En Pareja: A Latino couples intervention to help expectant fathers quit smoking

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DESCRIPTION (provided by applicant): Smoking among Latino males living in the U.S. is a significant public health problem. Latinos smoke at the same rate as White males but are less likely than Whites to quit smoking, which can contribute to health disparities in life expectancy and increase mortality due to lung cancer. Clearly, smoking cessation programs for Latinos are needed. Some programs tested among Latinos have shown efficacy, but at the short-term only. Further, none has attempted to encourage cessation at a teachable moment: a time when cessation may seem more relevant. To reach this underserved population of smokers, we are proposing to conduct a teachable moment intervention trial for recently immigrated Latino smokers in Durham and Raleigh, North Carolina. We will conduct the interventions in Spanish. We will attempt to capitalize on the teachable moment of Latinas' pregnancy as an impetus for Latinos' cessation because pregnancy is a time when men might consider stopping smoking. Also, including the woman could help sustain cessation after the program is complete. Thus, we are intervening with Latino couples to help the men quit smoking. We have partnered with community leaders at El Centro Hispano, a community resource center for Latinos in Durham. We will develop an intervention based primarily on Social Cognitive Theory and the Teachable Moments Model. We will teach men smoking cessation skills, help improve men's self-efficacy and outcome expectancies for quitting, and teach the couples optimal ways to communicate to reduce the stress that comes with a new baby. With better communication, the couple may be able to work together better to help him quit smoking and stay quit. We are proposing to recruit pregnant Latino couples (n=420) into a two-arm smoking cessation intervention. The program will be culturally tailored to emphasize Latino cultural values that could contribute to higher cessation rates, namely familismo, a high value on the family, and personalismo, valuing warm personal relationships. The study arms are: Arm 1: Self-help smoking cessation guide vs. Arm 2: Couple-based smoking cessation counseling. We propose to survey couples face-to-face at five time-points: baseline, 28 weeks gestation, and 2, 6, and 12 months postpartum. PUBLIC HEALTH RELEVANCE: The smoking rate among Latino males is too high. Few effective programs reach and promote long term smoking cessation among Latino Spanish-speaking smokers. This intervention approaches Latinos when their wives are pregnant to increase motivation for quitting. The intervention includes Latinas and teaches the couples effective communication skills to help sustain cessation effects long term.