Proud to Quit (P2Q): A Person-centered mobile technology intervention for smoking cessation among transgender adults

项目总结/摘要 美国的跨性别成年人受到烟草使用的影响不成比例。跨性别成年人更多 吸烟的可能性是普通美国成年人的两倍多。除了巨大的负担 烟草使用给这一人群带来的疾病中，烟草使用也是性别肯定的禁忌症。 护理是许多变性人实现身心健康的医疗必需品。尽管 变性成年人的健康相关需求，现有的戒烟干预措施未能解决具体的 这个人口的需要。因此，美国国家医学院和美国外科医生总确定， 针对变性人的保健需求，制定和测试针对变性人的干预措施的有效性， 跨性别成年人是国家优先事项。尽管卫生保健提供者可以在戒烟方面发挥作用， 成年人报告说，在获得基于证据的、由临床医生提供的干预措施方面存在障碍。一个变性人专用的 移动健康干预可以作为一种具有成本效益和可扩展的解决方案，以改善健康结果， 这往往是难以触及的人群。此外，这种干预措施可以成为一种卫生服务资源， 卫生保健提供者可能没有时间或专业知识提供性别肯定戒烟 支持他们的跨性别患者。基于我们团队在跨性别健康方面的研究专长， 移动健康、戒烟和卫生系统烟草相关护理，我们建议开发和试点测试一种 跨性别成年人的mHealth戒烟干预：自豪地戒烟（P2 Q）。P2 Q将提供量身定制的 信息、同伴社会支持和自我监控功能。我们将通过与 干预咨询工作组，由变性成年人和性别确认健康服务提供者组成 关心，并实施迭代干预设计过程和可用性测试。通过一个遥控飞行员 随机对照试验，我们将评估mHealth戒烟的可接受性和可行性 使用自我报告和客观生物标志物对跨性别成人进行干预及其初步疗效 数据这项建议的结果将为全面服务研究的可行性和协议提供信息 有效性试验。该项目将解决缺乏针对性的戒烟干预措施的问题， 通过提供一种新的工具和接触不同地点的跨性别成年人的能力， 将提供一种具有成本效益的方法，确保干预措施能够忠实地广泛传播; 最终，它将减少跨性别成年人与烟草相关的健康差异， 烟草使用的影响不成比例。

Project Summary/Abstract Transgender adults in the U.S. are disproportionately affected by tobacco use. Transgender adults are more than twice as likely to smoke cigarettes than the general U.S. adult population. In addition to the great burden of disease tobacco use places onto this population, tobacco use is also a contraindication for gender-affirming care, a medical necessity for many transgender persons to achieve full mental and physical health. Despite the health-related needs of transgender adults, existing smoking cessation interventions fail to address the specific needs of this population. As such, the National Academy of Medicine and U.S. Surgeon General identifies transgender-specific health needs and developing and testing the effectiveness of interventions for transgender adults a national priority. Despite the role health care providers can play in cessation, transgender adults report barriers to accessing evidence-based, clinician-delivered interventions. A transgender-specific mHealth intervention could serve as a cost-effective and scalable solutions to improving health outcomes for this often hard-to-reach population. Furthermore, such an intervention can be a health services resource for health care providers who might not have the time or expertise to provide gender affirming smoking cessation support to their transgender patients. Building on our team's research expertise in transgender health, mHealth, tobacco cessation, and health systems tobacco-related care, we propose to develop and pilot test an mHealth smoking cessation intervention for transgender adults: Proud to Quit (P2Q). P2Q will provide tailored messages, peer social support, and self-monitoring features. We will develop P2Q by collaborating with an Intervention Advisory Workgroup comprising of transgender adults and providers of gender affirming health care, and implement iterative intervention design processes and usability testing. Through a remote pilot randomized controlled trial, we will assess acceptability and feasibility of an mHealth smoking-cessation intervention for transgender adults as well as its preliminary efficacy using self-report and objective biomarker data. The findings from this proposal will inform the feasibility of and protocols for a full-scale services research effectiveness trial. The project would redress the dearth of smoking-cessation interventions tailored to transgender adults by offering a new tool and the ability to reach transgender adults in diverse locations; it would offer a cost-effective approach that ensures the intervention can be broadly disseminated with fidelity; and, ultimately, it would reduce tobacco-related health disparities among transgender adults, who are disproportionately affected by tobacco use.