Full Project I: Adolescent Tobacco and Areca Nut Use Prevention in Guam

摘要 美国附属太平洋群岛(USAPI)的人民面临着显著的健康差距 癌症和其他疾病的发病率和死亡率。大约有50万人生活在 USAPI和太平洋岛民是美国发病率增长最快的人口群体之一 肺癌、支气管癌和头颈癌的死亡率似乎明显高于#年。 USAPI在全国范围内超过了美国。中国人肺癌/支气管癌和口腔癌发病率较高 USAPI可能是由于该地区烟草和槟榔使用率较高所致。槟榔是槟榔的果实 槟榔一种棕榈，槟榔，通常用或不用烟草与坚果混合咀嚼，用于 刺激效果。我们最近的研究表明，烟草产品的使用，包括电子或电子- 关岛中学生的香烟使用量可能是美国全国学生的4-5倍 平均水平。显然，防止使用烟草产品(即香烟、咀嚼烟草、电子烟)和 在USAPI青少年中使用槟榔可能会减少USAPI在美国面临的癌症差异 从长远来看。目前没有有文化基础的、以证据为基础的烟草和槟榔 为USAPI青少年设计的预防方案。这项研究项目的长期目标是开发 一个以文化为基础、以证据为基础的烟草和槟榔预防计划，可能会在 USAPI的各个学校的教室。该项目将继续进行富有成效的合作 来自夏威夷大学癌症中心和关岛大学的研究人员， 作为由上一个周期的UCC/UOG伙伴关系赠款(U54)资助的试验性研究而启动。这个 拟议的研究将改编和测试Ho‘ouna Pono，一种创新的基于视频的课堂材料使用 为夏威夷原住民开发的预防课程，他们是太平洋岛民，文化上类似于 USAPI中的太平洋岛民。除了基于视频的课程外，我们还将测试基于社交媒体的 开展社会营销活动，防止烟草和槟榔的使用启动和升级。在8个公众中 关岛4所中学将被随机分配到“视频化课程+社会营销” 活动“条件(即，治疗)和4将被分配为”仅社会营销活动“ 条件(即，控制)。决定向控制组也提供干预，尽管力度较小 是以良好的社区实践道德为指导的。如果有效，以学校为基础的烟草和槟榔 可在USAPI全程提供预防使用课程，以减少青少年烟草 以及槟榔在该地区的使用情况。最终，该计划可能有助于降低 USAPI面临的癌症负担。

ABSTRACT People of the U.S. Affiliated Pacific Islands (USAPI) face significant health disparities in terms of higher morbidity and mortality due to cancer and other diseases. Approximately half a million people live in the USAPI and Pacific Islanders constitute one of the fastest growing demographic groups in the U.S. Morbidity and mortality due to lung and bronchus cancer and head-and-neck cancer appear to be markedly higher in the USAPI than the U.S. nationally. The higher rates for lung/bronchus and oral cancer incidence in the USAPI may be due to higher rates of tobacco and areca (betel) nut use in the region. Areca nut is the fruit of a type of palm, Areca catechu, which is commonly chewed with or without tobacco mixed with the nut, for stimulating effects. Our recent research suggests that tobacco product use, including electronic or e- cigarette use, among Guam middle school students may be 4-5 times higher than the U.S. national average. Clearly, preventing tobacco product use (i.e., cigarette, chewing tobacco, e-cigarette use) and areca nut use among USAPI adolescents is likely to reduce cancer disparities faced by the USAPI in the long run. Currently there are NO culturally grounded, evidence-based tobacco and betel nut prevention programs designed for USAPI youth. The long-term goal of this research project is to develop a culturally grounded, evidence-based tobacco and betel nut prevention program that may be delivered in the classrooms across schools in the USAPI. The project will continue a productive collaboration between researchers from the University of Hawaii Cancer Center (UHCC) and University of Guam (UOG), which initiated as a pilot study funded by the previous cycle of the UHCC/UOG Partnership grant (U54). The proposed study will adapt and test Ho'ouna Pono, an innovative video-based classroom substance use prevention curriculum developed for Native Hawaiians, who are Pacific Islanders and culturally similar to Pacific Islanders in the USAPI. In addition to the video-based curriculum, we will test a social media-based social marketing campaign to prevent tobacco and betel nut use initiation and escalation. Of the 8 public middle schools in Guam, 4 will be randomly assigned to the "video-based curriculum + social marketing campaign" condition (i.e., treatment) and 4 will be assigned to the "social marketing campaign only" condition (i.e., control). The decision to provide an intervention, albeit weaker, to the control group as well was guided by the ethics of good community practice. If efficacious, the school-based tobacco and betel nut use prevention curriculum may be delivered throughout the USAPI so as to reduce the adolescent tobacco and betel nut use prevalence in the region. Ultimately, the program may contribute to reducing the high cancer burden faced by the USAPI.