A smoke-free home intervention in federally subsidized housing

对联邦补贴住房进行无烟家庭干预

• 批准号: 10585905
• 负责人: Maya Vijayaraghavan
• 金额: $ 68.31万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585905
• 关键词: Abstinence; Adopted; Adoption; Adult; African American; African American population; Area; Asian population; Behavior; Biochemical; Black race; California; Cardiovascular Diseases; Cause of Death; Central American; Chinese; Chronic Disease; Counseling; County; Cuban; Development; Disease; Disparity; Ethnic Origin; Future; General Population; Geography; Health; Healthcare; Hispanic; Hispanic Populations; Home; Homelessness; Hospitalization; Household; Housing; Incidence; Intervention; Intervention Studies; Latino Population; Limited English Proficiency; Linguistics; Low Prevalence; Low income; Malignant Neoplasms; Malignant neoplasm of lung; Minority; Mission; Morbidity - disease rate; National Institute on Minority Health and Health Disparities; Neighborhoods; Pamphlets; Phase; Policies; Population; Population Heterogeneity; Prevalence; Public Health; Public Housing; Race; Randomized, Controlled Trials; Reporting; Research; Resources; San Francisco; Services; Site; Smoke-free home; Smoker; Smoking; Subgroup; Tobacco; Tobacco Use Cessation; Tobacco use; Tobacco-Related Carcinoma; Training; U.S. Department of Housing and Urban Development; Variant; Vulnerable Populations; Waiting Lists; Work; attributable mortality; bilingualism; comparison intervention; cost; cost effective; disparity reduction; effectiveness evaluation; ethnic disparity; ethnic diversity; evidence base; follow-up; health disparity; health equity; health equity promotion; implementation barriers; improved; income disparities; men; mortality; multi-component intervention; non-smoker; participant enrollment; poor health outcome; primary outcome; racial disparity; racial diversity; reduce tobacco use; secondary outcome; smoke-free policy; smoking cessation; smoking prevalence; stakeholder perspectives; supported housing; tobacco abstinence; tobacco exposure; treatment arm; treatment as usual

PROJECT SUMMARY The smoke-free home intervention study aims to reduce racial/ethnic disparities in tobacco use and exposure by increasing access to smoke-free homes and cessation resources among racially/ethnically- and linguistically-diverse populations in federally subsidized housing (“subsidized housing”). Black/African American, Hispanic/Latino, and Asian populations with limited English proficiency are over-represented in subsidized housing; these populations have higher rates of tobacco use and exposure than the general population. Tobacco-related cancer and cardiovascular disease contribute disproportionately to the excess morbidity and mortality in these populations. Comprehensive smoke-free policies have the potential to substantially reduce tobacco-related disparities among populations in subsidized housing. In 2018, the Department of Housing and Urban Development implemented a smoke-free policy in a minority of public housing, presenting a unique opportunity to expand the reach of such policies to all types of subsidized housing. This study fills this gap by identifying approaches to increase the implementation of smoke-free policies in all types of subsidized housing by increasing the voluntary adoption of smoke-free homes and promoting access to smoking cessation services. We will build on our pilot work, where we developed and evaluated the feasibility of a smoke-free home intervention to increase voluntary adoption of smoke-free homes in permanent supportive housing for formerly homeless adults. We adapted our previously-developed smoke-free home intervention to federally subsidized housing by incorporating new intervention components that align with racially-ethnically and linguistically-diverse populations in three geographically-diverse California Counties. The multi-faceted intervention, delivered by bilingual study staff in Chinese (Mandarin and Cantonese), English, or Spanish includes: 1) one-on-one counseling to residents who are smokers on how to adopt a smoke-free home, and 2) training housing staff as lay health workers to deliver monthly brief cessation coaching to residents. We propose to conduct a wait-list cluster randomized controlled trial of the adapted smoke-free home intervention compared to usual care among N=544 residents from 24 subsidized housing sites in Contra Costa, Oakland and San Francisco. Our specific aims are: Aim 1: To estimate the effect of our adapted smoke-free home intervention on the primary outcome of residents' voluntary adoption of smoke-free homes and the secondary outcome of biochemically-verified tobacco abstinence at 6-months follow-up. Aim 2: To determine the cost of our adapted smoke-free home intervention and determine whether it is a cost- effective use of health care resources. Aim 3: To evaluate variation in stakeholders’ perspectives on the adapted smoke-free home intervention’s adaptability, scalability and sustainability. The proposed intervention can expand access to smoke-free policies and smoking cessation services in subsidized housing, thereby reducing racial/ethnic disparities in tobacco use, tobacco exposure and chronic disease in these populations.

项目总结 无烟家庭干预研究旨在减少烟草使用和暴露方面的种族/民族差异 通过在种族/民族中增加无烟住宅和戒烟资源的获得-以及 联邦补贴住房(“补贴住房”)中语言多样化的人口。黑人/非洲人 英语水平有限的美国人、西班牙裔/拉丁裔和亚洲人在 补贴住房；这些人群的烟草使用率和接触烟草的比率高于一般人群 人口。与烟草相关的癌症和心血管疾病对过量吸烟的贡献不成比例 这些人群的发病率和死亡率。全面的无烟政策有可能 大幅减少补贴住房人口中与烟草有关的差距。2018年， 住房和城市发展部在少数公众中实施无烟政策 住房，提供了一个独特的机会，将这种政策的影响范围扩大到所有类型的补贴 住房。这项研究通过确定增加无烟实施的方法来填补这一空白 所有类型的补贴住房的政策，增加自愿采用无烟住宅和 促进获得戒烟服务。我们将在试点工作的基础上再接再厉，我们在那里开发和 评估了无烟家庭干预的可行性，以增加自愿采用无烟 为以前无家可归的成年人提供永久支持性住房的家庭。我们调整了之前开发的 通过加入新的干预组件，对联邦补贴住房进行无烟家庭干预 这与加州三个不同地理位置的种族和语言不同的人口相一致 各县。多方面的干预，由双语学习人员用中文(普通话和 (粤语)、英语或西班牙语包括：1)对吸烟者进行一对一辅导 采用无烟家庭，以及2)将住房工作人员培训为非专业卫生工作者，每月提供短暂的戒烟服务 指导住院医生。我们建议进行一项等待名单的整群随机对照试验 24个补贴住房中N=544名居民的无烟家庭干预与常规护理的比较 位于康特拉科斯塔、奥克兰和旧金山的网站。我们的具体目标是：目标1：评估我们的 适宜性无烟家庭干预对居民自愿采用无烟的主要效果 在6个月的随访中，家庭和生化验证的戒烟的次要结果。目标2： 为了确定我们改装的无烟家庭干预的成本，并确定它是否是成本- 有效利用卫生保健资源。目标3：评估利益相关者对 适应无烟家庭干预的适应性、可扩展性和可持续性。拟议的干预措施 可以扩大在补贴住房中获得无烟政策和戒烟服务的机会，从而 减少这些人口在烟草使用、烟草暴露和慢性病方面的种族/族裔差异。