Proud to Quit (P2Q): A Person-centered mobile technology intervention for smoking cessation among transgender adults

项目摘要/摘要 美国的变性人成年人受到烟草使用的影响不成比例。变性人成年人更多 吸烟的可能性是普通美国成年人的两倍多。除了沉重的负担之外 疾病烟草使用场所对这一人群的影响，烟草使用也是性别确认的禁忌症。 护理，这是许多跨性别者实现全面身心健康的医疗需要。尽管 对于变性人成年人的健康相关需求，现有的戒烟干预措施未能解决具体的 满足这一人群的需求。因此，美国国家医学科学院和美国卫生局局长确定 变性人特有的健康需求以及制定和测试干预措施的有效性 变性人成人是国家的优先事项。尽管医疗保健提供者可以在戒烟、变性人 成年人报告了获取循证的、临床医生提供的干预措施的障碍。变性人特有的 移动健康干预可以作为一种经济高效且可扩展的解决方案，以改善以下方面的健康结果 这些人往往很难接触到。此外，这样的干预可以作为卫生服务资源 可能没有时间或专业知识来提供性别确认戒烟的医疗服务提供者 支持他们的变性人患者。基于我们团队在变性人健康方面的研究专长， MHealth、戒烟和健康系统烟草相关护理，我们建议开发和试行 变性人成年人的mHealth戒烟干预：以戒烟为荣(P2Q)。P2Q将提供量身定制的 消息、同伴社交支持和自我监控功能。我们将通过与一个 由变性人成年人和性别确认健康提供者组成的干预咨询工作组 关注并实施迭代干预设计流程和可用性测试。通过远程试点 随机对照试验，我们将评估mHealth戒烟的可接受性和可行性 应用自我报告和客观生物标记物对变性人成人的干预及其初步效果 数据。这项提案的发现将为全面服务研究的可行性和方案提供参考 有效性试验。该项目将弥补缺乏针对以下目的的戒烟干预措施 通过提供新的工具和在不同地点接触到变性人成年人的能力；它 将提供一种成本效益高的方法，确保干预措施能够以保真的方式广泛传播； 最终，它将减少跨性别者成年人中与烟草相关的健康差距，他们是 不成比例地受到烟草使用的影响。

Project Summary/Abstract Transgender adults in the U.S. are disproportionately affected by tobacco use. Transgender adults are more than twice as likely to smoke cigarettes than the general U.S. adult population. In addition to the great burden of disease tobacco use places onto this population, tobacco use is also a contraindication for gender-affirming care, a medical necessity for many transgender persons to achieve full mental and physical health. Despite the health-related needs of transgender adults, existing smoking cessation interventions fail to address the specific needs of this population. As such, the National Academy of Medicine and U.S. Surgeon General identifies transgender-specific health needs and developing and testing the effectiveness of interventions for transgender adults a national priority. Despite the role health care providers can play in cessation, transgender adults report barriers to accessing evidence-based, clinician-delivered interventions. A transgender-specific mHealth intervention could serve as a cost-effective and scalable solutions to improving health outcomes for this often hard-to-reach population. Furthermore, such an intervention can be a health services resource for health care providers who might not have the time or expertise to provide gender affirming smoking cessation support to their transgender patients. Building on our team's research expertise in transgender health, mHealth, tobacco cessation, and health systems tobacco-related care, we propose to develop and pilot test an mHealth smoking cessation intervention for transgender adults: Proud to Quit (P2Q). P2Q will provide tailored messages, peer social support, and self-monitoring features. We will develop P2Q by collaborating with an Intervention Advisory Workgroup comprising of transgender adults and providers of gender affirming health care, and implement iterative intervention design processes and usability testing. Through a remote pilot randomized controlled trial, we will assess acceptability and feasibility of an mHealth smoking-cessation intervention for transgender adults as well as its preliminary efficacy using self-report and objective biomarker data. The findings from this proposal will inform the feasibility of and protocols for a full-scale services research effectiveness trial. The project would redress the dearth of smoking-cessation interventions tailored to transgender adults by offering a new tool and the ability to reach transgender adults in diverse locations; it would offer a cost-effective approach that ensures the intervention can be broadly disseminated with fidelity; and, ultimately, it would reduce tobacco-related health disparities among transgender adults, who are disproportionately affected by tobacco use.