Project Impact: A Culturally-Tailored Adherence Intervention for Latino Smokers

描述(申请人提供)：2009年，美国有438,000人死于吸烟，超过80%的肺癌与吸烟有关。肺癌是拉美裔男性癌症死亡的主要原因，也是拉美裔女性死亡的第二大原因。几种戒烟的药物疗法已被证明在提高戒烟率方面是有效的，包括尼古丁替代疗法(NRT)。尽管有这些有效的治疗方法，但坚持治疗对拉丁裔人来说是一个重大障碍。开发新的、有效的、具有文化针对性的干预措施，提高拉美裔吸烟者对NRT的依从性，最终可以为临床实践提供信息，并提高寻求戒烟的拉丁裔吸烟者的戒烟率。目前的研究试图开发和测试一种文化定制的服药依从性干预措施，其中将包括针对拉丁裔吸烟者的独特需求的短信和行为组件。这些新颖和有针对性的组成部分将解决与NRT治疗有关的误解和障碍，并提供实时提醒和信息提示，以提高依从性。在研究的初始开发阶段，将使用定性方法来开发干预措施中以拉丁裔为目标的部分。在研究的临床试验阶段，98名有兴趣戒烟的拉丁裔吸烟者将被随机分为两组-文化定制依从组(CTA)或标准用药管理组(SMM)。所有参与者将接受12周的NRT，并将接受对NRT依从性、烟草戒断的持续评估，并将根据我们的理论模型的结构(例如动机或行为技能)进行评估。这项拟议的研究将在一项为期五年的职业发展计划的背景下进行，该计划将提供关于拉丁裔特定健康干预措施、遵守干预措施、医疗保健技术使用和定性方法的高级培训。拟议的培训和研究计划旨在促进申请者的长期职业目标，即建立一个独立资助的烟草研究计划，重点放在拉丁裔人口上，他们受到毒瘾及其相关疾病的影响不成比例。此外，我们开发和测试治疗干预措施的短期目标将通过这项研究计划来实现，这些干预措施旨在解决低收入和种族多样化亚群的独特心理社会特征和需求。提出了一个全面的培训计划，将指导研究、由该领域知名研究人员指导的有组织的教学活动、正式的课程作业和研讨会以及参加布朗大学和巴特勒医院的研讨会结合在一起。

DESCRIPTION (provided by applicant): In 2009, tobacco use was implicated in 438,000 deaths in the U.S. and over 80% of lung cancers were attributed to smoking. Lung cancer is the primary cause of cancer death for Latino men and the second leading cause for Latina women. Several pharmacological treatments for smoking cessation have been shown to be effective at improving tobacco abstinence rates, including nicotine replacement therapy (NRT). Despite the availability of these efficacious treatments, adherence to treatment is a significant barrier for Latinos. Developing novel, effective and culturally targeted interventions that increase NRT adherence among Latinos can ultimately inform clinical practice and improve the cessation rates of Latino smokers seeking to quit. The current study seeks to develop and test a culturally tailored medication adherence intervention that will include text messaging and behavioral components that target the unique needs of Latino smokers. These novel and targeted components will address misperceptions and barriers related to NRT treatment and offer real-time reminders and informational prompts to enhance adherence. In the initial development phase of the research, qualitative methods will be used to develop the Latino-targeted components of the intervention. During the clinical trial phase of the study, 98 Latino smokers interested in quitting will be randomized to one of two groups - Culturally Tailored Adherence (CTA), or 2) Standard Medication Management (SMM). All participants will receive 12 weeks of NRT and will receive ongoing assessments of NRT adherence, tobacco abstinence, and will be assessed on the constructs of our theoretical model (e.g. motivation or behavioral skills). The proposed study will be conducted in the context of a five-year career development program that will provide advanced training in Latino-specific health interventions, adherence interventions, the use of technology in healthcare, and qualitative methodologies. The proposed training and research plans aim to promote the applicant's long-term career goal of establishing an independently-funded program of tobacco research with a focus on Latino populations, which are disproportionately impacted by addiction and its related diseases. Furthermore our short-term goal of developing and testing treatment interventions that address the unique psychosocial characteristics and needs of low-income and ethnically diverse subpopulations will be accomplished by this program of research. A comprehensive training plan is proposed, combining mentored research, structured didactic activities guided by established researchers in the field, formal coursework and workshops, and participation in seminars at Brown University and Butler Hospital.