Family Smoking Cessation in Romania Using Pregnancy as a Window of Opportunity

罗马尼亚家庭戒烟利用怀孕作为机会之窗

• 批准号: 9182908
• 负责人: Cristian Ioan Meghea
• 金额: $ 13.95万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9182908
• 关键词: Address; Adopted; Adoption; Area; Award; Balkans; Biometry; Birth; Canada; Cessation of life; Child; Clinic; Clinical; Clinical Trials; Conceptions; Country; Couples; Disease; Drug Addiction; Eastern Europe; Effectiveness; Enrollment; Epidemiology; European; Family; Family health status; Female; Funding; Future; Gender; Goals; Health; Health Psychology; Health system; Human; Income; Institution; International; Intervention; Knowledge; Lead; Life; Longevity; Medicine; Mentors; Mentorship; Methodology; Michigan; Mission; Morbidity - disease rate; Motivation; Outcome; Perinatal Epidemiology; Policies; Population; Postnatal Care; Postpartum Period; Pregnancy; Pregnant Women; Prenatal care; Prevention; Prevention Research; Preventive Intervention; Primigravidities; Problem Solving; Public Health; Qualitative Research; Randomized Controlled Trials; Relapse; Reporting; Research; Research Personnel; Resources; Role; Romania; Scientist; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Smoking Prevention; Source; Spouses; System; Target Populations; Testing; Tobacco; Tobacco Dependence; Tobacco use; Training; Treatment Efficacy; USSR; United States National Institutes of Health; Universities; Visit; Voice; Western Europe; Woman; Work; base; behavioral health; behavioral health intervention; care delivery; career development; cigarette smoking; cohort; college; design; dissemination research; evidence base; global health; implementation research; killings; low and middle-income countries; male; maternal cigarette smoking; member; mortality; novel strategies; offspring; postnatal; prenatal; prevent; professor; programs; public health intervention; public health relevance; quitline; reproductive; research and development; research data dissemination; smoking cessation; smoking prevalence; smoking relapse; tobacco control

DESCRIPTION (provided by applicant): This IRSDA K01 resubmission advances the Fogarty mission of facilitating global health research through building partnerships between research institutions in the U.S. and abroad, and training new global health scientists. Dr. Cristian Meghea is an Assistant Professor in the College of Human Medicine, at Michigan State University (MSU) and an Associated Researcher at Babes-Bolyai University (BBU), in Cluj-Napoca, Romania where he was born and raised. This award will prepare Dr. Meghea to establish himself as an independently- funded global health researcher with capacity to develop, evaluate, and implement effective, culturally-tailored, and sustainable interventions to prevent and reduce smoking in families during the reproductive years in resource limited settings such as Central and Eastern Europe. Pregnancy smoking and postnatal relapse are highly prevalent in Romania and Central and Eastern Europe, with lifetime negative health effects for the women and their children. There are higher odds of female smoking persistence during pregnancy, and of relapse once pregnant women quit, when the male partner also smokes. It is critically important to address the smoking behavior of couples at the beginning of reproductive life. Building on ongoing pilot work led by Dr. Meghea in Cluj-Napoca, Romania, the overall objective of the proposed research, conducted through BBU in the same clinic as the ongoing pilot, is to adapt, enhance, and test the implementation feasibility and preliminary efficacy of an evidence-based pregnancy and postnatal couple intervention for smoking cessation that begins early in pregnancy and has a postnatal component. The intervention will be based on the motivation and problem solving (MAPS) approach, successful in preventing smoking relapse postpartum in the US, which will be enhanced by targeting the couples' smoking behavior by focusing on dyadic efficacy for smoking cessation. The target population is primigravida pregnant women and their partners in Cluj-Napoca, Romania. The specific aims are: (1) To develop an adapted and enhanced couple intervention to reduce pregnancy smoking and postpartum relapse in Romania based on the MAPS approach. (2) To conduct a pilot randomized controlled trial to test the fidelity of the culturally adapted MAPS intervention enhanced for couples smoking prevention during pregnancy and postpartum. (3) To examine in the pilot the implementation feasibility and initial efficacy in increasing maternal pregnancy smoking cessation and reducing postnatal relapse, with secondary hypotheses regarding maternal smoking reduction and spousal cessation, relapse, and reduction. This study proposed in this award will form the basis for a larger, multicenter clinical trial that will be submitted by Dr. Meghea as an R01 application by the end of the 4th year of this award to evaluate the effectiveness of the proposed smoking prevention intervention. If proven effective in the subsequent R01 trial, the intervention has a high potential for broad spectrum population impact and sustainability. The long-term goal is the adoption in the national Romanian health system as a proactive extension of the existing STOP SMOKING national program which includes a quitline. To pursue this long-term research agenda, Dr. Meghea will enroll in courses, trainings, and work with an outstanding team of mentors to refine and develop five areas of expertise: (1) Global health and tobacco control; (2) Behavioral health, intervention adaptation, dissemination, and implementation research; (3) Tobacco and drug dependence epidemiology; (4) Perinatal epidemiology; (5) Advanced biostatistics. Dr. Voice, the primary US mentor, will provide mentorship on conducting international research in resource limited settings, and will be an important source for networking with other colleagues. For over 15 years, he has lead a Fogarty D43 training and research program in Romania and the neighboring Balkans. Dr. Adriana Baban, the primary Romania mentor in Cluj-Napoca at BBU, is an expert in health psychology, prevention, and qualitative research. Dr. Kristie Foley, US Co-Mentor, with expertise in behavioral health and tobacco research rounds out this 3-member core mentoring team. The current and future interactions with Dr. Foley, the Fogarty R01 she currently leads building tobacco research capacity in Romania since 2012, and her collaborators in the region are extraordinary opportunities for Dr. Meghea's career development and research. Scientific advisors include: Dr. Adrian Blow (couples and family health interventions), Dr. William Wadland (smoking cessation and tobacco dependence), Dr. Jim Anthony (tobacco and drug dependence epidemiology), Dr. Nigel Paneth (perinatal epidemiology), Dr. David Wetter, one of the original MAPS developers, and Dr. Teodora Ciolompea, the national coordinator of the STOP SMOKING program in Romania. Dr. Ciolompea will have a key advisory role in the intervention adaptation, implementation and sustainability by facilitating the future adoption of the intervention in the national Romanian health system. The access to a true conception cohort with prenatal and postnatal care, delivery, and repeat pregnancies in the same clinics, and the high smoking rate and rare polydrug use, have the potential to advance health discoveries faster, cheaper, and more efficiently than we could in the US. This award addresses tobacco use, a key Fogarty and NIH priority in global health research and will provide Dr. Meghea the opportunity to engage in and maintain a strong research program with a major impact.

描述（由申请人提供）：本次IRSDA K01重新提交，通过在美国和国外的研究机构之间建立伙伴关系，以及培训新的全球健康科学家，推进了Fogarty促进全球健康研究的使命。christian Meghea博士是密歇根州立大学（MSU）人类医学院的助理教授，也是罗马尼亚克卢日纳波卡的巴贝斯-博利亚大学（BBU）的副研究员，他在那里出生和长大。该奖项将使Meghea博士成为一名独立资助的全球卫生研究人员，有能力在中欧和东欧等资源有限的环境中制定、评估和实施有效的、适合文化的和可持续的干预措施，以预防和减少育龄家庭吸烟。怀孕期间吸烟和产后复吸在罗马尼亚和中欧及东欧非常普遍，对妇女及其子女的健康造成终生的负面影响。女性在怀孕期间持续吸烟的几率更高，一旦女性戒烟，当男性伴侣也吸烟时，复发的几率也更高。解决夫妇在生育初期的吸烟行为是至关重要的。在Meghea博士在罗马尼亚克卢日-纳波卡领导的正在进行的试点工作的基础上，拟议研究的总体目标是通过BBU在与正在进行的试点相同的诊所进行，以适应、加强和测试基于证据的怀孕和产后夫妇戒烟干预的实施可行性和初步效果，该干预从怀孕早期开始并具有产后成分。干预将以动机和问题解决（MAPS）方法为基础，在美国成功地预防了产后吸烟复发，通过关注戒烟的双重功效，针对夫妇的吸烟行为，将加强干预。目标人群是罗马尼亚克卢日-纳波卡的初产妇及其伴侣。具体目标是：(1)基于MAPS方法，开发一种适应和增强的夫妇干预措施，以减少罗马尼亚的怀孕吸烟和产后复发。(2)开展随机对照试验，检验文化适应性map干预在夫妻孕期和产后预防吸烟中的保真度。(3)在试点中考察提高孕产妇孕期戒烟和减少产后复吸的实施可行性和初步效果，并对孕产妇减少吸烟和配偶戒烟、复吸、减少进行次要假设。该奖项提出的这项研究将成为Meghea博士作为R01申请提交的更大的多中心临床试验的基础