Promoting Smoking Cessation Among Youth Exiting Foster Care

 描述(由申请人提供)：每年大约有30,000名青年由于18岁时“老化”而退出寄养系统，失去获得支持服务的机会，同时也要完全负责自己的经济、健康、就业和住房需求。这些初出茅庐的成年人从忽视和虐待的家庭中成长起来，面临着独立，大量使用烟草的可能性增加，最终发展为烟草使用障碍。事实上，寄养青年几乎无处不在地终生使用烟草，而日常吸烟率是普通人口的四倍。在年轻人留在寄养系统期间限制这种使用的服务严重有限，如果提供的话。一旦离开寄养家庭，与非寄养家庭的同龄人相比，这些青少年获得医疗服务的机会要少得多。拟议的可行性研究旨在解决寄养系统之外的青少年戒烟服务在可获得性、可及性和使用方面的这些差距。以计算机和移动电话为基础的干预措施有能力提供循证治疗内容，同时减少向寄养青年提供戒烟服务的许多障碍。这项拟议的研究将启动一项研究计划，以综合这些方法的好处，以满足与烟草相关的健康差距的弱势人群的需求。更具体地说，这项研究试图测试现有物质使用干预措施(iHeLP：交互式健康生活方式准备)在脱离寄养的老年青年中戒烟的适应性。IHeLP植根于动机访谈、跨理论模型和社会认知理论，是一种一次性的计算机化筛选和短暂干预(SBI)，辅之以六个月的量身定制的短信，基于参与者的SBI结果和随后的变化准备。这项初步研究的目的是获得关于一种新干预措施的可接受性和可行性的数据，并检查对总体改变动机和实际烟草使用的影响方向。因此，我们将进行一项双臂可行性试验，测试iHeLP在接触控制条件下的性能。日常文本的使用 消息传递代表了一种提供干预助推器的新方法。低强度、高频率的互动与传统干预措施相比是一个显著的变化，有很大潜力扩大最初的收益。此外，通过与参与者进行动态、基于文本的交流来定制这些信息也是一种创新。考虑到以低成本向多个高危人群广泛传播的潜力，拟议的研究具有很高的潜在公共卫生和临床意义。

 DESCRIPTION (provided by applicant): Each year, roughly 30,000 youth exit the foster care system due to "aging out" at age 18, losing access to support services while also becoming fully responsible for their own financial, health, employment, and housing needs. Progressing from homes disproportionately high in neglect and maltreatment, these emerging adults face independence with an increased likelihood of heavy tobacco use and, ultimately, the development of tobacco use disorders. Indeed, lifetime tobacco use is nearly ubiquitous among foster youth, while daily use rates are four times that of the general population. Services to curtail such use while young people remain in the foster care system are severely limited, if they are offered at all. Once removed from foster care, these youth have far less access to health services compared to their non-foster care peers. The proposed feasibility study seeks to address these gaps in availability, accessibility, and use of tobacco cessation services for youth aging out of the foster care system. Computer- and mobile phone-based interventions have the capacity to provide evidence-based treatment content while reducing many of the barriers relevant to tobacco cessation service delivery for foster youth. The proposed study will begin a program of research to synthesize the benefits of these approaches in a way that addresses the needs of a vulnerable population who experience tobacco-related health disparities. More specifically, this study seeks to test an adaptation of an existing substance use intervention (iHeLP: Interactive Healthy Lifestyle Preparation) for smoking cessation among youth aging out of foster care. Rooted in motivational interviewing, the transtheoretical model, and social cognitive theory, iHeLP is a one-time computerized screening and brief intervention (SBI), supplemented by six months of tailored text messaging based on participants' SBI results and subsequent fluctuations in their readiness to change. The goal of this pilot study is to obtain data on acceptability and feasibility of a novel intervention, as well as examine direction of effects on both overall motivation to change and actual tobacco use. As such, we will conduct a two-arm feasibility trial, testing iHeLP against a contact-control condition. The use of daily text messaging represents a novel method for delivering intervention boosters. Low-intensity, high-frequency interactions are a marked change from traditional interventions and have high potential for extending initial gains. In addition, tailoring of these messages through dynamic, text-based communication with participants is innovative. Given the potential of wide dissemination to multiple at-risk populations at low cost, the proposed study has high potential public health and clinical significance.