Tobacco Cessation Treatment for Alaska Native Youth

阿拉斯加原住民青少年戒烟治疗

• 批准号: 7656989
• 负责人: Christi A Patten
• 金额: $ 36.37万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7656989
• 关键词: 14 year old; 18 year old; Adolescent; Age; Alaska; Alaska Native; American Indian and Alaska Native; Behavior Therapy; Behavioral; Centers for Disease Control and Prevention (U.S.); Child; Cigarette; Cigarette Smoker; Clinical Trials; Cognitive; Collaborations; Communities; Development; Disease; Enrollment; Feedback; Future; Hawaiian population; Health; Intervention; Intervention Studies; Learning; Manuals; National Institute of Drug Abuse; Native Americans; Pacific Island Americans; Participant; Phase; Pilot Projects; Population; Prevalence; Primary Health Care; Professional counselor; Protocols documentation; Public Health; Randomized; Randomized Clinical Trials; Reporting; Risk; Rural Community; Self Efficacy; Smoke; Smokeless Tobacco; Social support; Staging; Students; Surveys; Teenagers; Testing; Tobacco; Tobacco Use Cessation; Tobacco use; Treatment Efficacy; United States; United States Substance Abuse and Mental Health Services Administration; Withholding Treatment; Work; Writing; Youth; Yukon Territory; Yukon-Kuskokwim Delta; aged; base; cancer risk; cigarette smoking; community setting; design; effective therapy; follow-up; high school; intervention effect; meetings; native youth; novel; programs; public health relevance; quitline; self help; social; theories; therapy development; tobacco abstinence; treatment program

DESCRIPTION (provided by applicant): Tobacco use among adolescents is a major public health problem in the United States. The prevalence of tobacco use among adolescents is currently highest among American Indians and Alaska Natives. Among Alaska Natives residing in the Yukon-Kuskokwim (Y-K) Delta region of western Alaska, approximately 29% of 11-14 year olds, and 63% of 15-18 year olds, use tobacco. No prior work has evaluated tobacco cessation interventions for Alaska Native adolescents. This proposal builds on our successful partnership and 7 year track record of collaboration with the Y-K Delta Alaska Native community. The objective of this proposal is to develop and pilot test a novel, culturally- appropriate, behavioral treatment approach for tobacco cessation among Y-K Delta Alaska Native adolescents ages 12 to 17. The behavioral intervention will include an initial, 2 day, group-based program with follow-up support for 6 weeks. Social cognitive (learning) theory is the conceptual basis for the proposed intervention. We expect that as a result of this stage I project, we will have developed a replicable, feasible, and acceptable intervention, the efficacy of which can be tested in future large-scale randomized clinical trials. This project will take place in two phases. In phase 1, we will develop the intervention with feedback from a teen advisory group, and develop a counselor manual. Follow-up strategies will also be developed, pilot- tested, and refined. Twenty adolescents will complete the protocol, which will be refined in an iterative manner based on feedback from participants and counselors. Phase 2, consisting of a pilot clinical trial, will apply a group-randomized design with assessments at weeks 0 (baseline), 6, and 26. Eight villages will be randomized to receive either the behavioral intervention or control condition (written self-help materials + quit line referral). Ten adolescents will be enrolled from each village, for a total of 80 participants. We will assess the feasibility and acceptability of the intervention, as determined by qualitative ratings of treatment acceptability, and recruitment and retention rates. We will estimate the magnitude of the effect of the intervention compared to the control condition on the biochemically confirmed tobacco abstinence rate at weeks 6 and 26, and estimate the intraclass correlation (ICC). At week 6, we will evaluate the effect of the intervention on changes from baseline on perceived social support, self-efficacy for stopping tobacco use, and other mechanisms of change consistent with our theoretical framework. The overall health related objective is to develop effective treatment programs for Alaska Native youth that will ultimately reduce their risk of tobacco- related disease. PUBLIC HEALTH RELEVANCE: About half of Alaska Native adolescents residing in the Yukon-Kuskokwim (Y-K) Delta region of western Alaska use tobacco. This study proposes to develop a behavioral intervention for tobacco cessation that is culturally appropriate for youth of this region. Developing effective tobacco cessation interventions for Alaska Native youth may ultimately reduce their risk of cancer and other tobacco-related disease.

描述（由申请人提供）：青少年吸烟是美国的一个主要公共卫生问题。目前，青少年吸烟率在美洲印第安人和阿拉斯加原住民中最高。在居住在阿拉斯加西部育空-库斯科奎姆 (Y-K) 三角洲地区的阿拉斯加原住民中，大约 29% 的 11-14 岁青少年和 63% 的 15-18 岁青少年使用烟草。之前没有研究评估过阿拉斯加原住民青少年的戒烟干预措施。该提案建立在我们与 Y-K 三角洲阿拉斯加原住民社区的成功合作伙伴关系和 7 年合作记录的基础上。该提案的目标是开发并试点测试一种新颖的、文化上适宜的行为治疗方法，以帮助 12 至 17 岁的 Y-K 三角洲阿拉斯加原住民青少年戒烟。行为干预将包括初始的为期 2 天的小组计划以及为期 6 周的后续支持。社会认知（学习）理论是所提出的干预措施的概念基础。我们预计，作为第一阶段项目的结果，我们将开发出一种可复制、可行且可接受的干预措施，其有效性可以在未来的大规模随机临床试验中得到检验。该项目将分两个阶段进行。在第一阶段，我们将根据青少年咨询小组的反馈制定干预措施，并制定咨询手册。后续策略也将被制定、试点和完善。二十名青少年将完成该方案，该方案将根据参与者和辅导员的反馈以迭代方式进行完善。第二阶段包括试点临床试验，将采用分组随机设计，并在第 0 周（基线）、第 6 周和第 26 周进行评估。将随机分配 8 个村庄接受行为干预或控制条件（书面自助材料 + 戒烟热线转介）。每个村庄将招募 10 名青少年，总共 80 名参与者。我们将根据治疗可接受性的定性评级以及招募率和保留率来评估干预措施的可行性和可接受性。我们将估计与对照条件相比，干预措施对第 6 周和第 26 周经生化证实的戒烟率的影响程度，并估计组内相关性 (ICC)。在第 6 周，我们将评估干预措施对感知社会支持、戒烟自我效能以及与我们的理论框架一致的其他变化机制的基线变化的影响。总体健康相关目标是为阿拉斯加原住民青年制定有效的治疗计划，最终降低他们患烟草相关疾病的风险。公共卫生相关性：居住在阿拉斯加西部育空-库斯科奎姆 (Y-K) 三角洲地区的阿拉斯加原住民青少年中约有一半使用烟草。本研究建议制定一种在文化上适合该地区年轻人的戒烟行为干预措施。为阿拉斯加原住民青年制定有效的戒烟干预措施可能最终降低他们患癌症和其他烟草相关疾病的风险。