Implementing Tobacco Use Treatment in HIV Clinics In Viet Nam

在越南艾滋病毒诊所实施烟草使用治疗

• 批准号: 10357093
• 负责人: Nam Truong Nguyen
• 金额: $ 9.76万
• 依托单位: NEW YORK UNIVERSITY
• 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 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10357093
• 关键词: Address; Ambulatory Care Facilities; Biochemical; Carbon; Caring; Chronic Disease; Cigarette; Clinic; Clinical Trials; Communicable Diseases; Counseling; Data; Enrollment; Food; Fostering; Funding; Goals; Grant; HIV; Health; Health Status; High Prevalence; Household; Income; Individual; Institutes; Interdisciplinary Study; Intervention; Link; Longitudinal Studies; Matched Group; Measures; Medical; Minority; Modeling; Outcome; Outpatients; Parents; Patient Self-Report; Patients; Policies; Population; Postdoctoral Fellow; Prevalence; Randomized; Randomized Controlled Trials; Research; Research Personnel; Resources; Risk Factors; Science; Smoke; Smoker; Smoking; Students; Surveys; Testing; Tobacco; Tobacco Use Cessation; Tobacco smoking behavior; Tobacco use; Training; Vietnam; Vulnerable Populations; arm; cancer prevention; career; cigarette smoke; compare effectiveness; cost effectiveness; evidence base; experience; follow-up; food insecurity; health care settings; health disparity; longitudinal design; low and middle-income countries; nicotine replacement; non-smoker; parent grant; post intervention; programs; quitline; recruit; reduce tobacco use; research study; screening; skills; smoking abstinence; smoking cessation; smoking prevalence; social; social determinants; standard care; supportive environment; three-arm study; tobacco cessation intervention; treatment program

Project Summary This supplement proposes a longitudinal study that will extend the parent’s grant current portfolio to examine the difference in household food insecurity among people living with HIV (PLWH) and the relationship between food insecurity and tobacco use in Vietnam. The supplement focuses on how decreased food insecurity may have significant impact in the health disparities experienced on PLWH as chronic and infectious diseases intersect; and the study is powered to assess the potential impact of smoking cessation on food insecurity. The study aims are 1) to estimate the difference in household food insecurity among PLWH who smoke compared with PLWH who are non-smokers at baseline, and 2) to examine mechanisms linking smoking and household food insecurity among PLWH at baseline and 6-months follow-up, and 3) to assess the impact of a reduction in tobacco use and tobacco cessation on measures of food Insecurity at 6-month follow-up. Using a longitudinal design with a matched comparison population we will assess and compare the prevalence of food insecurity at the household level among individual HIV+ smokers and non-smokers and explore mechanisms associated with food insecurity among PLWH (smokers and non-smokers); and assess the potential impact of smoking cessation on food insecurity. We hypothesize that HIV+ smokers who have quit smoking or reduced cigarettes smoked per day by more than 50% will on average experience lower food insecurity than HIV+ smokers who continued to smoke. Findings from this study will help to better understand how screening for food insecurity may be incorporated in multipronged treatment programs in a resource poor setting, thereby identifying food insecure patients, which may help to alleviate the negative impact of co-occurring conditions and to inform policies and programs that address cessation interventions. The supplement builds on the parent grant which addresses the high prevalence of smoking in Viet Nam among PLWH. The long-term goal of the grant is to develop a scalable model for implementing evidence-based tobacco use treatment in health care settings treating PLWH in LMICs. The objective the grant is to conduct a 3-arm randomized controlled trial that compares the effectiveness and cost-effectiveness of three practical multilevel, multicomponent tobacco cessation interventions in outpatient clinics (OPC). The three arms are: 1) 3As+R (Standard Care): Ask (screen all patients), Advise (advice to quit), Assist (brief counseling), and Refer to Viet Nam’s national Quitline; 2) SC+Counsel: Counsel= 6-session onsite cessation counseling intervention tailored to PLWH and delivered by trained, onsite clinic staff; and 3) SC+Counsel+N: N= 4 weeks of nicotine replacement therapy. Patients (n=672) will be recruited at 14 HIV OPCs in Viet Nam and randomized into one of the three study arms. The study will compare the 3As+R (standard care (SC) with Quitline referral) to SC plus two tobacco treatment model enhancements. Both the parent grant and supplement makes use of a well- established partnership between NYU and the Institute for Social Medical Sciences.

项目摘要 这项补充提案是一项纵向研究，将扩大父母的赠款当前投资组合以检查 艾滋病毒（PLWH）患者的家庭粮食不安全感与 越南粮食不安全和烟草使用。该补充侧重于改善粮食不安全的可能性 作为慢性和传染病的PLWH上经历的健康分布产生重大影响 相交;这项研究有助于评估戒烟对粮食不安全的潜在影响。 研究目的是1）估计吸烟的PLWH中家庭粮食不安全的差异 与PLWH是基线的非吸烟者，以及2）检查与吸烟和家庭联系的机制 基线时PLWH和6个月的随访以及3）评估减少的影响 在6个月的随访中使用烟草对粮食不安全的措施的使用和烟草戒烟。使用纵向 与比较人群相匹配的设计，我们将评估和比较粮食不安全的普遍性 单个艾滋病毒+吸烟者和非吸烟者之间的家庭水平，并探索相关的机制 PLWH（吸烟者和非吸烟者）之间的粮食不安全；并评估吸烟的潜在影响 停止粮食不安全感。我们假设戒烟或减少香烟的艾滋病毒+吸烟者 每天熏制超过50％的烟熏饮食不安全比艾滋病毒+吸烟者低的粮食不安全 继续抽烟。这项研究的发现将有助于更好地了解筛查粮食不安全感 可以在资源不佳的环境中纳入多收益的治疗计划，从而确定食物 不安全的患者，这可能有助于减轻同时发生条件的负面影响并告知 解决停止干预措施的政策和计划。根据父母赠款建立的补品 这探讨了越南在PLWH中吸烟的高流行。赠款的长期目标是 开发可扩展模型，用于在医疗保健环境中实施基于证据的烟草使用治疗 在LMIC中处理PLWH。赠款的目的是进行3臂随机对照试验 比较三个实用的多级多组分烟草的有效性和成本效益 门诊诊所（OPC）的停止干预措施。这三个臂是：1）3AS+R（标准护理）：询问 （筛选所有患者），建议（辞职建议），协助（简短的咨询），并参考越南国家 quitline; 2）SC+律师：律师=量身定制的6条戒烟咨询干预措施 并由训练有素的现场诊所工作人员提供；和3）SC+律师+N：n = 4周尼古丁替代品 治疗。患者（n = 672）将在越南的14个HIV OPC下招募，并随机分为三个 研究臂。该研究将将3AS+R（标准护理（SC）与Quitline转介）与SC加两个比较 烟草治疗模型增强。父母赠款和补充都利用了 纽约大学与社会医学研究所之间建立了伙伴关系。