A behavioral economic intervention for low-income smokers - Resubmission - 1 - Revision - 1

项目总结 低收入的人面临着独特的戒烟障碍，包括高水平的财务困境、创伤和 未得到满足的社会需求，导致使用吸烟作为一种应对机制。行为经济学进一步发现 经历经济困难的人们必须以牺牲 延迟的目标(如戒烟的长期健康益处)。缓解金融压力的干预措施 困难和其他社会需求可能会提高这一人群的戒烟率。我们的家长R37资助正在评估 综合干预的有效性、行为经济机制和成本效益 为戒烟提供财务辅导和转介至财务赋权服务和社会服务 治疗。最新的创伤相关行为理论表明，干预方法可以改变 从烟草使用的个人决定因素转向社会和结构决定因素烟草使用 可能会通过创建更全面、更无评判和 以弹性为导向的戒烟流程。此外，具有多个边缘化社会的参与者 身份在参与干预时可能会有独特的体验和戒烟过程 这承认了一个人更广泛的生活经历和烟草使用的社会决定因素。最后，共生现象 健康状况，如睡眠卫生不良，可能会与戒烟干预措施相互作用，但这些 相互作用在文献中一直没有得到充分的研究。本行政副刊的总体目标是 使用定性方法确定未包括在原始R37提案中的多层次因素 加强或限制干预对治疗参与度、初始戒烟和长期戒烟的影响 停止维护。定性的结果将进一步用于指导新的定量指标的选择 在母公司R37赠款的数据收集和分析方法中包括的措施，以提供对以下方面的见解 为什么干预有效，对谁有效，在什么情况下有效。拟议的补编的具体目的是 目的：1)定性检查干预相关和背景相关的因素，这些因素可能会增强或限制 干预对治疗参与度、初始戒烟和戒烟维持的影响 子目标1.1)探索社会因素和其他健康状况如何相互作用，影响参与者的 干预经验、行为改变过程以及干预的潜在作用机制。 目标2)以目标1中确定的定性主题为指导，选择新的多层次量化措施以 包括在父R37赠款的数据收集和分析方法中，以增强父项目的 了解干预的关键作用机制和背景影响。结果是 预计将产生关于解决以下社会背景决定因素的干预措施的重要见解 低收入吸烟者的烟草使用情况。

PROJECT SUMMARY People with low income face unique barriers to cessation, including high levels of financial distress, trauma, and unmet social needs, resulting in the use of smoking as a coping mechanism. Behavioral economics further finds that people experiencing financial hardship must attend to their immediate needs for survival at the expense of delayed goals (such as the long-term health benefits of quitting smoking). Interventions that alleviate financial hardship and other social needs may improve quit rates in this population. Our parent R37 grant is evaluating the effectiveness, behavioral economic mechanisms, and cost-effectiveness of an intervention that integrates financial coaching and referral to financial empowerment services and social services into smoking cessation treatment. Recent trauma-informed theories of behavior suggest that intervention approaches that that shift the focus away from individual determinants of tobacco use to the social and structural determinants tobacco use may improve intervention engagement and effectiveness by creating a more holistic, non-judgmental and resilience-oriented smoking cessation process. Additionally, participants with multiple marginalized social identities may have unique experiences and smoking cessation processes while participating in interventions that acknowledge one’s broader lived experience and social determinants of tobacco use. Lastly, co-occurring health conditions, such as poor sleep hygiene, may interact with tobacco cessation interventions but these interactions have been under-studied in the literature. The overall objective of this administrative supplement is to use qualitative methods to identify multi-level factors not included in the original R37 proposal that may enhance or limit the intervention’s impacts on treatment engagement, initial smoking cessation, and long-term cessation maintenance. The qualitative results will be further used to inform the selection of new quantitative measures to include in the parent R37 grant’s data collection and analytic approaches to provide insights into why the intervention works, for whom, and in which contexts. The Specific Aims of the proposed supplement are to: Aim 1) Qualitatively examine intervention-related and context-related factors that may enhance or limit the intervention’s impacts on treatment engagement, initial smoking cessation, and smoking cessation maintenance, with Sub-Aim 1.1) Explore how social factors and other health conditions may interact to influence participants’ intervention experiences, behavior change processes, and the intervention’s potential mechanisms of action. Aim 2) Guided by the qualitative themes identified during Aim 1, select new multi-level quantitative measures to include in the parent R37 grant’s data collection and analytic approaches to enhance the parent project’s understanding of the intervention’s key mechanisms of action and contextual influences. The results are expected to generate important insights about interventions that address sociocontextual determinants of tobacco use in people with low income who smoke.