Effect of integration of tobacco control into HIV care in Kenya on distribution of household expenses

肯尼亚将烟草控制纳入艾滋病毒护理对家庭支出分配的影响

• 批准号: 10850616
• 负责人: STELLA AGUINAGA BIALOUS
• 金额: $ 15万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-16 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10850616
• 关键词: Address; Administrative Supplement; Alcohols; Biochemical; Budgets; Bupropion; Cancer Control; Cardiovascular Diseases; Caring; Cause of Death; Cessation of life; Clinic; Communicable Diseases; Cost-Benefit Analysis; Counseling; County; Data; Economics; Education; Expenditure; Financial Hardship; Food; General Population; HIV; HIV Infections; Household; Incidence; Intervention; Kenya; Malignant Neoplasms; Modeling; Parents; Patients; Pattern; Persons; Policy Developments; Prevalence; Randomized; Resource Allocation; Respondent; Sampling; Specific qualifier value; Surveys; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Treatment outcome; brief intervention; cancer risk; cancer therapy; experience; interest; mortality; nicotine replacement; parent grant; programs; public policy on tobacco; quitline; response; scale up; sociodemographic disparity; syndemic; tobacco cessation intervention; tobacco control; tobacco user; treatment and outcome

PROJECT SUMMARY This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA- 23-052. Kenya is experiencing a syndemic of HIV and cancer that is aggravated by consumption of tobacco. Use of tobacco negatively impacts HIV treatment outcomes, increase the risks of cancer, and negatively impacts cancer treatment outcomes, and people living with HIV (PLHIV) have higher tobacco use rates than the general population. In Kenya, cancer is the third leading cause of death after infectious and cardiovascular diseases. From 2012 to 2018, the annual incidence of cancer increased from 37,000 to 47,887 new cases/year. During the same period, annual cancer mortality rose almost 16%, to 32,987 cancer-related deaths. There are significant socio-demographic disparities in tobacco, with people in the lower educational and economic strata having higher rates of tobacco use. Therefore, it is important to understand how household expenditures on tobacco impacts a household ability to access essential goods such as food and education. In this proposed administrative supplement, we will ask a sample of PLHIV who use tobacco about their expenditures on tobacco and other goods. The primary study (U01 CA261620-03) is a cluster randomized superiority trial assessing the impact of integrating tobacco use cessation into HIV care in 20 clinics in Kisumu County, Kenya. The primary study will compare 12-months biochemically verified point prevalence among tobacco users who received a brief intervention with tobacco users who received an intensive intervention. One of the primary study aims was to conduct in a cost-benefit analysis of the interventions but did not include the impact of the interventions on expenditures. Therefore, the Aims of this study are to: 1) Compare household spending patterns among PLHIV who use tobacco to household spending patterns among people in the general population who use tobacco in Kenya; 2) Compare the potential effect of a brief and an intensive tobacco cessation interventions on household expenditures among a sample of PLHIV who use tobacco, and 3) Model the potential effect of brief and intensive tobacco cessation interventions on household expenditures among PLHIV in Kenya. We will use items from the 2015- 2016 National Household Expenditure Survey to ask our sample (N=580) of PLHIV who use tobacco about their expenditures. We will then compare the results from this sample with the results of the national survey, which does not provide HIV-status of respondents. This will allow us to assess any financial burden related to tobacco expenditures among PLHIV. Further, we will be able to assess the impact of brief and intensive cessation interventions on household expenditures. This will provide data to model what the impact of scaling up a cessation intervention on national household expenditures on tobacco. The results of this project will inform allocation of resources for tobacco dependence treatment within tobacco and cancer control plans.

项目摘要 本申请是为了响应被标识为“NOT-CA-”的特别利益通知（NOSI）而提交的。 23-052.肯尼亚正在经历艾滋病毒和癌症的综合流行病，而烟草消费又加剧了这种流行病。 吸烟对艾滋病毒治疗结果产生负面影响，增加癌症风险， 影响癌症治疗结果，艾滋病毒感染者（PLHIV）的烟草使用率高于 普通民众。在肯尼亚，癌症是继传染病和心血管疾病之后的第三大死亡原因。 疾病从2012年到2018年，癌症的年发病率从37，000增加到47，887新发 例/年。在同一时期，每年癌症死亡率上升近16%，达到32，987例癌症相关死亡。 死亡在烟草方面存在着显著的社会人口差异，受教育程度较低的人 以及烟草使用率较高的经济阶层。因此，重要的是要了解如何 家庭烟草支出影响家庭获得食物等基本商品的能力， 教育在这份拟议的行政补充文件中，我们将询问一个吸烟的艾滋病毒感染者样本， 他们在烟草和其他商品上的支出。主要研究（U 01 CA 261620 -03）是一项随机分组研究 在基苏穆20家诊所评估将戒烟纳入艾滋病护理影响的优效性试验 肯尼亚县。初步研究将比较12个月生化验证点患病率， 接受短暂干预的烟草使用者与接受强化干预的烟草使用者。 研究的主要目的之一是对干预措施进行成本效益分析，但不包括 干预措施对支出的影响。因此，本研究的目的是：1）比较 吸烟的艾滋病毒感染者的家庭支出模式 在肯尼亚使用烟草的一般人群; 2）比较简短和密集的潜在影响 戒烟干预对吸烟的艾滋病毒感染者样本家庭支出的影响，以及 3)模拟短期和强化戒烟干预对家庭支出的潜在影响 在肯尼亚的艾滋病毒感染者中。我们将使用2015- 2016年全国家庭支出调查的项目来询问 我们的样本（N=580）的艾滋病毒感染者谁使用烟草对他们的支出。然后我们将比较结果 从这一抽样中，我们可以看到全国调查的结果，其中没有提供答卷人的艾滋病毒状况。这 将使我们能够评估艾滋病毒感染者与烟草支出有关的任何财政负担。此外，我们将 能够评估简短和密集的戒烟干预对家庭支出的影响。这将 提供数据，以模拟扩大戒烟干预对全国家庭的影响 烟草支出。该项目的结果将为烟草依赖的资源分配提供信息 烟草和癌症控制计划中的治疗。