Full Project I: Adolescent Tobacco and Areca Nut Use Prevention in Guam

摘要 美国附属太平洋岛屿（USAPI）的人们在较高的健康水平方面面临着巨大的健康差距。 癌症和其他疾病的发病率和死亡率。大约有50万人生活在 USAPI和太平洋岛民是美国增长最快的人口群体之一。 肺癌、支气管癌和头颈癌的死亡率似乎明显高于 比美国全国的USAPI。肺癌/支气管癌和口腔癌的发病率较高， USAAPI可能是由于该地区烟草和槟榔的使用率较高。槟榔是一种水果， 一种棕榈树，槟榔，通常与坚果混合在一起咀嚼， 刺激效果。我们最近的研究表明，烟草产品的使用，包括电子或电子- 关岛中学生吸烟率可能比美国全国中学生高4-5倍。 指数.显然，防止烟草产品的使用（即，香烟、咀嚼烟草、电子烟使用）和 槟榔在USAPI青少年中的使用可能会减少USAPI在美国面临的癌症差异。 长远目前，没有任何基于文化的证据，烟草和槟榔 为USAPI青年设计的预防计划。该研究项目的长期目标是开发 一个基于文化的、循证的烟草和槟榔预防计划， 在USAPI的各个学校的教室里。该项目将继续在以下方面开展富有成效的合作： 来自夏威夷大学癌症中心（UHCC）和关岛大学（UOG）的研究人员， 作为试点研究启动，由UHCC/UOG伙伴关系赠款（U 54）的上一个周期资助。的 拟议的研究将适应和测试Ho'ouna Pono，一个创新的基于视频的课堂物质使用 为夏威夷土著人制定预防课程，夏威夷土著人是太平洋岛民，文化上类似于 太平洋岛民在USAPI。除了基于视频的课程外，我们还将测试基于社交媒体的 开展社会营销运动，防止烟草和槟榔的使用开始和增加。在8个公共 在关岛的中学，4将被随机分配到“基于视频的课程+社会营销 活动”条件（即，治疗）和4将被分配到“社会营销活动只” 条件（即，对照）。决定提供干预，虽然较弱，控制组以及 是以良好的社区实践的道德规范为指导。如果有效的话，学校的烟草和槟榔 可以在整个USAPI提供使用预防课程，以减少青少年吸烟 和槟榔的使用率。最终，该计划可能有助于减少高 美国癌症协会面临的癌症负担。

ABSTRACT People of the U.S. Affiliated Pacific Islands (USAPI) face significant health disparities in terms of higher morbidity and mortality due to cancer and other diseases. Approximately half a million people live in the USAPI and Pacific Islanders constitute one of the fastest growing demographic groups in the U.S. Morbidity and mortality due to lung and bronchus cancer and head-and-neck cancer appear to be markedly higher in the USAPI than the U.S. nationally. The higher rates for lung/bronchus and oral cancer incidence in the USAPI may be due to higher rates of tobacco and areca (betel) nut use in the region. Areca nut is the fruit of a type of palm, Areca catechu, which is commonly chewed with or without tobacco mixed with the nut, for stimulating effects. Our recent research suggests that tobacco product use, including electronic or e- cigarette use, among Guam middle school students may be 4-5 times higher than the U.S. national average. Clearly, preventing tobacco product use (i.e., cigarette, chewing tobacco, e-cigarette use) and areca nut use among USAPI adolescents is likely to reduce cancer disparities faced by the USAPI in the long run. Currently there are NO culturally grounded, evidence-based tobacco and betel nut prevention programs designed for USAPI youth. The long-term goal of this research project is to develop a culturally grounded, evidence-based tobacco and betel nut prevention program that may be delivered in the classrooms across schools in the USAPI. The project will continue a productive collaboration between researchers from the University of Hawaii Cancer Center (UHCC) and University of Guam (UOG), which initiated as a pilot study funded by the previous cycle of the UHCC/UOG Partnership grant (U54). The proposed study will adapt and test Ho'ouna Pono, an innovative video-based classroom substance use prevention curriculum developed for Native Hawaiians, who are Pacific Islanders and culturally similar to Pacific Islanders in the USAPI. In addition to the video-based curriculum, we will test a social media-based social marketing campaign to prevent tobacco and betel nut use initiation and escalation. Of the 8 public middle schools in Guam, 4 will be randomly assigned to the "video-based curriculum + social marketing campaign" condition (i.e., treatment) and 4 will be assigned to the "social marketing campaign only" condition (i.e., control). The decision to provide an intervention, albeit weaker, to the control group as well was guided by the ethics of good community practice. If efficacious, the school-based tobacco and betel nut use prevention curriculum may be delivered throughout the USAPI so as to reduce the adolescent tobacco and betel nut use prevalence in the region. Ultimately, the program may contribute to reducing the high cancer burden faced by the USAPI.