En Pareja: A Latino couples intervention to help expectant fathers quit smoking

描述(申请人提供)：居住在美国的拉丁裔男性吸烟是一个严重的公共卫生问题。拉丁裔的吸烟率与白人男性相同，但戒烟的可能性低于白人，这可能导致预期寿命的健康差距，并增加肺癌死亡率。显然，针对拉美裔的戒烟计划是必要的。在拉美裔中测试的一些项目已经显示出效果，但只是短期的。此外，没有人试图鼓励在可教的时刻戒烟：在这个时候，戒烟似乎更相关。为了接触到这一服务不足的吸烟者群体，我们提议在北卡罗来纳州的达勒姆和罗利对最近移民的拉丁裔吸烟者进行一项可教的时刻干预试验。我们将用西班牙语进行干预。我们将试图利用拉丁裔怀孕这一具有教育意义的时刻作为拉丁裔戒烟的推动力，因为怀孕是男性可能考虑戒烟的时期。此外，包括这名女性可能有助于在该计划完成后维持戒烟。因此，我们正在与拉丁裔夫妇进行干预，以帮助这些男性戒烟。我们已经与El Centro Hispano的社区领导人合作，El Centro Hispano是达勒姆的拉丁裔社区资源中心。我们将开发一个主要基于社会认知理论和可教时刻模型的干预方法。我们将教授男性戒烟技能，帮助提高男性戒烟的自我效能和戒烟结果预期，并向夫妇传授最佳沟通方式，以减少新生儿带来的压力。有了更好的沟通，这对夫妇可能会更好地合作，帮助他戒烟并保持戒烟状态。我们建议招募怀孕的拉丁裔夫妇(n=420)参加双臂戒烟干预。该项目将在文化上进行量身定做，以强调可能导致更高戒烟率的拉丁裔文化价值观，即家庭主义，高度重视家庭，以及个人主义，重视温馨的个人关系。研究的手臂是：ARM 1：自助戒烟指南与ARM 2：基于夫妇的戒烟咨询。我们建议在五个时间点对夫妇进行面对面调查：基线、怀孕28周、产后2、6和12个月。与公共健康相关：拉美裔男性的吸烟率太高。很少有有效的计划在说拉丁语的吸烟者中达到并促进长期戒烟。这种干预接近拉美裔人，当他们的妻子怀孕时，以增加戒烟的动机。这种干预包括拉丁裔，并教会夫妇有效的沟通技能，以帮助长期维持戒烟效果。

DESCRIPTION (provided by applicant): Smoking among Latino males living in the U.S. is a significant public health problem. Latinos smoke at the same rate as White males but are less likely than Whites to quit smoking, which can contribute to health disparities in life expectancy and increase mortality due to lung cancer. Clearly, smoking cessation programs for Latinos are needed. Some programs tested among Latinos have shown efficacy, but at the short-term only. Further, none has attempted to encourage cessation at a teachable moment: a time when cessation may seem more relevant. To reach this underserved population of smokers, we are proposing to conduct a teachable moment intervention trial for recently immigrated Latino smokers in Durham and Raleigh, North Carolina. We will conduct the interventions in Spanish. We will attempt to capitalize on the teachable moment of Latinas' pregnancy as an impetus for Latinos' cessation because pregnancy is a time when men might consider stopping smoking. Also, including the woman could help sustain cessation after the program is complete. Thus, we are intervening with Latino couples to help the men quit smoking. We have partnered with community leaders at El Centro Hispano, a community resource center for Latinos in Durham. We will develop an intervention based primarily on Social Cognitive Theory and the Teachable Moments Model. We will teach men smoking cessation skills, help improve men's self-efficacy and outcome expectancies for quitting, and teach the couples optimal ways to communicate to reduce the stress that comes with a new baby. With better communication, the couple may be able to work together better to help him quit smoking and stay quit. We are proposing to recruit pregnant Latino couples (n=420) into a two-arm smoking cessation intervention. The program will be culturally tailored to emphasize Latino cultural values that could contribute to higher cessation rates, namely familismo, a high value on the family, and personalismo, valuing warm personal relationships. The study arms are: Arm 1: Self-help smoking cessation guide vs. Arm 2: Couple-based smoking cessation counseling. We propose to survey couples face-to-face at five time-points: baseline, 28 weeks gestation, and 2, 6, and 12 months postpartum. PUBLIC HEALTH RELEVANCE: The smoking rate among Latino males is too high. Few effective programs reach and promote long term smoking cessation among Latino Spanish-speaking smokers. This intervention approaches Latinos when their wives are pregnant to increase motivation for quitting. The intervention includes Latinas and teaches the couples effective communication skills to help sustain cessation effects long term.