TRANSforma Tu Salud Dejando de Fumar: Advancing smoking cessation among transgender individuals

项目总结 移动卫生(MHealth)干预是克服障碍和提供文化支持的一种有前途的方式 在变性人中进行适当的治疗。移动健康干预在以下几个方面可能是合适的 变性人，因为新出现的证据表明，虚拟空间被用来访问性别确认 支持和资源。此外，移动健康干预可以使人们能够真实地自我表达 变性人，这在线下并不总是可能的。在过去的7年里，我们的团队发展了 Decídetex to，一种为美国拉丁裔吸烟者提供的文化适应的戒烟短信干预。 Decídetex to已扩展到不同的拉丁美洲国家/地区(例如墨西哥和波多黎各)， 并已适应不同的人群(例如，携带艾滋病毒的美国拉丁裔吸烟者)。最近完工的一座 对美国拉丁裔吸烟者(n=457)进行的随机对照试验(RCT)表明，美国拉丁裔吸烟者 接受Decídetex to干预的人比接受标准护理(吸烟)的人更有可能 6个月时戒烟(34.1%vs20.6%；p&lt；0.001)。尽管事实证明 Decídetex to在美国拉丁裔中的有效性，我们已经发现这种干预不足以 解决变性人在戒烟方面遇到的独特障碍(例如，社会支持低， 性别焦虑症是一种压力源，需要进行性别确认的医疗程序)。我们建议将我们的 在移动健康、戒烟、变性人保健、社区参与性研究方面的专业知识，以及 开发文化住宿，试点测试(R21)，然后正式评估(R33)TransformáTu Salud Dejando de Fumar(西班牙语中“戒烟改变健康”的意思)--一种文化上的适应 针对变性人的戒烟干预。TransformáTu Salud dejando de Fumar Will 包括1)为期12周的基于WhatsApp的计划，可促进基于多媒体的纵向和双向 (即文本、图像、视频和音频)与参与者对话，以及2)与电子药房集成以访问 尼古丁替代疗法(NRT)免费。 R21目标1：开发TransformáTu Salud dejando de Fumar，一种文化上适应的戒烟方法 对变性人的干预。R21目标2：评估可行性、可接受性和初步影响 在变性人中的TransformáTu Salud dejando de Fumar。R33目标1：评估 TransformáTu Salud dejando de Fumar与6个月时戒烟护理标准的比较 在变性人中。R21-R33能力建设。我们将建设移动健康行为的能力 通过早期职业研究人员参与指导活动和通过学术活动进行研究 美国和阿根廷之间的伙伴关系。

PROJECT SUMMARY Mobile health (mHealth) interventions are a promising modality for overcoming barriers and providing culturally appropriate treatment among transgender individuals. mHealth interventions may be appropriate among transgender individuals, as emergent evidence suggests that virtual spaces are used to access gender affirming support and resources. Moreover, mHealth interventions may enable authentic self-expression among transgender individuals, which is not always possible offline. Over the past 7 years, our team has developed Decídetexto, a culturally accommodated smoking cessation text messaging intervention for U.S. Latino smokers. Decídetexto has been expanded to different Latin American countries/regions (e.g., Mexico and Puerto Rico), and has been adapted to different populations (e.g., U.S. Latino smokers living with HIV). A recently completed randomized controlled trial (RCT) with U.S. Latino smokers (n=457) demonstrated that U.S. Latinos receiving the Decídetexto intervention were significantly more likely than those receiving standard of care (smoking cessation printed materials) to be smoking abstinent at Month 6 (34.1% vs 20.6%; p<0.001). Despite the proven effectiveness of Decídetexto among U.S. Latinos, we have identified that this intervention does not adequately address unique barriers to smoking cessation encountered by transgender individuals (e.g., low social support, gender dysphoria as a stressor, need for gender affirming medical procedures). We propose to integrate our expertise in mHealth, smoking cessation, transgender health care, community-based participatory research, and cultural accommodation to develop, pilot test (R21), and then formally evaluate (R33) TRANSformá Tu Salud Dejando de Fumar (Spanish for “TRANSform Your Health by Quitting Smoking”) – a culturally accommodated smoking cessation intervention for transgender individuals. TRANSformá Tu Salud Dejando de Fumar will consist of 1) a 12-week WhatsApp-based program that facilitates longitudinal and bidirectional multimedia-based (i.e., text, image, video, and audio) dialogue with participants, and 2) integration with an e-Pharmacy to access nicotine replacement therapy (NRT) at no cost. R21 Aim 1: Develop TRANSformá Tu Salud Dejando de Fumar, a culturally accommodated smoking cessation intervention for transgender individuals. R21 Aim 2: Assess the feasibility, acceptability, and preliminary impact of TRANSformá Tu Salud Dejando de Fumar among transgender individuals. R33 Aim 1: Assess the efficacy of TRANSformá Tu Salud Dejando de Fumar compared to standard of care on smoking abstinence at Month 6 among transgender individuals. R21-R33 Capacity building. We will build capacity for mHealth behavioral research through the engagement of early career investigators in mentored activities and through academic partnerships between the U.S. and Argentina.