A smoke-free home intervention in federally subsidized housing

对联邦补贴住房进行无烟家庭干预

基本信息

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
项目类别：
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

项目摘要

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的种族/民族分布通过增加种族/种族/种族和种族的戒烟资源的机会，联邦补贴住房中的语言多样性人群（“补贴住房”）。黑人/非洲美国，西班牙裔/拉丁美洲裔和英语水平有限的亚洲人群的代表性过高补贴住房；这些人群的使用率比一般的烟草使用率更高人口。与烟草有关的癌症和心血管疾病造成过多的贡献不成比例这些人群的发病率和死亡率。全面无烟政策有可能在补贴住房中，人群中与烟草相关的差异大大减少了。在2018年住房和城市发展部在少数公众中实施了无烟政策住房，提供了一个独特的机会，将这些政策的影响范围扩大到所有类型的补贴住房。这项研究通过识别增加无烟实施的方法来填补这一空白通过增加自愿采用无烟房屋和促进获得戒烟服务。我们将建立我们的飞行员工作，我们开发的地方和评估了无烟家庭干预以增加自愿采用无烟的可行性原来的无家可归成年人的永久支持住房房屋。我们改编了以前开发的通过合并新的干预组件，无烟家庭干预对联邦补贴的住房与三个地理多样性的加利福尼亚州的大致和语言多样性人群相吻合县。由双语学习人员以中文（普通话和广东话），英语或西班牙语包括：1）对吸烟者的居民一对一的咨询采用无烟的房屋，以及2）培训住房人员作为外行卫生工作者，以提供每月短暂的停止向居民指导。我们建议进行适应的等待名单群集随机对照试验与来自24个补贴住房的N = 544名居民的常规护理相比，无烟家庭干预 Contra Costa，Oakland和San Francisco的地点。我们的具体目的是：目标1：估计我们的影响适应居民自愿采用无烟的主要结果的适应性无烟家庭干预在6个月的随访中，房屋和生化验证的烟草禁欲的次要结果。目标2：确定我们适应的无烟家庭干预的成本，并确定是否是成本 - 有效利用医疗保健资源。目标3：评估利益相关者对适应无烟家庭干预的适应性，可伸缩性和可持续性。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减少这些人群中烟草使用，烟草暴露和慢性疾病的种族/族裔差异。