling Country Data Sources Depressed mood Development Disease Dose Educational Background Effectiveness of Interventions Ensure Ethnic Origin Evaluation Exposure to Health Income Individual Intervention Investments Knowledge Low income Massachusetts Measures Mediator of activation protein Methods Minority Groups Modality Morbidity - disease rate Motivation Nicotine Dependence Outcome Outcome Assessment Outcome Study Participant Persons Pharmaceutical Preparations Pharmacological Treatment Play Poverty Prevalence Public Health Public Housing Questionnaires Randomized Records Recruitment Activity Research Infrastructure Role Self Efficacy Services Site Smoker Smoking Social support Stress Telephone Testing Time Tobacco Tobacco Dependence Tobacco use Training Update Ursidae Family Use Effectiveness Withholding Treatment Work Writing base cost cost effectiveness efficacy testing follow-up group intervention improved interest intervention effect low socioeconomic status meetings mortality novel strategies preference primary outcome programs public health relevance quitline randomized trial self help smoking cessation smoking prevalence socioeconomics standard care success treatment program

项目摘要

DESCRIPTION (provided by applicant): Quitting smoking is the most important step that smokers can take to benefit their health. However, low-income smokers are less successful in quitting than higher-income smokers. If these socioeconomic disparities in smoking and smoking cessation rates persist, low-income smokers will bear an increasingly disparate burden of smoking-related morbidity and mortality. Therefore, interventions to improve the rate of smoking cessation among low-income smokers are urgently needed. Smoking cessation treatment programs such as telephone quitlines and clinic-based programs exist but are underutilized, particularly by low-income smokers. We propose to conduct a group-randomized trial among public housing residents to test whether the use of resident Community Health Advocates with special training in smoking cessation (Tobacco Treatment Advocates (TTAs) can improve (1) utilization of quitlines and clinic-based programs and (2) smoking cessation rates among smokers in public housing. Twenty public housing developments (PHDs) in Boston will be randomly assigned to receive either the TTA intervention or enhanced standard care, with 250 smokers recruited for each condition. The intervention period for each participant will last 6 months, with final outcome assessment 6 months later. At intervention PHDs and TTAs will have 7-9 interactions with smokers to motivate them to use a treatment program, assist in determining which program best meets their needs, proactively connect smokers to programs, address logistical problems and other barriers to program participation, reinforce and augment counseling messages, encourage full utilization of programs including adherence to medication, and provide social support for quitting during and after treatment. Participants at control PHDs will meet once with a TTA who will provide them with culturally-appropriate self-help materials and information on smoking cessation services available through the Quitline and clinic-based programs. The primary outcomes for the study will be (1) utilization of Quitline or clinic-based cessation services (including dose of treatment), and (2) 7-and 30-day biochemically-verified smoking abstinence measured at 3, 7, and 12 months. Data sources for outcomes, as well as hypothesized mediators and moderators, will include quitline and clinic records, TTA records, and questionnaires administered at four time points. A cost-effectiveness evaluation of the cost per additional quit will provide information on the potential for disseminability. PUBLIC HEALTH RELEVANCE: Quitting smoking is the most important step that smokers can take to benefit their health, but low-income smokers are less successful in quitting than higher-income smokers. Interventions to improve the rate of smoking cessation among low-income smokers are urgently needed, or else these smokers will bear an increasingly disparate burden of smoking-related disease and death. Using residents from low-income communities, such as public housing, to help their fellow residents quit smoking may be an effective method to increase the rate of smoking cessation.

描述（由申请人提供）：戒烟是吸烟者可以采取有益于其健康的最重要步骤。但是，低收入吸烟者在戒烟方面的成功率不如高收入吸烟者。如果这些在吸烟和戒烟率中的社会经济差异持续存在，那么低收入吸烟者将承担与吸烟有关的发病率和死亡率越来越不同的负担。因此，迫切需要采取干预措施以提高低收入吸烟者的戒烟率。存在戒烟治疗计划，例如电话问题和基于诊所的计划，但没有充分利用，尤其是低收入吸烟者。我们建议在公共住房居民中进行一项集体助理试验，以测试使用特殊培训的居民社区卫生倡导者是否在戒烟方面接受特殊培训（烟草治疗倡导者（TTAS））是否可以改善（TTAS）（1）在公共住房中，在公共住房中随机吸烟的烟雾中的吸烟率（PHD）（PHD）（PHD）（PHDS）（phds）（phds）（phds）（1）使用。干预或增强的标准护理，每个参与者的干预期都有250个吸烟者。在6个月后，最终的结果评估和TTA的最终评估。利用包括遵守药物的计划，并在治疗期间和之后提供社会支持。 Control Phds的参与者将与TTA见面一次，TTA将为他们提供适合文化的自助材料，并提供有关通过基于戒烟和基于诊所的计划获得的有关戒烟服务的信息。该研究的主要结果将是（1）利用基于终止或基于临床的戒烟服务（包括治疗剂量），以及（2）7和30天生物化学验证的戒烟，在3、7和12个月中测量。结果的数据源以及假设的调解人和主持人将包括在四个时间点进行的Quitline和Clinic Records，TTA记录和问卷。对每次戒烟的成本进行成本效益评估将提供有关具有分散性的可能性的信息。公共卫生相关性：戒烟是吸烟者可以采取的最重要步骤，以使其健康受益，但低收入吸烟者在退出方面的成功率要比高收入吸烟者少。迫切需要采取干预措施，以提高低收入吸烟者的戒烟速度，否则这些吸烟者将承担与吸烟有关的疾病和死亡的越来越不同的负担。使用低收入社区（例如公共住房）来帮助其同胞戒烟的居民可能是提高戒烟率的有效方法。