Alaska Native Family-Based, Financial Incentives Intervention for Smoking Cessation: an RCT

基于阿拉斯加原住民家庭的戒烟经济激励干预措施：随机对照试验

基本信息

批准号：
10400485
负责人：
Christi A Patten
金额：
$ 63.76万
依托单位：
MAYO CLINIC ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-01 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10400485
关键词：
Adopted Adoption Adult Alaska Alaska Native American Indians Biochemical COVID-19 Car Phone Cardiovascular system Climate Communities Cost Effectiveness Analysis Data Decision Making Effectiveness Effectiveness of Interventions Enrollment Exposure to Family Family member Future Geography Goals Health Health Services Accessibility Health system Home Household Incentives Individual Intervention Interview Life Style Literature Maintenance Malignant neoplasm of lung Measures Mediator of activation protein Morbidity - disease rate Native-Born Odds Ratio Participant Patient Recruitments Persons Policies Population Pregnant Women Process Randomized Randomized Clinical Trials Randomized Controlled Trials Reach Effectiveness Adoption Implementation and Maintenance Research Resources Rewards Role Rural Smoke Smoking Smoking Cessation Intervention Smoking Status Social Distance Social support System Telephone Testing Time Tobacco Work addiction base behavioral economics cigarette smoking collaborative approach comparison intervention cultural values design digital effectiveness evaluation evidence base family support financial incentive frontier group intervention health disparity health organization hybrid type 1 design incentive-based intervention indexing intervention effect mortality non-Native pandemic disease post intervention programs residence respiratory sex smoking abstinence smoking cessation smoking prevalence social media theories therapy design tribal health urban area urban residence virtual intervention

项目摘要

PROJECT SUMMARY In Alaska (AK), smoking prevalence of Alaska Native and American Indian (ANAI) people is more than double that of non-Native adults (37% vs. 17%). Unlike other Indigenous populations, tobacco is not used in traditional ceremony. Current cessation strategies have not reduced smoking prevalence among ANAI people. AK geography (largely frontier and road-less) and climate further limit treatment access and reach. Based on behavioral economic theory, financial incentives to promote cessation is a promising approach in other populations, with smoking abstinence rates more than doubling one year after discontinued rewards compared with no incentives. Community input for this study indicate family members are essential in supporting smoking cessation; consistent with the ANAI cultural value of interdependence, defined as relationship-based, collaborative, and reliance on family systems rather than individuals. Our research and others’ document the influence of naturally occurring social support networks on smoking cessation. Family-based incentive interventions have not been evaluated for smoking or other addictions. To fill this gap, the proposed study will evaluate the effectiveness and implementation of a culturally-adapted, ANAI family-based incentives intervention for smoking cessation with the following Specific Aims: (1) Adapt an effective 6-month financial incentive intervention for ANAI people who smoke and family members; (2) Conduct a randomized controlled trial (RCT) to evaluate reach and effectiveness of the intervention compared with the control condition on confirmed, prolonged smoking abstinence at six and 12 months post-intervention; and (3) Evaluate key process indicators relevant to intervention adoption, implementation, and maintenance, and conduct a cost- effectiveness analysis to support further adaptation and dissemination. RCT-enrolled dyads (adult ANAI person who smokes [index participant] and adult family member) will be stratified by index participant’s sex, rural/urban location, residence with family member, and by family member’s smoking status, then randomized to a no incentives control condition (n=328 dyads) or a 6-month incentive intervention (n=328 dyads). All dyads will receive materials on evidence-based cessation resources, social support strategies, and family wellness. We will measure index participant smoking status in both groups weekly for four weeks, and at three and six months. Intervention index participants will receive rewards for verified smoking abstinence at each time point, up to $750; and the family member will receive rewards (e.g., fuel or other needs) equal to the value earned by the index participant. We will explore potential moderators (e.g., index participant sex) and mediators (e.g., interdependence) of intervention effects. To enhance reach, we will recruit participants statewide, primarily with social media, and deliver the intervention virtually. If successful, our results will inform Tribal policy to adopt the intervention within the AK Tribal Health System; and possibly, for use within ANAI communities beyond AK.

项目概要在阿拉斯加 (AK)，阿拉斯加原住民和美洲印第安人 (ANAI) 的吸烟率是其两倍多非土著成年人的比例（37% vs. 17%）与其他土著人口不同，传统中不使用烟草。目前的戒烟策略并未降低 ANAI 人群的吸烟率。地理（主要是边境和无路）和气候进一步限制了治疗的获取和覆盖范围。根据行为经济学理论，促进戒烟的经济激励在其他领域是一种有前途的方法人口，与停止奖励一年后的戒烟率相比，戒烟率增加了一倍多这项研究的社区投入表明家庭成员对于支持吸烟至关重要。停止；符合 ANAI 相互依赖的文化价值观，定义为基于关系，我们的研究和其他人的研究记录了这一点。自然存在的社会支持网络对戒烟的影响。尚未对吸烟或其他成瘾的干预措施进行评估。为了填补这一空白，拟议的研究将进行。评估适应文化、ANAI 以家庭为基础的激励措施的有效性和实施情况戒烟干预措施的具体目标如下： (1) 制定有效的 6 个月财务计划对吸烟的 ANAI 人群及其家庭成员进行激励干预；（2）进行随机对照研究；试验（RCT），与对照条件相比，评估干预措施的范围和有效性干预后 6 个月和 12 个月确认长期戒烟；以及 (3) 评估关键点与干预措施的采用、实施和维护相关的过程指标，并进行成本评估支持进一步适应和传播 RCT 的有效性分析（成人 ANAI 人员）。谁吸烟[索引参与者]和成年家庭成员）将按索引参与者的性别进行分层，农村/城市位置、与家庭成员居住的情况以及家庭成员的吸烟状况，然后随机化无激励控制条件（n=328 对）或 6 个月激励干预（n=328 对）。将收到有关循证戒烟资源、社会支持策略和家庭健康的材料。我们将在四个星期内每周测量两组指数参与者的吸烟状况，并在第三周和第六周测量干预指数参与者将因在每个时间点验证戒烟而获得奖励，高达 750 美元；并且家庭成员将获得相当于所赚取的价值的奖励（例如燃料或其他需求）我们将探索潜在的调节因素（例如，指数参与者性别）和调解因素（例如，为了扩大影响范围，我们将主要招募参与者。社交媒体，并以虚拟方式进行干预。如果成功，我们的结果将告知部落政策采取该措施。在 AK 部落卫生系统内进行干预；并可能在 AK 以外的 ANAI 社区内使用。