Development and pilot testing of a culturally-tailored smartphone-delivered intervention for commercial smoking cessation in American Indians

开发和试点测试针对文化定制的智能手机提供的美洲印第安人商业戒烟干预措施

• 批准号: 10457333
• 负责人: Dana Mowls Carroll
• 金额: $ 15.56万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10457333
• 关键词: Abstinence; Address; Adult; Affect; Agreement; American Indians; Biochemical; COVID-19 pandemic; Cancer Center; Cancer Prevention Intervention; Cellular Phone; Cigarette; Clinic; Clinical Practice Guideline; Clinical Trials; Collaborations; Communities; Data; Development; Elderly; Elements; Foundations; Frequencies; General Population; Goals; Health; Health Professional; Health education; Hour; Intervention; Interview; Location; Malignant Neoplasms; Malignant neoplasm of lung; Methods; Minnesota; Morbidity - disease rate; Motivation; Native Americans; Persons; Prevalence; Process; Professional counselor; Public Health; Qualitative Methods; Race; Randomized; Randomized Controlled Trials; Research; Resources; Risk; Rural; Rural Community; Self Efficacy; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Technology; Testing; Time; Tobacco; Tobacco Control Research; Tobacco use; Tobacco-Related Carcinoma; Tribes; Universities; Urban Community; Work; acceptability and feasibility; behavioral health; cigarette smoking; cigarette user; combat; comparative; design; efficacy outcomes; efficacy testing; experience; feasibility testing; improved; individualized medicine; informant; innovation; interest; iterative design; mortality; multidisciplinary; northern plains; novel; pilot test; programs; prototype; skills; smartphone Application; smoking cessation; smoking prevalence; smoking-related cancer; spiritual healing; theories; tobacco control; tribal health

As many as two out of every three American Indian (AI) adults located in the northern plains region of the US smoke commercial cigarettes. As a result, AIs in the northern plains experience rates of smoking-related cancers as high as three-fold other races. AIs are only about half as likely to quit commercial smoking compared to other races. Poor access and engagement with existing cessation programs has been put forward as a main reason for low quitting in AI smokers. Our long-term goal is to develop cessation interventions for AI commercial smokers that are wide-reaching, engaging, and culturally appropriate. NCI’s QuitGuide is a publicly available smartphone app for smoking cessation that allows for immediate access to interactive treatment content, such as real-time guidance on how to navigate smoking triggers, and therefore has great potential for reaching and engaging AI smokers. However, QuitGuide does not include guidance on triggers unique to AI persons such as commercial cigarette use at pow wows nor does it address traditional tobacco which is a spiritual practice common among AIs in the northern plains. The lack of content on traditional tobacco use is particularly problematic because of our team’s prior research showing that cultural references to traditional tobacco in commercial smoking cessation messages can improve self-efficacy to quit. Our present objective is to develop and pilot test a culturally-tailored version of the QuitGuide in AI commercial smokers. Our hypothesis is that a culturally-tailored QuitGuide will result in greater ratings of feasibility and acceptability in AI smokers versus the standard QuitGuide. The project builds on the Masonic Cancer Center’s and the American Indian Cancer Foundation’s research collaborations with AI communities. Our multidisciplinary team has expertise in AI tobacco use, smoking cessation, tailoring cancer prevention interventions to the cultural of AIs, and smartphone app development. Our community partners represent a rurally located Tribe and an urban clinic serving AIs, both of which are located in the northern plains region of the US. A community advisory board will oversee all activities and we have an agreement to work with the same technology experts who created NCI’s QuitGuide app. Our first aim is to conduct in-depth interviews among AI smokers (n=40) and key-informants (n=10) to guide the cultural tailoring of the QuitGuide that will result in a tailored app prototype. Our second aim is to assess the preliminary feasibility and acceptability of the tailored app prototype using iterative testing among AI smokers (two groups of n=6; N=12) and to refine the app. Our third aim is to conduct a pilot randomized controlled trial to test the feasibility, acceptability, and preliminary efficacy of the tailored QuitGuide app (n=40) versus the standard QuitGuide app (n=40) among AI smokers. At the conclusion, we will have a blueprint to guide the development of a clinical trial intended to test the efficacy of a culturally-tailored version of the QuitGuide smartphone app for AI smokers. Given that AIs in the northern plains experience some of the most extreme smoking disparities, this culturally-tailored treatment approach could have a meaningful public health impact on the burden of tobacco-related cancers among AIs.

多达三分之二的美洲印第安人 (AI) 成年人生活在美国北部平原地区 吸商业香烟的结果是，北部平原的人工智能患上与吸烟相关的癌症的比例较高。 与其他种族相比，人工智能戒掉商业吸烟的可能性只有其他种族的三倍左右。 现有戒烟计划的参与度和参与度不佳被认为是一个主要原因。 我们的长期目标是为人工智能商业吸烟者开发戒烟干预措施。 NCI 的 QuitGuide 是一款影响广泛、引人入胜且适合文化的智能手机。 用于戒烟的应用程序，允许立即访问交互式治疗内容，例如实时 关于如何应对吸烟诱因的指导，因此在接触和吸引人工智能方面具有巨大潜力 然而，戒烟指南不包括针对人工智能人群特有的触发因素的指导，例如商业吸烟者。 战俘中使用香烟，也没有涉及传统烟草，这是一种常见的精神实践 北部平原的人工智能缺乏有关传统烟草使用的内容尤其成问题。 我们团队之前的研究表明，商业戒烟中对传统烟草的文化参考 我们目前的目标是开发和试点测试一种适合文化的戒烟方法。 我们的假设是，根据文化量身定制的戒烟指南将会是人工智能商业吸烟者的戒烟指南。 与标准戒烟指南项目相比，人工智能吸烟者获得了更高的可行性和可接受性评级。 建立在共济会癌症中心和美洲印第安人癌症基金会的研究合作基础上 我们的多学科团队在人工智能烟草使用、戒烟、定制方面拥有专业知识。 对人工智能文化的癌症预防干预以及我们的社区合作伙伴。 代表一个位于农村的部落和一个为人工智能提供服务的城市诊所，两者都位于北部平原 美国地区的社区咨询委员会将监督所有活动，我们已达成合作协议。 创建 NCI 戒烟指南应用程序的技术专家我们的首要目标是进行深入访谈。 AI 吸烟者 (n=40) 和关键信息提供者 (n=10) 之间的关系，以指导戒烟指南的文化定制， 我们的第二个目标是评估该应用程序的初步可行性和可接受性。 使用 AI 吸烟者（两组，每组 n=6；N=12）进行迭代测试来定制应用程序原型并完善应用程序。 我们的第三个目标是进行试点随机对照试验，以测试可行性、可接受性和初步结果。 定制戒烟指南应用程序 (n=40) 与标准戒烟指南应用程序 (n=40) 在 AI 吸烟者中的疗效。 结论是，我们将制定一个蓝图来指导旨在测试疗效的临床试验的开发 鉴于北方地区的人工智能吸烟者，推出了针对人工智能吸烟者的 QuitGuide 智能手机应用程序的文化定制版本。 平原地区经历了一些最极端的吸烟差异，这种根据文化量身定制的治疗方法可以 对人工智能中与烟草相关的癌症负担具有有意义的公共卫生影响。