TRANSforma Tu Salud Dejando de Fumar: Advancing smoking cessation among transgender individuals

TRANSforma Tu Salud Dejando de Fumar：促进跨性别者戒烟

• 批准号: 10741034
• 负责人: Ines Aristegui
• 金额: $ 32.5万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-22 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10741034
• 关键词: 2 arm randomized control trial; Abstinence; Address; Adherence; Argentina; Behavior; Behavioral Research; Birth; Clinical Research; Cotinine; Country; Disparity; Effectiveness; Epidemiology; Ferrous fumarate; Fright; Gender Identity; HIV; Health; Healthcare; Image; Income; Individual; Intervention; Interview; Latin American; Latino; Latino Population; Lesbian Gay Bisexual Transgender; Literature; Medical; Mentors; Mexico; Modality; Modification; Multimedia; Participant; Persons; Pharmacy facility; Pilot Projects; Population; Prevalence; Printing; Procedures; Puerto Rico; Randomized; Randomized, Controlled Trials; Reporting; Research; Research Design; Research Personnel; Resources; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social support; Suicide attempt; Testing; Text; Tobacco; Work; arm; career; community based participatory research; cost; efficacy evaluation; experience; follow up assessment; follow-up; gender affirmation; gender dysphoria; gender expression; health care service; health care settings; housing instability; mHealth; maltreatment; nicotine replacement; pilot test; programs; recruit; satisfaction; sex; smoking abstinence; smoking cessation; social; standard of care; stressor; systematic review; text messaging intervention; transgender; translational study; usability; virtual

PROJECT SUMMARY Mobile health (mHealth) interventions are a promising modality for overcoming barriers and providing culturally appropriate treatment among transgender individuals. mHealth interventions may be appropriate among transgender individuals, as emergent evidence suggests that virtual spaces are used to access gender affirming support and resources. Moreover, mHealth interventions may enable authentic self-expression among transgender individuals, which is not always possible offline. Over the past 7 years, our team has developed Decídetexto, a culturally accommodated smoking cessation text messaging intervention for U.S. Latino smokers. Decídetexto has been expanded to different Latin American countries/regions (e.g., Mexico and Puerto Rico), and has been adapted to different populations (e.g., U.S. Latino smokers living with HIV). A recently completed randomized controlled trial (RCT) with U.S. Latino smokers (n=457) demonstrated that U.S. Latinos receiving the Decídetexto intervention were significantly more likely than those receiving standard of care (smoking cessation printed materials) to be smoking abstinent at Month 6 (34.1% vs 20.6%; p<0.001). Despite the proven effectiveness of Decídetexto among U.S. Latinos, we have identified that this intervention does not adequately address unique barriers to smoking cessation encountered by transgender individuals (e.g., low social support, gender dysphoria as a stressor, need for gender affirming medical procedures). We propose to integrate our expertise in mHealth, smoking cessation, transgender health care, community-based participatory research, and cultural accommodation to develop, pilot test (R21), and then formally evaluate (R33) TRANSformá Tu Salud Dejando de Fumar (Spanish for “TRANSform Your Health by Quitting Smoking”) – a culturally accommodated smoking cessation intervention for transgender individuals. TRANSformá Tu Salud Dejando de Fumar will consist of 1) a 12-week WhatsApp-based program that facilitates longitudinal and bidirectional multimedia-based (i.e., text, image, video, and audio) dialogue with participants, and 2) integration with an e-Pharmacy to access nicotine replacement therapy (NRT) at no cost. R21 Aim 1: Develop TRANSformá Tu Salud Dejando de Fumar, a culturally accommodated smoking cessation intervention for transgender individuals. R21 Aim 2: Assess the feasibility, acceptability, and preliminary impact of TRANSformá Tu Salud Dejando de Fumar among transgender individuals. R33 Aim 1: Assess the efficacy of TRANSformá Tu Salud Dejando de Fumar compared to standard of care on smoking abstinence at Month 6 among transgender individuals. R21-R33 Capacity building. We will build capacity for mHealth behavioral research through the engagement of early career investigators in mentored activities and through academic partnerships between the U.S. and Argentina.

项目摘要 移动的保健干预措施是克服障碍和提供文化服务的一种有前途的模式。 对跨性别者进行适当的治疗。移动健康干预措施可能适用于 跨性别者，因为新出现的证据表明，虚拟空间被用来访问性别肯定 支持和资源。此外，移动健康干预措施可以使真正的自我表达， 跨性别者，这并不总是可能离线。在过去的7年里，我们的团队已经开发了 Decidetexto，一个针对美国拉丁裔吸烟者的文化适应戒烟短信干预。 Decídetexto已扩展到不同的拉丁美洲国家/地区（例如，墨西哥和波多黎各）， 并且已经适应于不同的人群（例如，美国拉丁裔吸烟者感染艾滋病毒）。最近完成的一 一项针对美国拉丁裔吸烟者（n=457）的随机对照试验（RCT）表明， Decídetexto干预组比接受标准治疗组（吸烟组） 戒烟印刷材料）在第6个月时戒烟（34.1% vs 20.6%; p<0.001）。尽管事实证明 在美国拉丁美洲人中的Decídetexto的有效性，我们已经确定，这种干预不足以 解决变性人戒烟遇到的独特障碍（例如，社会支持度低， 性别焦虑作为压力源，需要性别肯定的医疗程序）。我们建议将我们的 在移动健康，戒烟，跨性别医疗保健，基于社区的参与性研究，和 文化适应发展，试点测试（R21），然后正式评估（R33） Dejando de Fumar（西班牙语：“通过戒烟来改变你的健康”）-一个文化适应 对跨性别者进行戒烟干预。Transformá Tu Salud Dejando de Fumar will 包括1）一个为期12周的基于WhatsApp的计划，促进纵向和双向的基于多媒体的 (i.e.,文本、图像、视频和音频）与参与者对话，以及2）与电子药房集成以访问 尼古丁替代疗法（NRT）是免费的。 R21目标1：制定符合文化的戒烟方法-TRANSformá Tu Salud Dejando de Fumar 对跨性别者的干预。R21目标2：评估可行性、可接受性和初步影响 TRANSformá Tu Salud Dejando de Fumar在变性人中的应用。R33目标1：评估 第6个月时，与标准治疗相比，TRANSformá Tu Salud Dejando de Fumar戒烟 在跨性别者中。R21-R33能力建设。我们将建立移动健康行为能力 通过早期职业调查人员参与指导活动和通过学术研究， 美国和阿根廷之间的关系。