FRESH Delivers: An Innovative Approach to Reducing Tobacco Use Among Rural Black/African American Smokers

FRESH 提供：减少农村黑人/非裔美国吸烟者烟草使用的创新方法

• 批准号: 10436493
• 负责人: Pebbles Fagan
• 金额: $ 64.58万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10436493
• 关键词: Abstinence; Acetaldehyde; Acrolein; Address; African American; Arkansas; Benzaldehyde; Biological Markers; Body mass index; COVID-19 pandemic; Cancer Etiology; Carbon Monoxide; Cessation of life; Chronic Disease; Cigarette; Community Trial; Consumption; Cotinine; Counseling; County; Discrimination; Dose; Evidence based intervention; Face; Failure; Food; Food Access; Formaldehyde; Foundations; Goals; Health; Health Food; Healthcare; Home; Income; Intervention; Knowledge; Malignant Neoplasms; Measures; Medical; Modeling; Morbidity - disease rate; Motivation; Nicotine Dependence; Population; Poverty; Prevalence; Preventable cancer cause; Research; Resources; Risk Behaviors; Role; Rural; Science; Smoker; Smoking; Social Change; Social Conditions; Social Justice; Structural Racism; Structure; System; Testing; Time; Tobacco; Transportation; Unemployment; United States; Universities; Withdrawal; arm; attributable mortality; base; cancer health disparity; cancer prevention; cancer risk; cigarette smoking; community partnership; craving; effective intervention; efficacy testing; evidence base; experience; food insecurity; food security; fruits and vegetables; health care availability; health disparity; hydroxycotinine; improved; innovation; mortality; multidisciplinary; novel; programs; randomized controlled design; recruit; reduce tobacco use; rural African American; rural counties; smoking abstinence; smoking cessation; smoking prevalence; social; social disparities; social factors; social interventions; social stressor; social structure; stressor; tobacco exposure; tobacco-free; treatment group; trend; voucher

SUMMARY – PROJECT 2 Blacks/African Americans have the highest cigarette smoking-attributable cancer mortality rates in the United States. Cigarette smoking is nearly double the national average (23%-26%) in Arkansas rural counties where more than 48% of the population is Black/African American. Social structural stressors such as persistent poverty, low educational attainment, high rates of unemployment, the COVID-19 pandemic, poor transportation, poor access to health care, and historical oppression pose tremendous barriers to successful quitting. Quitting smoking can substantially reduce cancer morbidity and mortality among African Americans, but successful quitting as well as the reach of evidence-based interventions to rural African Americans is alarmingly low. Few studies have empirically tested the efficacy of social structural interventions (home-based food delivery) that address the dynamic interplay of cancer risk behaviors, like smoking, and social factors that perpetuate disparities like food insecurity. The long-term goal of this study is to fill a critical gap in knowledge on the role of social structural interventions in the elimination of cancer health disparities in low resource rural Arkansas counties with high proportions of Blacks/African Americans and high smoking prevalence. Our aims are to 1) test the efficacy of a social change intervention (home-based food delivery) on smoking abstinence using a 3-armed randomized controlled design, 2) examine changes in measures of cigarette abuse liability, and 3) examine the extent to which home-based food delivery improves recruitment and retention of Black/African American smokers in the treatment conditions. Our academic-community partnership – the University of Arkansas for Medical Sciences, Coalition for a Tobacco Free Arkansas, and the Arkansas Foodbank – has a strong collaborative foundation and experience in working together to reduce tobacco use in rural Arkansas Delta counties with high proportions of Blacks/African Americans. Multilevel interventions are needed to address persistent social conditions that potentially increase the abuse liability of smoking and impede successful quitting. Smokers who are more food insecure are less likely to quit smoking. Our multidisciplinary team will use the Socioecological Model to test our central hypothesis: smokers who receive evidence-based real-time video-based motivational counseling and a social change intervention (home-based food delivery) will have greater cotinine-verified 7-day point prevalence abstinence than those who receive motivational counseling alone or social change alone. Social structural interventions that meet the immediate social needs of Black/African American smokers hold tremendous promise for improving Black/African American recruitment and retention into helpful cancer prevention community trials, increasing successful quitting, and reducing social disparities that perpetuate tobacco-caused cancer disparities.

摘要 - 项目2 黑人/非洲裔美国人的吸烟 - 吸烟癌症的癌症死亡率最高 国家。在阿肯色州农村县，吸烟几乎是全国平均水平的两倍（23％-26％） 超过48％的人口是黑人/非裔美国人。社会结构压力源，例如持续 贫困，低教育程度，高失业率，共同199大流行，运输不良， 获得医疗保健的机会不佳，历史意见为成功的安静带来了巨大的障碍。退出 吸烟可以大大降低非裔美国人的癌症发病率和死亡率，但成功 戒烟以及对粗糙的非裔美国人的基于证据的干预措施的范围令人震惊。很少 研究已经验测试了社会结构干预效率（基于家庭的食物提供）的效率 解决癌症风险行为的动态相互作用，例如吸烟和社会因素永久存在 粮食不安全感等差异。这项研究的长期目标是填补了解角色的关键空白 在阿肯色州低资源农村地区消除癌症健康分布方面的社会结构干预措施 比例很高的黑人/非洲裔美国人且吸烟率高的县。我们的目标是1）测试 社会变革干预措施（基于家庭的食物交付）对戒烟的效率，使用3臂 随机对照设计，2）检查香烟滥用责任测量的变化，3）检查 基于家庭的粮食送货改善了黑人/非裔美国人吸烟者的招聘和保留 在治疗条件下。我们的学术社区合作伙伴关系 - 阿肯色大学医学 科学，烟草免费阿肯色州和阿肯色州食品银行的联盟 - 有一个很强的合作 基金会和合作的经验，以减少烟草在阿肯色州三角洲县的烟草使用 黑人/非裔美国人的特性。需要多层次干预措施来解决持续的社会 有可能增加吸烟责任并阻碍成功安静的条件。吸烟者谁 更多的食物不安全不太可能戒烟。我们的多学科团队将使用社会生态学 测试我们的中心假设的模型：接受基于证据的实时视频的烟气的吸烟者 咨询和社会变革干预措施（以家庭为基础的食物交付）将具有更大的可替宁验证的7天 比单独接受激励性咨询或单独进行社会变革的人的戒律。 满足黑人/非裔美国人吸烟者的紧急社会需求的社会结构干预措施 改善黑人/非裔美国人招募和保留为有用癌症的巨大希望 预防社区试验，增加成功的安静以及减少永久存在的社会差异 烟草引起的癌症分布。