Adaptation and testing of a novel text-based tobacco cessation and education intervention in Kenyan Emergency Department patients

对肯尼亚急诊室患者进行基于文本的新型戒烟和教育干预的调整和测试

• 批准号: 10303917
• 负责人: Christine Ngaruiya
• 金额: $ 23.63万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10303917
• 关键词: Accident and Emergency department; Address; Adoption; Africa; African; Alcohol consumption; Americas; Biochemical; Car Phone; Carbon Monoxide; Cessation of life; Communicable Diseases; Country; Data; Diabetes Mellitus; Educational Intervention; Effectiveness; Emergency Department patient; Exhalation; Explosion; Focus Groups; Future; General Population; HIV/TB; Health; Health Knowledge, Attitudes, Practice; Health Technology; Hospitals; Human Resources; Hybrids; Hypertension; Income; International; Intervention; Interview; Kenya; Knowledge; Leadership; Maintenance; Measurement; Methods; Morbidity - disease rate; Nonrespondent; Outcome; Patient Self-Report; Patients; Population; Process; Prospective cohort; Randomized; Randomized Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reporting; Research; Research Personnel; Resources; Respondent; Risk Factors; Sampling; Smoker; Smoking; Smoking Status; Suggestion; Surveys; Techniques; Telephone; Testing; Text; Text Messaging; Tobacco; Tobacco Use Cessation; Tobacco use; Translations; Work; arm; base; cost; cost estimate; craving; effectiveness evaluation; effectiveness implementation study; epidemiology study; experience; high risk population; implementation science; implementation strategy; improved; informant; low and middle-income countries; mHealth; mortality; novel; novel strategies; post intervention; preference; primary outcome; programs; prospective; prototype; recruit; smoking cessation; social cognitive theory; sociodemographics; technology development; theories; tobacco user; tool; willingness

PROJECT SUMMARY Non-Communicable Diseases (NCDs) are the leading cause of global mortality, constituting 70% of deaths worldwide, 80% of which occur in Low- and Middle-Income Countries (LMICs). Tobacco use, a leading risk factor for NCDs, is responsible for 8 million deaths annually. Among all regions of the world, Africa has the highest predicted increase in tobacco use by 2025 (37%), even as use in the Americas is expected to decrease by 54%. Interventions are needed to address the explosion in tobacco use in Africa and other LMICs and to avert global deaths from tobacco. Emergency Department (ED) populations are a high-risk group that are opportune for interventions targeting NCDs and NCD risk factors, like tobacco. However, research in ED populations in LMICs is limited. Our team has led research in African ED populations, including conducting the largest epidemiological study on NCDs, and demonstrated that the burden of NCDs and NCD risk factors, such as tobacco, are systematically worse in ED populations than the general population. Mobile health (mHealth) interventions have had demonstrated effectiveness for tobacco cessation in High-Income Countries and for ED-based mHealth interventions in the US as shown by our team and others. mHealth interventions have been used in Africa to target communicable diseases such as HIV and tuberculosis, however there have been no trials assessing effectiveness for NCDs. This represents a substantial missed opportunity: mHealth is ideal for African settings because it can circumvent limited human resources, disseminate information to large populations, and do so at minimal cost. Our team has developed Text2Quit, a novel text message-based mHealth tool addressing tobacco cessation in the US. The program has shown a doubling of biochemically confirmed smoking cessation in US populations, and has been adapted in two international settings. In this study, we hypothesize that adapting and implementing Text2Quit in a Kenyan ED population will increase knowledge and cessation. We plan to use a mixed-methods, hybrid implementation-effectiveness approach to assess these outcomes. Our results will inform a randomized, controlled trial in a nationally representative sample of EDs in future. This study will be the first to target tobacco use in this population, the first to use mobile cessation, and will contribute to advancing implementation science on tobacco cessation globally. It will also provide a novel approach to implementation for mHealth interventions, with findings that can be generalized to other NCDs and risk factors, such as alcohol use, hypertension and diabetes. Our team, which includes the creators of Text2Quit, experts in implementation science, and mixed methods researchers with more than two decades of experience in ED populations, mHealth and NCDs in Africa, is well poised to conduct this study.

项目概要 非传染性疾病 (NCD) 是全球死亡的主要原因，占全球死亡人数的 70% 全球死亡人数中，80% 发生在低收入和中等收入国家 (LMIC)。烟草使用是一个主要的 非传染性疾病的危险因素，每年导致 800 万人死亡。在世界所有地区中，非洲是 到 2025 年，烟草使用量预计将增长最高（37%），尽管美洲的烟草使用量预计将减少 54%。需要采取干预措施来解决非洲和其他中低收入国家烟草使用激增的问题，并避免 全球因烟草死亡。急诊室 (ED) 人群是高危人群，需要及时就诊 针对非传染性疾病和非传染性疾病风险因素（如烟草）的干预措施。然而，针对 ED 人群的研究 中低收入国家的数量有限。我们的团队领导了对非洲 ED 人群的研究，包括开展最大规模的研究 对非传染性疾病的流行病学研究，并证明非传染性疾病的负担和非传染性疾病的危险因素，例如 烟草在 ED 人群中的情况比一般人群更严重。移动医疗（移动医疗） 干预措施已证明对高收入国家的戒烟有效 我们的团队和其他人展示了美国基于 ED 的移动医疗干预措施。移动医疗干预措施已 在非洲用于治疗艾滋病毒和结核病等传染病，但目前还没有 评估非传染性疾病有效性的试验。这代表着一个重大的错失机会：移动医疗非常适合 非洲环境，因为它可以绕开有限的人力资源，向大规模传播信息 人口，并以最小的成本做到这一点。我们的团队开发了 Text2Quit，一种新颖的基于短信的 解决美国戒烟问题的移动医疗工具。该计划显示生化水平加倍 证实美国人口已戒烟，并已在两个国际环境中进行了调整。在这个 研究中，我们假设肯尼亚 ED 人群中适应和实施 Text2Quit 的人数将会增加 知识和停止。我们计划使用混合方法、混合实施-有效性方法来 评估这些结果。我们的结果将为全国代表性的随机对照试验提供信息 未来 ED 的样本。这项研究将是第一个针对该人群烟草使用的研究，也是第一个使用 移动戒烟，并将有助于推进全球戒烟的实施科学。它会 还提供了一种实施移动医疗干预措施的新方法，其研究结果可以 推广到其他非传染性疾病和危险因素，例如饮酒、高血压和糖尿病。我们的团队， 包括 Text2Quit 的创建者、实施科学专家以及混合方法研究人员 在非洲 ED 人群、移动医疗和非传染性疾病方面拥有二十多年的经验，已做好准备开展 这项研究。