Partnering with a State Food Bank to Provide Tobacco Treatment to Underserved Smokers

与国家食品银行合作，为服务不足的吸烟者提供烟草治疗

• 批准号: 10012450
• 负责人: Damon J. Vidrine
• 金额: $ 55.09万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-07 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10012450
• 关键词: Accounting; Address; Adult; Behavioral; Biochemical; Cancer Center; Car Phone; Cellular Phone; Cessation of life; Charities; Chronic lung disease; Client; Clip; Communities; Community Networks; Cost Analysis; County; Data; Development; Disease; Enrollment; Evaluation; Food; Goals; Health Care Visit; Health Personnel; Health Resources; Health Services Accessibility; Health system; Healthcare Systems; Homicide; Hunger; Incidence; Individual; Intervention; Link; Malignant Neoplasms; Malignant neoplasm of lung; Mediating; Morbidity - disease rate; Motivation; Myocardial Infarction; Oklahoma; Online Systems; Participant; Pilot Projects; Population; Prevalence; Public Health; Randomized; Research Personnel; Resource Sharing; Resources; Risk; Risk Factors; Series; Sex Behavior; Site; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social Work; Socioeconomic Status; Stress; Stroke; Suicide; Tablets; Text; Text Messaging; Time; Tobacco; Tobacco Use Cessation; Tobacco use; Treatment Efficacy; Underserved Population; United States; Work; alcohol and other drug; attributable mortality; base; cost; cost effective; cost effectiveness; design; disorder prevention; economic evaluation; economic impact; evidence base; experience; follow up assessment; food resource; health disparity; improved; low socioeconomic status; mHealth; mobile application; mortality; negative affect; nicotine replacement; programs; quitline; safety net; smoking abstinence; smoking cessation; smoking prevalence; social disparities; standard care; tobacco cessation intervention; tobacco control; treatment group; vehicular accident; web portal

SUMMARY Efficiently connecting underserved smokers with limited resources to efficacious tobacco cessation treatments that are easily accessible is crucial for disease prevention and the elimination of health disparities. This study seeks to address this need through partnering with a large social service network to evaluate the efficacy and economic impact of a theoretically-based, fully automated, interactive smartphone-based smoking cessation intervention. The Regional Food Bank of Oklahoma (RFBO) is the largest hunger-relief charity in the state, and through a network of 14 Food and Resource Centers (FRC), provides food to more than 136,000 food insecure clients each week across 53 counties. Our preliminary data indicate that the prevalence of current smoking among adult clients is 46% (more than 3 times the prevalence in the general US population). Participants (n=500) will be randomized to one of two treatment conditions: 1) Standard Treatment (ST; n=250) or Automated Treatment (AT; n=250). ST participants will be electronically connected to the Oklahoma Tobacco Helpline using a tablet-based web portal that is specific to this study. This approach is designed to mirror the Ask Advise Connect (AAC) approach to linking smokers in healthcare systems with quitline treatment that our team has previously developed and evaluated. ST will be evaluated against AT, a fully automated treatment enrollment and delivery approach. In the AT condition, participants will receive an interactive smartphone- based intervention that comprises content delivered via audio/video clips and interactive text content. Much of the programming and developmental work for AT has already been completed by the Stephenson Cancer Center's mHealth Shared Resource, and results from a series of pilot studies (including work conducted in partnership with the RFBO sites) with beta versions of the mobile application are extremely encouraging. Nicotine replacement therapy (NRT) in the form of transdermal patches will be provided to all participants (ST and AT). Our overall goal of this project is to determine if AT performs better than the more resource intensive ST approach. If efficacy is established, the AT approach will be readily scalable, easily implemented by community-based organizations, and offer an efficient way to allocate limited public health resources to tobacco control interventions. The primary aim is to evaluate the efficacy of AT and ST in facilitating abstinence from smoking. It is hypothesized that at the 12-month follow-up assessment, 7-day point prevalence smoking abstinence rates will be higher in AT compared to ST. Secondary aims are to: 1) Compare the magnitude of the mediated effects via common mechanisms (i.e., motivation, agency, and stress/negative affect) on smoking abstinence between the AT and ST treatment groups; and 2) Conduct economic evaluations to assess the cost and/or cost-effectiveness of AT vs. ST. There is a critical need for theoretically-based, cost-effective, and sustainable cessation treatments that have broad dissemination potential, and the AT intervention has been designed to help fill this need.

概括 有效地将资源有限、服务不足的吸烟者与有效的戒烟治疗联系起来 易于获取的资源对于预防疾病和消除健康差距至关重要。这项研究 寻求通过与大型社会服务网络合作来评估有效性和满足这一需求 基于理论的、全自动的、交互式的、基于智能手机的戒烟的经济影响 干涉。俄克拉荷马州地区食品银行 (RFBO) 是该州最大的饥饿救济慈善机构， 通过 14 个食品和资源中心 (FRC) 组成的网络，为超过 136,000 名粮食不安全者提供食品 每周都有来自 53 个县的客户。我们的初步数据表明，当前吸烟的流行率 成年客户中的患病率为 46%（是美国普通人群患病率的 3 倍多）。参加者 (n=500) 将被随机分配至两种治疗条件之一：1) 标准治疗（ST；n=250）或 自动治疗（AT；n=250）。 ST 参与者将通过电子方式连接到俄克拉荷马烟草公司 使用专门针对本研究的基于平板电脑的门户网站的帮助热线。这种方法旨在反映 Ask Advise Connect (AAC) 方法将医疗保健系统中的吸烟者与我们的戒烟热线治疗联系起来 团队之前已经开发和评估过。 ST 将对照全自动治疗 AT 进行评估 招生和交付方式。在AT条件下，参与者将收到一部交互式智能手机- 基于干预，包括通过音频/视频剪辑和交互式文本内容传递的内容。很多 AT 的编程和开发工作已经由 Stephenson Cancer 完成 中心的移动医疗共享资源，以及一系列试点研究的结果（包括在 与 RFBO 网站的合作）以及移动应用程序的测试版非常令人鼓舞。 将为所有参与者提供透皮贴剂形式的尼古丁替代疗法（NRT）（ST 和 AT）。我们这个项目的总体目标是确定 AT 的性能是否优于资源密集型 ST方法。如果功效得到证实，AT 方法将很容易扩展，并且很容易由 以社区为基础的组织，并提供一种有效的方式来分配有限的公共卫生资源 烟草控制干预措施。主要目的是评估 AT 和 ST 在促进戒断方面的功效 来自吸烟。假设在 12 个月的随访评估中，7 天点吸烟率 与 ST 相比，AT 的戒断率更高。次要目标是： 1）比较 通过常见机制（即动机、代理和压力/负面影响）对吸烟产生的中介效应 AT 和 ST 治疗组之间的戒断； 2) 进行经济评估以评估成本 和/或 AT 与 ST 的成本效益。迫切需要基于理论的、具有成本效益的、 具有广泛传播潜力的可持续戒烟治疗，并且 AT 干预已 旨在帮助满足这一需求。