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Ending Tobacco Use through Interactive Tailored Messaging for Cambodian People Living with HIV/AIDS (EndIT)

通过为柬埔寨艾滋病毒/艾滋病感染者提供交互式定制信息来结束烟草使用 (EndIT)

基本信息

批准号：
10697333
负责人：
Thanh C. Bui
金额：
$ 69.94万
依托单位：
H. LEE MOFFITT CANCER CTR & RES INST
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-17 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10697333
关键词：
Abstinence Address Adoption Adult Behavior Therapy Biochemical Cambodia Cambodian Cancer Center Caring Cellular Phone Clinic Collaborations Complement Comprehensive Health Care Confidence Intervals Control Groups Country Data Developed Countries Development Enrollment Evaluation Female HIV HIV/AIDS Health Promotion Health Sciences Healthcare Income Influentials Intervention Life Literature Mediator Modeling Morbidity - disease rate Oklahoma Participant Patient Self-Report Persons Pharmacological Treatment Phase Pilot Projects Prevalence Proliferating Public Health Randomized Randomized, Controlled Trials Relative Risks Reporting Research Research Personnel Resource-limited setting Smoke Smoking Cessation Intervention Special Population Surveys Tobacco Tobacco Use Cessation Tobacco use Tobacco-Related Carcinoma Treatment Efficacy Universities University of Texas M D Anderson Cancer Center Wireless Technology Woman World Health Organization Writing antiretroviral therapy brief advice care delivery cigarette smoke comparative cost effectiveness cost effective economic evaluation efficacy evaluation follow-up high risk improved low income country mHealth male men mobile computing mortality nicotine replacement novel primary outcome randomized trial recruit secondary outcome self help sexual identity smoking cessation smoking prevalence standard care tailored messaging text messaging intervention tobacco cessation intervention tobacco control treatment group treatment program

项目摘要

PROJECT SUMMARY Although the prevalence of tobacco use has declined in developed nations in recent decades, the prevalence of smoking remains strikingly high in many low-income countries. In Cambodia, recent national surveys have indicated that 33%–43% of adult men and 3% of adult women smoke cigarettes. Certain special populations, such as people living with HIV (PLWH), are confronted with disproportionately high risks associated with tobacco use. Available estimates indicate that 43%–65% of male PLWH and 3%–5% of female PLWH smoke cigarettes. Although Cambodia has widespread coverage for antiretroviral treatment (ART), no known efforts have been made to provide tobacco treatment to ART recipients who smoke. Thus, complementing ART with efficacious tobacco cessation treatment offers tremendous potential to improve HIV care and to prolong life for PLWH. To address this need, we propose a randomized controlled trial with pharmacological and behavioral treatment components, including a fully automated, interactive smartphone-delivered intervention. Mobile health (mHealth) interventions are proliferating in the US, but efforts to utilize similar approaches in Cambodia are extremely limited. The World Health Organization acknowledges that mHealth is cost-effective, scalable, and sustainable, including for the least developed countries. We have already developed the mHealth platform and intervention approach proposed for this study, and we have completed a pilot study with 50 Cambodian PLWH who smoked and received care at an ART clinic. Results from this pilot indicated that the biochemically confirmed, 7-day point prevalence abstinence rates at 2-months follow-up were 40% in the group receiving the mHealth intervention vs. 8% in a standard care control group (relative risk: 5.0). In this proposed study, Cambodian PLWH of all sexual identities will be recruited through the 6 largest ART clinics in Phnom Penh, which provide comprehensive care to more than 14,000 PLWH. Participants (n=800) will be randomized to one of 2 treatment groups: Standard Care (SC; n=400), or Automated Messaging (AM; n=400). SC consists of brief advice to quit smoking delivered by research staff, self-help written materials, and an 8-week supply of nicotine replacement therapy (NRT) in the form of transdermal patches. AM consists of the SC components plus a fully automated smartphone-based treatment program that involves interactive and tailored proactive messaging. The primary outcome is biochemically confirmed self-reported 7-day point prevalence abstinence at 12-months post-study enrollment. Secondary outcomes include abstinence at 3- and 6-months post-enrollment. The primary aims are to evaluate the efficacy of AM for Cambodian PLWH who smoke and to compare the cost- effectiveness of AM vs. SC. If our findings indicate that AM is efficacious and cost-effective, our collaboration with influential Cambodian governmental agencies will facilitate wide-scale implementation to HIV clinics across the country. Thus, the project has the potential to transform HIV care delivery throughout the country and to reduce tobacco-induced cancer morbidity and mortality significantly.

项目总结尽管近几十年来发达国家的烟草使用率有所下降，但在许多低收入国家，吸烟率仍然高得惊人。在柬埔寨，最近的全国调查显示调查显示，33%-43%的成年男性和3%的成年女性吸烟。某些特殊人群，例如艾滋病毒携带者(PLWH)，面临与以下疾病相关的高风险烟草使用。现有的估计表明，43%-65%的男性长寿老人和3%-5%的女性长寿老人吸烟香烟。尽管柬埔寨的抗逆转录病毒治疗(ART)覆盖面很广，但没有已知的努力已经被要求为吸烟的抗逆转录病毒疗法接受者提供烟草治疗。因此，对艺术的补充有效的戒烟治疗为改善艾滋病毒护理和延长患者生命提供了巨大潜力 PLWH。为了解决这一需求，我们提出了一项随机对照试验，包括药理学和行为学治疗组件，包括全自动、交互式智能手机提供的干预。莫比尔县健康(MHealth)干预措施在美国正在激增，但在柬埔寨，利用类似方法的努力是极其有限的。世界卫生组织承认，移动健康具有成本效益、可扩展、和可持续的，包括对最不发达国家。我们已经开发了移动健康平台和干预方法，我们已经完成了对50名柬埔寨人的初步研究 PLWH吸烟，并在一家艺术诊所接受治疗。这项试验的结果表明，在生物化学上经证实，在接受2个月随访的组中，7天点戒断率为40% MHealth干预与标准护理对照组的8%(相对风险：5.0)。在这项拟议的研究中，柬埔寨所有性别的PLWH将通过金边最大的6家艺术诊所招募，这些医院为14,000多名妇女提供全面的护理。参与者(n=800)将被随机分成一组 2个治疗组：标准护理(SC；n=400)或自动消息传递(AM；n=400)。SC由Brief组成由研究人员提供的戒烟建议，自助书面材料，以及8周的尼古丁供应贴片形式的替代疗法(NRT)。AM由SC组件和完整的基于智能手机的自动化治疗计划，涉及交互式和定制的主动消息传递。主要结果是生化证实的自我报告的7天点戒断在12个月内流行。进修后招生。次要结果包括在注册后3个月和6个月禁欲。这个主要目的是评估AM对柬埔寨吸烟的PLWH的疗效，并比较其成本- AM与SC的有效性。如果我们的调查结果表明AM是有效且经济高效的，我们的合作与有影响力的柬埔寨政府机构将促进艾滋病毒诊所的广泛实施在全国各地。因此，该项目有可能改变全国艾滋病毒护理服务的提供。并显著降低烟草诱发癌症的发病率和死亡率。