A trial of Positively Smoke Free group therapy for HIV-infected smokers

对感染艾滋病毒的吸烟者进行积极无烟团体治疗的试验

• 批准号: 8602908
• 负责人: Jonathan Shuter
• 金额: $ 77.4万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8602908
• 关键词: AIDS-Related Opportunistic Infections; Abstinence; Address; Administrator; Alcohol consumption; Alcohol or Other Drugs use; Automobile Driving; Behavior Therapy; Cardiac; Caring; Cessation of life; Communities; Comorbidity; Cost Analysis; Counseling; Data; Development; Drug usage; Economics; Epidemic; Evaluation; Event; Feedback; Foundations; Funding; Future; Group Therapy; Guidelines; HIV; Health; Health Priorities; Highly Active Antiretroviral Therapy; Individual; Intention; International; Intervention; Knowledge; Learning; Life; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Mediating; Mediator of activation protein; Meta-Analysis; Modality; Moods; Motivation; Nicotine; Odds Ratio; Outcome; Patients; Persons; Pilot Projects; Population; Prevalence; Provider; Published Comment; Publishing; Randomized; Randomized Controlled Trials; Recommendation; Relapse; Reporting; Research; Research Priority; Resources; Scientist; Self Efficacy; Services; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social Behavior; Social support; Societies; Telephone; Therapeutic community technique; Tobacco; Tobacco Use Cessation; United States National Institutes of Health; United States Public Health Service; Urban Population; Vulnerable Populations; Work; base; cigarette smoking; cohort; cost; evidence base; follow-up; health disparity; improved; insight; interest; meetings; nicotine replacement; peer; pilot trial; post intervention; programs; psychosocial; public health relevance; randomized trial; standard care; success; therapy design; treatment strategy; trend; working group

DESCRIPTION (provided by applicant): There are 1.1 million persons living with HIV (PLWH) in the US, 60% of them smoke cigarettes, and 75% of these are interested in quitting. Almost none are currently accessing smoking cessation interventions designed to meet their specific needs and concerns. Cigarette smoking is responsible for 24% of deaths among PLWH, and 30% of non-AIDS defining malignancies. It is driving the alarming rise in cardiac events and lung cancers in this highly vulnerable population. The lack of access to proven, effective, culturally appropriate tobacco cessation services represents a health disparity of the first order. The psychosocial profile of the PLWH-smoker community, characterized by high rates of psychiatric comorbidity, drug and alcohol use, and low levels of social support, suggests that achieving high cessation rates will be a great challenge. Positively Smoke Free (PSF) is an intensive, multisession, group cessation program specifically developed for PLWH smokers. A pilot study of PSF yielded promising results. This proposal aims (1) to perform a definitive efficacy study of PSF by comparing 6-month biochemically confirmed abstinence rates in subjects randomized to PSF vs. standard care in a cohort of 450 PLWH smokers, (2) to determine the sociobehavioral moderators and mediators associated with successful cessation, and (3) to complete a careful cost analysis of PSF in order to estimate the incremental cost per quit associated program participation. If PSF is proven to be effective it will establish a new treatment option for PLWH smokers. Determination of moderators and mediators of program success will provide insight into the mode of action of the intervention and will help guide the development of additional treatment strategies in the future. Finally, the cost analyses will provide critical information abut the feasibility of program dissemination and implementation.

描述（由申请人提供）：美国有110万艾滋病毒感染者（PLWH），其中60%吸烟，75%有戒烟的兴趣。目前，几乎没有人能够获得旨在满足其具体需求和关切的戒烟干预措施。 吸烟是导致艾滋病毒感染者死亡的24%，以及30%的非艾滋病定义的恶性肿瘤。它正在推动这一高度脆弱人群中心脏病事件和肺癌的惊人增长。无法获得经证实的、有效的、文化上适当的戒烟服务是一种最严重的健康差距。艾滋病毒/艾滋病感染者-吸烟者群体的社会心理状况，其特点是精神病合并症、药物和酒精使用率高，社会支持水平低，这表明实现高戒烟率将是一个巨大的挑战。 Positively Smoke Free（PSF）是一个专门为PLWH吸烟者开发的密集，多阶段，团体戒烟计划。PSF的试点研究取得了可喜的成果。该提案旨在（1）通过比较450名PLWH吸烟者队列中随机接受PSF与标准治疗的受试者6个月生化证实的戒烟率，进行PSF的确定性疗效研究，（2）确定与成功戒烟相关的社会行为调节因子和介导因子，以及（3）完成PSF的仔细成本分析，以估计每次退出相关计划参与的增量成本。 如果PSF被证明是有效的，它将为PLWH吸烟者建立一个新的治疗选择。确定项目成功的调节者和调解者将有助于深入了解干预的作用模式，并有助于指导未来其他治疗策略的制定。最后，成本分析将提供有关计划传播和实施的可行性的关键信息。