Randomized Trial of Lay Health Worker Smoking Cessation Intervention for Latinos

描述(申请人提供)：肺癌是拉美裔癌症死亡的主要原因，而吸烟是这些死亡中近90%的原因。拉美人特有的文化因素可能会增加(例如家庭)或减少(例如男子汉气概)戒烟的成功率。在社区需求评估中，LACRC社区诊所合作伙伴表示，戒烟服务是高度优先的。在我们之前在LACRC的工作中，我们还发现吸烟者对戒烟感兴趣，并同意参与吸烟研究。值得注意的是，这项研究还表明，抑郁和饮酒与吸烟行为有关。其他人的研究表明，电话咨询在非拉丁裔群体中是有效和具有成本效益的，我们的合作伙伴已经表示，这种方法在他们的诊所是可行的。在这项试点中，我们使用社会网络模型来评估一项随机临床试验(n=175)，该临床试验由非专业卫生工作者(LHW)提供为期6个疗程(和一个3个月的助推器)的文化定制电话咨询干预，与常规护理(转诊至非定制西班牙烟草戒烟线)进行比较。我们还将提供抑郁症和酒精使用的筛查和转介，并向参与者通报尼古丁戒断的药物支持。我们的首要目标是评估与使用简单的语言翻译现有材料相比，由参与者的社交网络中的同行进行文化定制和交付的影响。相关的目的是：1)检验这样的假设，即在6周和3个月时，干预组的戒酒尝试和戒断率将高于对照组，2)探索文化信仰是否会调节干预的效果，以及3)探索共病饮酒和抑郁是否中介了干预的效果。如果有效，受过培训的LHW将能够继续在诊所进行咨询计划。这一结果还将用于扩大这项试验并开发更多的戒烟研究。该项目负责人斯佩尔纳克博士还将利用这一试点项目获得烟草控制方面的指导，并在拉美文化中扎根，这样她就可以成为癌症差异方面的独立研究人员。

DESCRIPTION (provided by applicant): Lung cancer is the leading cause of cancer death in Latinos and smoking is responsible for almost 90% of these deaths. Cultural factors unique to Latinos may act to either increase (e.g., family) or decrease (e.g., machismo) success of smoking cessation. In a community needs assessment, LACRC community clinic partners indicated that tobacco cessation services were a high priority. In our prior work in the LACRC, we also found that smokers were interested in cessation and would agree to participate in smoking studies. Of note, this work also demonstrated that depression and alcohol use were associated with smoking behavior. Research by others has shown that telephone counseling is effective and cost-effective in non-Latino groups and our partners have indicated that this approach was feasible in their clinics. In this pilot, we use the Social Networks Model to evaluate a randomized clinical trial (n=175) of a 6-session (and one 3 month booster), culturally-tailored telephone counseling intervention delivered by a lay health worker (LHW) compared to usual care (referral to a non-tailored Spanish tobacco quit line). We will also provide screening and referral for depression and alcohol use and inform participants about pharmaceutical support for nicotine withdrawal. Our overarching goal is to assess the impact of cultural tailoring and delivery by a peer from the participant's social network compared to use of simple language translation of existing materials. The associated aims are to: 1) test the hypothesis that the intervention group will have higher rates of quit attempts and abstinence than the control group at 6 weeks and 3 months, 2) explore whether cultural beliefs moderate the effects of the intervention, and 3) explore whether co-morbid alcohol use and depression mediate the effects of the intervention. If effective, the trained LHWs will be able to continue the counseling program at the clinics. The results will also be used to extend this trial and develop additional tobacco cessation research. Dr. Spernak, the project leader, will also be able to use this pilot to gain mentoring in tobacco control and grounding in Latino culture so that she can become an independent researcher in cancer disparities.