Quit For Life (QFL): Smoking Cessation Among Chinese Smokers Living with HIV

终身戒烟（QFL）：中国艾滋病病毒感染者吸烟者的戒烟情况

• 批准号: 10155450
• 负责人: Lisa M. Quintiliani
• 金额: $ 18.55万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10155450
• 关键词: AIDS/HIV problem; Abstinence; Address; Adult; Ambulatory Care Facilities; Behavioral; Biochemical; CD4 Lymphocyte Count; Caring; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Cessation of life; China; Chinese People; Clinic; Clinical Practice Guideline; Collaborations; Communicable Diseases; Control Groups; Counseling; Data; Development; Disease; Disease Progression; Enrollment; Erectile dysfunction; Focus Groups; Frequencies; Funding Mechanisms; General Population; Goals; Guidelines; HIV; HIV Infections; Health Policy; Health care facility; Health system; Healthcare Systems; Hong Kong; Hospitals; Individual; Infrastructure; Intervention; Leadership; Letters; Life; Manuals; Mediator of activation protein; Medical Records; Morbidity - disease rate; Motivation; Outcome; Outcome Measure; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Premature Mortality; Preparation; Prevalence; Psychological reinforcement; Randomized; Randomized Controlled Trials; Reaction; Research; Resources; Risk Factors; Role; Self Efficacy; Services; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Smoking Status; Solid; System; Techniques; Telephone; Testing; Text Messaging; Time; Tobacco; Tobacco smoke; Tobacco smoking behavior; Tobacco use; Treatment outcome; Update; Work; antiretroviral therapy; arm; base; brief advice; care delivery; cigarette smoking; compliance behavior; design; effective therapy; effectiveness testing; evidence base; health care delivery; improved; innovation; interest; intervention effect; intervention program; low and middle-income countries; mHealth; medication compliance; mortality; motivational enhancement therapy; nicotine replacement; population health; post intervention; preference; prevent; programs; satisfaction; self help; smoking abstinence; smoking cessation; social cognitive theory; social culture; standard care; success; theories; tobacco cessation intervention; tobacco control; tobacco user

PROJECT SUMMARY. Cigarette smoking among people living with HIV/AIDS (PLH) is a leading preventable cause of morbidity and mortality. With an adult smoking rate of 28.1% China has 301 million smokers. Because smoking rates are 2-3 times higher in PLH than in the general population, we anticipate that more than half of the 866,000 PLH in China smoke tobacco. Tobacco use significantly impacts the progression and outcome of HIV disease, and has been identified as the leading contributor to premature mortality among PLH. Therefore, increasing access to effective cessation treatment for these smokers could reduce tobacco-related morbidity and mortality and improve HIV treatment outcome. This project proposes to adapt and test the effect of a theory-based and tailored behavioral smoking cessation intervention for Chinese PLH who smoke (PLHS). We will develop an intervention program (Quit For Life, QFL), which is based on a smoking cessation program that demonstrated efficacy in our previous trial among Chinese erectile dysfunction patients in Hong Kong. QFL will be a social cognitive theory-based cessation program that focuses on goal setting and increasing self-efficacy as important intervention targets and mediators of change. In addition, QFL will be tailored for HIV and cultural issues, include prompts about the role of tobacco use on anti-retroviral therapy (ART) treatment outcome, use mHealth platform (text messaging) to reinforce counseling and delivered using Motivational Interviewing. The Specific Aims are to: i) develop and evaluate the QFL to support smoking cessation among Chinese PLHS, and ii) assess the preliminary effect of QFL on validated smoking abstinence. The study will be implemented in two phases. Phase1, a qualitative study, will tailor PI’s previously tested smoking cessation intervention to make it appropriate for Chinese PLHS. Focus groups of PLHS will explore how to boost the outcome of the previous intervention and incorporate issues that are more relevant to PLHS, and to create QFL. Phase2 will be a randomized controlled trial of the adapted QFL intervention. Eligible PLHS who will attend the HIV clinic of the Infectious Disease Hospital to receive ART will be randomized to intervention or control group. Both groups will receive clinician delivered brief advice on quit smoking (Standard Care, SC), free NRT for up to 8 weeks and self-help manual. Upon randomization, over the period of 8 weeks, the QFL group will receive 100 minutes of counseling, delivered in four different contacts (3 in-person and 1 over phone), two 5-minute booster phone calls, and 2-3 text messages/week; the control group will receive SC reinforcement (SCR) advice (~3 minutes) in one in-person contact. All subjects will be followed for 6 months post intervention. Building on the success of our earlier studies in Chinese and our ongoing collaboration, we propose to document the initial effect of “QFL” and develop the evidence base of tailored smoking cessation intervention for PLHS in China. This project is significant because it leverages the “real world,” setting of HIV clinic’s existing healthcare delivery system, and, thus, has high potential for population, health system and policy level impact.

项目摘要。艾滋病毒/艾滋病（PLH）的人中吸烟是可以预防的领先 发病率和死亡率的原因。中国的成年吸烟率为28.1％，有3.1亿吸烟者。因为 PLH的吸烟率是普通人群的2-3倍，我们预计会超过一半 中国的866,000 PLH烟烟。烟草使用显着影响 艾滋病毒疾病，已被确定为PLH过早死亡的主要贡献者。所以， 增加吸烟者获得有效戒烟治疗的机会可能会降低与烟草有关的发病率 和死亡率并改善HIV治疗结果。该项目的提议适应和测试 基于理论的和量身定制的行为戒烟干预措施为中国PLH吸烟（PLH）。我们 将制定一项干预计划（戒烟，QFL），该计划基于一个戒烟计划，该计划 在香港中国勃起功能障碍患者中，我们以前的试验表现出了效率。 QFL会 成为一个基于社会认知理论的戒烟计划，侧重于目标设定并提高自我高效 作为重要的干预目标和变革的介体。此外，QFL将针对艾滋病毒和文化量身定制 问题，包括有关烟草使用在抗逆转录病毒疗法（ART）治疗结果中的作用的提示，使用 MHealth平台（文本消息传递），以增强咨询并使用动机访谈进行交付。这 具体目的是：i）开发和评估QFL，以支持中国PLH的戒烟， ii）评估QFL对戒烟的初步影响。该研究将在 两个阶段。定性研究阶段1将量身定制PI先前测试的戒烟干预措施 使其适合中文PLH。 PLH的焦点小组将探索如何提高 先前的干预措施，并结合了与PLH更相关的问题，并创建了QFL。阶段2将 成为适应QFL干预的随机对照试验。符合条件的PLH，他们将参加艾滋病毒诊所 接收ART的传染病医院将被随机分为干预或对照组。两组 将收到有关戒烟（标准护理，SC）的临床医生的简短建议，最多为8周 和自助手册。随机化后，在8周的时间内，QFL组将获得100分钟 咨询，分别以四个不同的联系方式（3个面对面和1个通过电话），两台5分钟的助推器手机 电话和2-3条短信/周；对照组将获得SC增强（SCR）建议（〜3分钟） 在一个面对面的联系中。干预后6个月将遵循所有受试者。建立在成功的基础上 我们较早的中文研究以及我们正在进行的合作，我们建议记录“ QFL”的最初效果 并为中国的PLH开发量身定制的戒烟干预的证据基础。这个项目是 意义重大，因为它利用了艾滋病毒诊所现有的医疗保健提供系统的“现实世界”，以及 因此，对人口，卫生系统和政策水平的影响很高。