Targeting Tobacco Cessation Interventions for Latinos/as with Depression

描述(申请人提供)：这是一项为期一年的研究，旨在为在公共卫生机构服务的拉丁裔抑郁症患者量身定做戒烟干预措施，以便为测试这些干预措施的更大规模的多点试验做准备。在美国，肺癌是拉美裔人癌症死亡的头号原因，在拉美裔人中排名第二；然而，大多数肺癌病例可以通过对成年吸烟者实施戒烟干预来预防。患有抑郁症的人的吸烟率明显高于普通人群，患有抑郁症的拉美裔人的烟草使用率明显高于没有抑郁症的拉美裔人。不幸的是，与没有抑郁症的人相比，抑郁症患者戒烟的成功率较低，并且在戒烟过程中抑郁症状复发的风险更高；因此，他们需要额外的支持性治疗和资源。尽管针对拉美裔人口的文化上适当的戒烟干预措施在促进戒烟方面取得了成功，但这些方案并不是专门为患有抑郁症的拉美裔人量身定做的，这一群体在心理健康和戒烟治疗方面面临着重大障碍(例如，耻辱、获得护理的机会、语言)。目前的项目建议为希望戒烟且主要在科罗拉多州拉里默县公共社区卫生中心接受治疗的拉美裔社区精神卫生诊所的精神病患者定制一个低负担提供者工具包和干预材料(由Morris博士、Waxmonsky博士、Giese博士和Graves女士开发)。为了有效地让这些目标人群参与戒烟干预，Waxmonsky博士和Morris博士正在与拉美裔/a研究和政策中心合作，提供指导和文化专业知识。通过使用卫生保健提供者焦点小组、患者/家庭成员焦点小组(单独的西班牙语和英语焦点小组)和与社区主要利益攸关方(拉丁裔/a抑郁症患者、社区成员、科罗拉多州拉里默县的心理健康和初级保健提供者以及文化专家)的结构化访谈，该项目将(1)获得关于在戒烟治疗中招募/留住拉美裔人战略的意见；(2)根据利益攸关方的意见修改现有工具包和干预措施，并翻译现有干预材料，以确保戒烟干预措施的文化适当性和相关性，以满足拉丁裔抑郁症患者的特定/独特需求；以及(3)获得关于定向干预材料的接受性、可行性和可用性的定性数据。该项目将根据利益相关者团体的反馈，为目标人群制作西班牙语和英语的量身定做的干预材料和实施战略，以进行多点临床试验并最终在全州范围内传播。

DESCRIPTION (provided by applicant): This is a proposal to conduct a one year study to tailor smoking cessation interventions for Latino persons with depression with depression served in public health settings in order to prepare for a larger multi-site trial testing those interventions. In the U.S., lung cancer is the leading cause of cancer death among Latinos and second among Latinas; however most cases of lung cancer can be prevented by implementing smoking cessation interventions for adult smokers. Persons with depression have significantly higher rates of smoking than the general population and Latinos with depression have significantly higher rates of tobacco use than Latinos without depression. Unfortunately, persons with depression have less success with smoking cessation than persons without depression and are at increased risk for relapse of depressive symptoms during their quit attempts; thus they require additional supportive therapy and resources. Although culturally appropriate smoking cessation interventions for Latino populations have demonstrated success in facilitating abstinence from smoking, these programs have not been specifically tailored for Latinos with depression, a population that faces significant barriers in terms of treatment for mental health and tobacco cessation (e.g., stigma, access to care, language). The current project proposes to tailor a low burden provider toolkit and intervention materials (developed by the Drs. Morris, Waxmonsky, Giese, and Ms. Graves, MPH) for persons with mental illnesses served in community mental health clinics for Latinos/as persons with depression who wish to quit tobacco use and who primarily are treated in public community health centers in Larimer County, Colorado. In order to effectively engage this target population in tobacco cessation interventions, Drs. Waxmonsky and Morris are partnering with the Latino/a Research and Policy Center to provide direction and cultural expertise. Through the use of health care provider focus groups, patient/family member focus groups (separate Spanish and English focus groups), and structured interviews with key community stakeholders (Latino/a persons with depression, community members, mental health and primary care providers in Larimer County Colorado, and cultural experts), the project will (1) obtain input on strategies to recruit/retain Latinos in tobacco cessation treatments; (2) Modify the existing toolkit and interventions based on stakeholder input and translate the existing intervention materials to insure the cultural appropriateness and relevance of the tobacco cessation intervention to address specific/unique needs of Latino persons with depression; and (3) Garner qualitative data about the acceptance, feasibility, and usability of the targeted intervention materials. The project will create tailored intervention materials in both Spanish and English and implementation strategies for the targeted population based on the feedback from the stakeholder groups for a multisite clinical trial and eventual dissemination statewide.