A Novel Worksite Smoking Cessation intervention for Hispanic Construction Workers

 说明(申请人提供)：建筑工人是所有职业中吸烟率最高的，并且经常暴露在各种工作场所的危险中(例如毒素)，这些危险与吸烟相互作用，增加了他们的健康风险。与其他群体相比，少数族裔建筑工人的吸烟率更高，戒烟率更低，他们普遍表现出更低的戒烟和健康促进服务的获得和参与。过去十年，美国建筑业雇用的拉美裔工人数量增加了两倍，达到260万人(占所有建筑工人的23%)。鉴于建筑行业仍然以男性为主，拉美裔男性工人构成了一个庞大且不断增加的需要戒烟和促进健康的群体。然而，这一群体的戒烟努力受到以下因素的阻碍：1)流动性/周转率高，2)获得戒烟和健康促进服务的机会有限，3)缺乏针对西班牙裔建筑困难的工作/生活环境而量身定做的文化敏感的戒烟干预措施 工人们。我们团队最近尝试的一种新方法是与午餐车合作，午餐车定期访问建筑工地，提供基于工地的简短、有效的健康促进干预措施。我们拟议的探索性研究旨在通过以下方式解决西班牙裔建筑工人戒烟的主要障碍：1)通过使用建筑工地作为干预环境和午餐车作为干预交付方式来接触和招募他们，增加他们获得戒烟的机会，以及2)让他们参与制定和评估适应他们独特文化和工作环境的试点戒烟干预措施。因此，我们的具体目标是：1)围绕探索性焦点小组，为拉美裔建筑工人开发简短的、具有文化敏感性的戒烟干预措施；2)与午餐车结合，招募100名拉美裔男性建筑吸烟者进行试点随机对照试验，以测试强化护理干预的可行性和潜在有效性(包括在午餐车上提供单一的面对面行为咨询课程，两个简短的后续电话咨询电话，传真转诊至佛罗里达州戒烟热线(QL)，并提供8周的免费NRT)，与标准护理(包括传真转诊至QL，3)在登记3个月后进行干预后评估面谈，以评估他们对戒烟干预若干特征的有用性和适当性的看法，并进一步调整干预措施，以便进行更广泛的测试和传播。这项研究将首次在难以接触和服务不足的西班牙裔男性建筑工人群体中开发和评估一种新的、低成本的招聘和干预策略。我们的数据将为更大规模的戒烟方法有效性研究提供信息，这些方法具有很大的翻译和传播潜力，可以传播给全美的少数族裔建筑工人。

 DESCRIPTION (provided by applicant): Construction workers have the highest rate of smoking among all occupations, and are frequently exposed to a wide range of workplace hazards (e.g. toxins), which interact with smoking to increase their health risks. Minority construction workers, in particular, have higher smoking and lower cessation rates compared to other groups, and they generally show lower access and participation in cessation and health promotion services. The number of Hispanic workers employed in the construction industry in the US has tripled in the past decade to 2.6 million (23% of all construction workers). Given that construction trades remain overwhelmingly male dominated, male Hispanic workers constitute a large and increasing group in need for smoking cessation and health promotion. Cessation efforts amongst this group however, are hindered by their: 1) high mobility/ turnover, 2) limited access to cessation and health promotion services, and 3) lack of culturally-sensitive smoking cessation interventions tailored for the difficult work/life circumstances of Hispanic construction workers. A novel approach that was recently piloted by our team is to partner with the lunch truck that routinely visits construction sites to deliver brief worksite-based, effective health promotion interventions. Our proposed exploratory study aims to tackle these major barriers to smoking cessation in Hispanic construction workers, by: 1) increasing their access to cessation through the use of the construction site as the intervention setting and the lunch truck as the intervention delivery modality to reach and recruit them, and 2) involving them in the development and evaluation of a pilot smoking cessation intervention adapted to their unique cultural and work circumstances. Therefore, our Specific Aims are: 1) Develop a brief, culturally sensitive smoking cessation intervention for Hispanic construction workers, built around exploratory focus groups, 2) In conjunction with the lunch truck, recruit 100 Hispanic male construction smokers to conduct a pilot randomized controlled trial to test the feasibility and potential efficacy of enhanced care intervention (consists of a single face-to-face behavioral counseling session delivered at the lunch truck, two brief follow-up phone counseling calls, fax referral to the Florida tobacco quitline (QL), and provision of eight weeks of free NRT), compared to standard care (consists of fax referral to the QL, and provision of eight weeks of free NRT), and 3) Conduct a post- intervention evaluation interview after 3-months of enrolment to assess their views on the usefulness and appropriateness of several features of the cessation intervention and to further fine-tune the intervention for wider testing and dissemination. This study will be the first to develop and evaluate a novel, low cost recruitment and intervention strategy in a hard-to-reach and underserved population of Hispanic male construction workers. Our data will inform a larger study of the effectiveness of cessation approaches that have great potential for translation and dissemination to minority construction workers throughout the US.