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

项目摘要/摘要 美国有3400万成年人吸烟，每年因吸烟而死亡的人数超过48万人 吸烟和吸烟暴露。尽管吸烟率相似，每天的香烟消费量也更少，但非洲人 与白人相比，美国人更有可能死于几种由烟草引起的癌症。戒烟 降低过早死亡的风险并延长预期寿命；然而，在每年的 非裔美国人和白人的离职率分别为4.9%和7.1%。这种不平等是由几个社会因素造成的 决定因素。因此，研究可扩展的、基于证据的策略来增加吸烟是至关重要的 在非裔美国人中停止。与非裔美国人相比，非裔美国人使用放弃的可能性是 白色的。然而，人们对移动健康干预在使用mHealth的非裔美国人中的影响知之甚少。 放弃了。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 消息传送对于监测吸烟状态和提供戒烟支持是可行的。然而， 这些研究并不是为了评估干预措施对少数群体的影响。最近的一项研究 比较黑人和白人吸烟者在全国范围内戒发短信的参与率和禁烟率 计划并发现黑人和白人一样有可能注册并留在该计划中；然而黑人 不太可能对禁欲评估做出反应并报告戒烟。很少有研究集中在 非裔美国人对退出短信服务的行为和看法。目前的项目提出了 评估宾夕法尼亚州戒烟热线的数据，为量身定做的mHealth戒烟干预提供信息。这个 这个辅导型职业发展奖(K01)的总体目标是在候选人的高级 博士后培训，通过发展她的专业知识来调查和缓解与烟草相关的差异 通过使用技术干预措施，为少数族裔的疾病提供支持。职业发展目标是 培养以下方面的专业知识：1)移动健康戒烟应用；2)定性数据分析；3)临床 生态瞬时评估中的研究技巧。中心假设是，社会决定因素将 用科技解释非裔美国人和白人吸烟者在戒烟方面的差异 戒烟辅助剂。这项研究的具体目的是：1)对PA Quiline进行二次分析 发送短信计划数据，并提供注册期间的服务参与度和吸烟率概述 在6个月的随访中；2)对参加PA戒烟热线的非裔美国人进行定性访谈 短信程序，以更好地了解阻碍参与和禁欲的因素；3) 进行一项EMA试点研究，为非裔美国人量身定做的mHealth戒烟干预提供信息。 研究环境是一个学术医学中心，拥有设施、技术、资源和 支持本奖项建议的研究和培训的先进设备。

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.