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.

项目摘要 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 通过增加种族/族裔-和 在联邦补贴住房（“补贴住房”）中的语言多样化人口。黑人/非裔 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暴露率高于一般人群 人口与烟草有关的癌症和心血管疾病对过量的吸烟起了不成比例的作用 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之间与烟草有关的差距。2018年 住房和城市发展部在少数公共场所实施无烟政策 住房，提供了一个独特的机会，将这种政策的范围扩大到所有类型的补贴 住房这项研究填补了这一空白，确定方法，以增加无烟的实施， 在所有类型的补贴住房政策中，增加自愿采用无烟住房的人数， 促进获得戒烟服务。我们将在试点工作的基础上再接再厉， 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性支助性住房。我们调整了我们先前开发的 通过纳入新的干预内容，将无烟家庭干预措施纳入联邦补贴住房 与三个地理上多样化的加州的种族-民族和语言多样化的人口相一致 个县多方面的干预，由双语研究人员提供中文（普通话和 广东话），英语，或西班牙语包括：1）一对一的辅导居民谁是吸烟者如何 采取无烟家庭，以及2）培训住房工作人员作为非专业卫生工作者，每月提供短暂的戒烟 指导居民。我们建议进行一项调整后的等待名单集群随机对照试验， 在来自24个补贴住房的N=544名居民中，与常规护理相比，无烟家庭干预 康特拉科斯塔，奥克兰和旧金山弗朗西斯科的网站。我们的具体目标是：目标1：评估我们的 适应性无烟家庭干预对居民自愿采用无烟 家庭和6个月随访时经生化验证的戒烟的次要结局。目标二： 为了确定我们适应无烟家庭干预的成本，并确定它是否是一个成本- 有效利用医疗保健资源。目标3：评估利益攸关方对 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 可以扩大在补贴住房中获得无烟政策和戒烟服务， 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。