Quit4Life+: Adapting and Evaluating a Phone-Based Tobacco Use Cessation Program for People Living with HIV in Uganda and Zambia

Quit4Life：针对乌干达和赞比亚艾滋病毒感染者调整和评估基于电话的戒烟计划

• 批准号: 10269613
• 负责人: Heather L Wipfli
• 金额: $ 69.08万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10269613
• 关键词: Abstinence; Acquired Immunodeficiency Syndrome; Africa; Africa South of the Sahara; African; Alcohol consumption; Antiviral Therapy; Awareness; Behavioral; Biochemical; Cardiovascular Diseases; Cause of Death; Chronic Obstructive Airway Disease; Communities; Country; Data; Disease; Enrollment; Ensure; Environment; General Population; Goals; HIV; Health Personnel; Health Professional; Health behavior; Healthcare; Intervention; Low income; Lung; Malignant Neoplasms; Measures; Mental Health; Morbidity - disease rate; Nicotine Dependence; Outcome; Participant; Patient Self-Report; Pattern; Pharmacology; Pneumonia; Policies; Population; Positioning Attribute; Prevalence; Provider; Public Health Schools; Randomized; Research; Resources; Risk; Risk Factors; Savings; Services; Smoke; Smoker; Smoking; Social isolation; Telephone; Testing; Text Messaging; Time; Tobacco; Tobacco Use Cessation; Tobacco use; Tuberculosis; Uganda; Universities; World Health Organization; Zambia; attributable mortality; base; brief advice; co-infection; comorbidity; comparative; comparative efficacy; control trial; cost; cost effective; cost effectiveness; cost estimate; cost-effectiveness ratio; depressive symptoms; design; disorder risk; efficacy evaluation; efficacy testing; health economics; improved; incremental cost-effectiveness; insight; interest; intervention effect; low and middle-income countries; low income country; mHealth; medical schools; mortality; nicotine patch; nicotine replacement; nicotine treatment; programs; scale up; secondary outcome; social stigma; standard of care; success; therapy adherence; tobacco cessation intervention; tobacco control; tobacco user; treatment arm; treatment center

Project Summary/Abstract While AIDS-related morbidity and mortality among people living with HIV (PLWH) have decreased with the introduction of combination antiviral therapy (ART), HIV continues to kill nearly 1 million people annually, the majority of whom live in sub-Saharan Africa. Tobacco use among PLWH contributes substantially to the HIV burden, with nearly a quarter of AIDS-related deaths attributable to smoking. While there is substantial evidence supporting interventions to help tobacco users in the general population quit, little is available relevant to the challenges facing HIV+ tobacco users, especially those living in low-income African countries, including higher rates of depressive symptoms, greater use of alcohol and illegal substances, lack of awareness about tobacco’s effects on HIV treatment, and social isolation resulting from HIV stigma. We approach this gap with the first randomized control trial (RCT) to test the efficacy of a tailored short message service (SMS) based tobacco use cessation intervention on prolonged tobacco use abstinence at 6 months post program initiation in comparison to the standard of care (brief advice to quit) and nicotine replacement therapy (nicotine patches) among PLWH in Uganda and Zambia. Our study will provide insight into the efficacy, feasibility, applicability, and affordability of delivering tobacco cessation interventions through health care professionals at HIV treatment centers in two countries with different tobacco use patterns, policy environments, and health care resources and provide needed information to providers and policymakers looking for cost-effective tobacco cessation interventions. The previously tested SMS-platform to be used in our study is uniquely positioned to be scaled in low- and middle-income countries worldwide, in which case rigorous research showing even modest success in reducing the prevalence of tobacco consumption among PLWH could confer enormous health and economic benefits. The primary partners in the study include the Center for Tobacco Control in Africa at the Makerere University School of Public Health, the Keck School of Medicine of USC; and the RAND Corporation; with technical support from the World Health Organization.

项目总结/摘要 虽然艾滋病毒感染者与艾滋病有关的发病率和死亡率随着艾滋病的发展而下降， 尽管联合抗病毒治疗（ART）的引入，艾滋病毒每年仍导致近100万人死亡， 其中大多数生活在撒哈拉以南非洲。艾滋病毒/艾滋病感染者中的烟草使用是艾滋病毒的主要原因 艾滋病造成的负担，近四分之一的艾滋病相关死亡可归因于吸烟。虽然有大量的 支持采取干预措施帮助普通人群戒烟的证据很少 与艾滋病毒+烟草使用者，特别是生活在低收入非洲国家的烟草使用者面临的挑战有关， 包括更高的抑郁症状发生率，更多地使用酒精和非法物质，缺乏 艾滋病患者对烟草对艾滋病治疗的影响的认识，以及艾滋病污名化导致的社会孤立。我们 通过第一个随机对照试验（RCT）来测试定制短信的功效， 基于SMS的烟草使用戒烟干预对6个月时长期烟草使用戒烟的影响 与标准治疗（戒烟的简短建议）和尼古丁替代相比，计划启动后 在乌干达和赞比亚的艾滋病毒携带者中使用尼古丁贴片治疗。我们的研究将提供深入了解 通过健康提供戒烟干预措施的有效性、可行性、适用性和可负担性 两个国家的艾滋病毒治疗中心的护理专业人员具有不同的烟草使用模式，政策 环境和卫生保健资源，并为提供者和决策者提供所需的信息 寻找具有成本效益的戒烟干预措施。之前测试的SMS平台将用于 我们的研究在全球低收入和中等收入国家具有独特的优势，在这种情况下， 严谨的研究表明，在减少吸烟者的吸烟率方面， PLWH可以带来巨大的健康和经济效益。这项研究的主要合作伙伴包括 马凯雷雷大学公共卫生学院、凯克大学 南加州大学医学院和兰德公司;世界卫生组织提供技术支持。