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

描述（由申请人提供）：2009年，烟草使用与美国438，000例死亡有关，超过80%的肺癌归因于吸烟。肺癌是拉丁美洲男性癌症死亡的主要原因，也是拉丁美洲女性癌症死亡的第二大原因。几种戒烟药物治疗已被证明可有效提高戒烟率，包括尼古丁替代疗法（NRT）。尽管有这些有效的治疗方法，坚持治疗是拉丁美洲人的一个重大障碍。开发新的，有效的和有文化针对性的干预措施，提高拉丁美洲人的NRT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美洲吸烟者的戒烟率。目前的研究旨在开发和测试一种文化定制的药物依从性干预措施，其中包括针对拉丁美洲吸烟者独特需求的短信和行为组件。这些新的和有针对性的组件将解决与NRT治疗相关的误解和障碍，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的拉丁美洲目标组件。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配到两组之一-文化定制依从性（CTA）或2）标准药物管理（SMM）。所有参与者将接受12周的NRT，并将接受NRT依从性、戒烟的持续评估，并将根据我们的理论模型（例如动机或行为技能）进行评估。拟议的研究将在一个为期五年的职业发展计划的背景下进行，该计划将提供拉丁美洲戒烟和健康，定性方法，坚持干预，烟草成瘾和戒烟以及医疗保健技术的使用方面的高级培训。拟议的培训和研究计划旨在促进申请人的长期职业目标，即建立一个独立资助的烟草研究计划，重点是拉丁美洲人口。提出了一个全面的培训计划，结合指导研究，结构化的导师指导活动，由该领域的研究人员，正式的课程和研讨会，并在布朗大学和巴特勒医院参加研讨会。

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 smoking cessation and health, qualitative methods, adherence interventions, tobacco addiction and cessation, and the use of technology in healthcare. 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. A comprehensive training plan is proposed, combining mentored research, structured mentorship activities guided by established researchers in the field, formal coursework and workshops, and participation in seminars at Brown University and Butler Hospital.