Mixed methods research to increase engagement and smoking abstinence among African Americans enrolled in Quitline text messaging services

项目总结/摘要 超过3400万美国成年人使用香烟，每年造成超过48万人死亡， 吸烟和烟雾暴露。尽管吸烟率相似，每天吸烟量较少，但非洲人 与白人相比，美国人更有可能死于几种烟草引起的癌症。戒烟 降低过早死亡的风险，增加预期寿命;然而， 非裔美国人和白人之间的戒烟率（4.9%对7.1%）。这种差异是由于一些社会因素造成的。 决定因素因此，研究可扩展的、基于证据的策略来增加吸烟量至关重要 停止在非洲裔美国人。非裔美国人使用退出线的可能性是非裔美国人的两倍， 白人然而，很少有人知道移动健康干预措施在非洲裔美国人中的影响， 退出热线在宾夕法尼亚州立大学调查人员进行的初步研究中，我们发现自动文本 短信是可行的监测吸烟状况和提供戒烟支持。然而，在这方面， 这些研究的目的不是评估干预措施对少数群体的影响。最近的一项研究 在一项全国性的短信戒烟活动中，比较了黑人和白色吸烟者的参与率和戒烟率 计划，并发现黑人一样有可能白人注册并留在该计划;但黑人 对禁欲评估和报告戒烟的可能性较小。很少有研究关注 非裔美国人的戒烟短信服务的行为和看法。本项目提出 评估宾夕法尼亚戒烟热线的数据，为量身定制的mHealth戒烟干预提供信息。的 这个指导职业发展奖（K01）的总体目标是建立在候选人的先进的 通过发展她的专业知识来调查和减轻烟草相关领域的差距， 通过使用技术干预措施，为少数民族提供疾病。职业发展目标是 发展专业知识：1）戒烟的mHealth应用程序，2）定性数据分析，3）临床 生态瞬时评估的研究技能。核心假设是，社会决定因素 解释非裔美国人和白色吸烟者使用技术戒烟的差异， 停止援助。本研究的具体目的是：1）对PA退出线进行二次分析 发送短信计划数据，并提供登记期间服务参与和吸烟率的概述， 在6个月随访时; 2）对参加PA退出线的非裔美国人进行定性访谈 短信计划，以更好地了解作为参与和禁欲障碍的因素; 3） 开展EMA试点研究，为非裔美国人量身定制的mHealth戒烟干预提供信息。 研究环境是一个学术医疗中心，拥有设施，技术，资源， 先进的设备，以支持本奖项中提出的研究和培训。

Project Summary/Abstract Cigarettes are used by over 34 million U.S. adults and cause more than 480,000 deaths annually due to smoking and smoke exposure. Despite smoking at similar rates and consuming less cigarettes per day, African Americans are more likely to die from several tobacco-caused cancers compared to Whites. Quitting smoking reduces the risk of premature death and adds years to life expectancy; however, a disparity exists in annual quit rates between African Americans and Whites (4.9% vs. 7.1%). This disparity is due to several social determinants. Thus, it is critical to investigate scalable, evidence-based strategies to increase smoking cessation among African Americans. African Americans are twice as likely to use quitlines compared to Whites. However, little is known about the impact of mHealth interventions among African Americans using quitlines. In preliminary studies conducted by Penn State investigators, we found that automated text messaging was feasible for monitoring smoking status and providing smoking cessation support. However, these studies were not designed to assess the impact of interventions in minority populations. A recent study compared engagement and abstinence rates between Black and White smokers in a national texting cessation program and found that Blacks were just as likely as Whites to enroll and remain in the program; yet Blacks were less likely to respond to abstinence assessments and report cessation. Few studies have focused on the behaviors and perceptions of quitline texting services among African Americans. The current project proposes to assess data from the Pennsylvania quitline to inform a tailored mHealth smoking cessation intervention. The overall goal of this Mentored Career Development Award (K01) is to build on the candidate’s advanced postdoctoral training by developing her expertise to investigate and alleviate disparities in tobacco-related disease for racial minorities through the use of technology interventions. Career development objectives are to develop expertise in: 1) mHealth applications for smoking cessation, 2) qualitative data analysis, and 3) clinical research skills in ecological momentary assessment. The central hypothesis is that social determinants will explain differences in smoking abstinence between African Americans and White smokers using technology as a cessation aid. The specific aims for this study will be to 1) conduct a secondary analysis of the PA quitline texting program data and provide an overview of service engagement and smoking rates during enrollment and at 6-month follow-up; 2) to conduct qualitative interviews with African Americans who enrolled in the PA quitline texting program to better understand the factors that serve as barriers to engagement and abstinence; 3) To conduct a pilot EMA study to inform a tailored mHealth smoking cessation intervention for African Americans. The research environment is an academic medical center with the facilities, technology, resources, and advanced equipment to support the research and training proposed in this award.