Research Project

促进孕妇戒烟的生物标记物反馈 阿拉斯加土著妇女 项目负责人： 彭定康，博士。 明尼苏达州罗切斯特梅奥诊所 项目总结： 为美国印第安人和阿拉斯加原住民开发怀孕期间有效的戒烟方法是一项国家优先事项，将有助于美国减少与烟草相关的癌症健康差距的公共卫生目标。拟议的项目建立在我们与阿拉斯加土著社区的成功伙伴关系以及之前与阿拉斯加土著孕妇的合作基础上。我们建议开发和测试一种新的生物标记物反馈干预措施，将孕妇尿液中的可替宁水平与孕妇和婴儿可能接触烟草特有的亚硝胺和致癌物质4-(甲基亚硝胺)-1-(3-吡啶)-1-丁酮(NNK)(NNK)联系起来。这项为期5年的项目将分三个阶段进行。在第一阶段，我们将利用一项非随机的临床观察试验，在150对母婴中检测尼古丁和致癌物质暴露的生物标记物(分别是尿可替宁和总NNAL[NNK的代谢物])，并在怀孕和分娩时进行评估。在第二阶段，我们将通过对32名使用烟草的妇女进行个人访谈，获得对第一阶段调查结果的定性反馈，以制定生物标记物反馈干预信息。第三阶段将包括对80名孕妇进行生物标记物反馈干预的形成性评估，使用两组随机设计来评估干预的可行性和可接受性，以及怀孕结束时生化确认的禁酒率。该项目的所有阶段都将由社区咨询委员会指导。每个阶段都是一个 促进我们对生物标记物反馈作为帮助阿拉斯加土著孕妇戒烟的战略的潜力的重要一步。从公共卫生的角度来看，干预的潜在影响很大，因为每年有600多名烟草使用者在安克雷奇的阿拉斯加土著医疗中心提供服务，拟议的项目将在那里进行。制定有效的孕期戒烟干预措施，对于减少对母亲和新生儿的不良健康后果以及今后烟草引起的癌症风险具有重要意义。

Biomarker Feedback to Motivate Tobacco Cessation in Pregnant Alaska Native Women Project Leader: Christi Patten, Ph.D. Mayo Clinic Rochester MN Project Summary: Developing effective tobacco cessation inten/entions during pregnancy for American Indian and Alaska Native people is a national priority and will contribute to the U.S. public health objective of reducing tobaccorelated cancer health disparities. The proposed project builds on our successful partnership with the Alaska Native community and previous work with Alaska Native pregnant women. We propose to develop and test a novel biomarker feedback intervention relating cotinine levels in the urine of pregnant women with the woman and infant's likely exposure to the tobacco specific nitrosamine and carcinogen 4-(methylnitrosamino)-1 -(3-pyridyl)-1-butanone) (NNK). This 5-year project will be conducted in three phases. In Phase 1 we will utilize a non-randomized, clinical observational trial to examine biomarkers of nicotine and carcinogen exposure (urine cotinine and total NNAL [a metabolite of NNK], respectively) among 150 maternal-infant pairs with assessments conducted during pregnancy and at delivery. In Phase 2, we will obtain qualitative feedback on the findings from Phase 1 through individual interviews conducted with 32 women who use tobacco to develop the biomarker feedback intervention messages. Phase 3 will consist of a formative evaluation of the biomarker feedback intervention with 80 pregnant women using a two-group randomized design to assess the intervention's feasibility and acceptability, and the biochemically confirmed abstinence rate at the end of pregnancy. All phases of the project will be guided by a Community Advisory Committee. Each phase is an important step to advance our understanding of the potential for biomarker feedback as a strategy to help Alaska Native pregnant women quit tobacco use. The potential reach of the intervention is significant from a public health perspective as over 600 tobacco users deliver each year at the Alaska Native Medical Center in Anchorage where the proposed project will take place. Developing effective interventions for tobacco cessation during pregnancy is important to reduce adverse health consequences for the mother and neonate and future risk of tobacco-caused cancers.