Assessing Telephone All Nations Breath of Life for Efficacy

评估电话万国生命之息的功效

• 批准号: 10668295
• 负责人: CHRISTINE Makosky DALEY
• 金额: $ 64.73万
• 依托单位: LEHIGH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10668295
• 关键词: Abstinence; Address; African American population; American Indians; Anthropology; Bayesian Modeling; Behavioral; Biochemical; Biometry; Cancer Etiology; Cardiovascular Diseases; Cause of Death; Cessation of life; Communities; Community Participation; Cotinine; County; Demographic Factors; Education; Electronic cigarette; Epidemiology; Ethnic Population; Failure; Family Practice; Feasibility Studies; Geographic Locations; Goals; Health; Individual; Intervention; Kansas; Letters; Life; Malignant neoplasm of lung; Medical center; Methods; Motivation; Nicotine; Outcome; Persons; Pharmacotherapy; Plants; Population; Premature Mortality; Prevalence; Qualifying; Recording of previous events; Recreation; Reporting; Research; Research Methodology; Research Personnel; Risk Factors; Salivary; Self Efficacy; Smoker; Smoking; Social support; Telephone; Testing; Tobacco; Tobacco use; United States; Universities; acceptability and feasibility; addiction; cigarette smoking; community based participatory research; community college; community organizations; efficacy testing; efficacy trial; enhancing factor; ethnic identity; follow-up; future implementation; health disparity; health literacy; implementation study; intervention program; pilot test; primary endpoint; programs; psychosocial; quitline; recruit; reservation-based; response; retention rate; smoking cessation; success; telephone based; tobacco control; urban Native American

PROJECT SUMMARY AI have the highest smoking rates of all major ethnic groups in the US, at 31.8%, nearly double that of both African Americans and Whites. Despite these high rates of smoking, few researchers have addressed this issue, in part because tobacco is a sacred plant to many AI and cannot be treated completely negatively, as most smoking cessation programs do. Researchers at the University of Kansas Medical Center (KUMC) and Johnson County Community College (JCCC) have been working with regional partners using community- based participatory research (CBPR) to address recreational tobacco since 2003. We have developed a successful culturally tailored program, All Nations Breath of Life (ANBL), that respects tobacco as a sacred plant and promotes honoring it rather than abusing it recreationally. Our in-person, group-based program had an intent-to-treat quit rate of 27.9% versus 17.4% compared to current best practices at end of treatment (12 weeks) in a reservation-based efficacy trial (N=463). Cessation was 20% vs. 12% at 6 months (p=0.02). In a large urban implementation feasibility study (N=312 across five states), the quit rate was 22% at 6-months (p<0.002 compared to the highest previously reported rates for an urban AI population); retention was 71%. Based on a request from the community, we created an individual telephone-based version of the program, tANBL, which was pilot tested with N=33 individuals and had a 24.2% quit rate at 6 months, assuming those lost to follow-up as smokers. The program had an 81.8% retention rate at 6 months. We are now ready to formally test tANBL for efficacy; that is proposed here using a Bayesian Adaptive Design (BAD) and our community-based participatory research (CBPR) framework. We will address the following specific aims: (1) To compare tANBL with an individual non-tailored telephone-based comparison program (CP) using a Bayesian Adaptive Design (n=500); (2) To examine the acceptability and feasibility of implementing an individual telephone-based ANB and (3) To compare individual telephone ANBL with an individual non-tailored telephone-based comparison program using a Bayesian Adaptive Design (N=500). Our primary endpoint will be 7-day point prevalence abstinence from recreational smoking biochemically verified by salivary cotinine level at 6 months post-baseline. Quit rates in the ANBL program will be significantly better than in the non- tailored program (24% versus 10%). We will address the following secondary aims: (1) To compare tANBL and CP 30-day point prevalence and continuous abstinence rates at 6 months and 12 months post-baseline; (2) To examine individual factors such as type of pharmacotherapy (if any), level of addiction, use of other nicotine products such as e-cigarettes, quitting history, motivation, tobacco health literacy, social support, self- efficacy, ethnic identity, psychosocial health and demographic factors for effect on quit rates; (3) To maximize and assess the cultural relevance of the intervention program and all of its components and (4) To identify factors that enhance dissemination of telephone-based ANBL and contribute to program success or failure.

项目总结 人工智能的吸烟率是美国所有主要种族中最高的，为31.8%，几乎是两者的两倍 美国黑人和白人。尽管吸烟率很高，但很少有研究人员解决这个问题 这个问题，部分是因为烟草对许多人工智能来说是一种神圣的植物，不能完全负面地对待，就像 大多数戒烟计划都是这样做的。堪萨斯大学医学中心(KUMC)和 约翰逊县社区学院(JCCC)一直在与地区合作伙伴合作，使用社区- 自2003年以来，以参与性研究(CBPR)为基础，致力于解决休闲烟草问题。我们已经开发出一种 成功的文化定制方案，所有国家的生命呼吸(ANBL)，尊重烟草是一种神圣的 植物，促进尊重它，而不是娱乐地滥用它。我们的面对面、基于小组的计划 在治疗结束时，打算治疗的戒毒率为27.9%，而当前的最佳实践为17.4%(12 周)，在基于保留的疗效试验中(N=463)。6个月时停药率分别为20%和12%(p=0.02)。在一个 大城市实施可行性研究(五个州的N=312)，6个月后退房率为22% (P&lt；0.002，而此前城市人工智能人口的保留率最高)；保留率为71%。 根据社区的请求，我们创建了该程序的个人电话版本， TANBL在N=33人中进行了试点测试，6个月后戒烟率为24.2%，假设 失去了作为吸烟者的后续行动。该计划在6个月时保留率为81.8%。我们现在准备好了 正式测试tANBL的有效性；这里建议使用贝叶斯自适应设计(BAD)和我们的 基于社区的参与性研究(CBPR)框架。我们将针对以下具体目标：(1) 将tANBL与单个非定制的基于电话的比较程序(CP)进行比较 贝叶斯自适应设计(n=500)；(2)检查实施 基于个人电话的ANB和(3)比较个人电话ANBL和个人非定制的ANB 基于电话的比较程序，使用贝叶斯自适应设计(N=500)。我们的主要终端将 用唾液可替宁生化方法验证休闲吸烟的7天时点流行戒烟 在基线后6个月的水平。ANBL计划中的戒烟率将明显好于非 定制计划(24%对10%)。我们将解决以下次要目标：(1)比较tANBL 基线后6个月和12个月的CP 30d时点患病率和持续戒断率； (2)检查个别因素，例如药物治疗的类型(如有)、成瘾程度、使用其他药物 尼古丁产品，如电子烟，戒烟史，戒烟动机，烟草健康素养，社会支持，自我 效能感、种族认同、心理社会健康和人口因素对戒烟率的影响；(3)最大限度地 并评估干预计划及其所有组成部分的文化相关性，以及(4)确定 加强以电话为基础的ANBL的传播，并对项目的成败做出贡献的因素。