Ending Tobacco Use through Interactive Tailored Messaging for Cambodian People Living with HIV/AIDS (EndIT)

通过为柬埔寨艾滋病毒/艾滋病感染者提供交互式定制信息来结束烟草使用 (EndIT)

基本信息

批准号：
10490323
负责人：
Thanh C. Bui
金额：
$ 66.95万
依托单位：
H. LEE MOFFITT CANCER CTR & RES INST
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-17 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10490323
关键词：
AIDS/HIV problem Abstinence Address Adoption Adult Behavior Therapy Biochemical Cambodia Cambodian Cancer Center Caring Cellular Phone Clinic Collaborations Complement Comprehensive Health Care Confidence Intervals Control Groups Country Data Developed Countries Development Enrollment Evaluation Federal Government Female Government Agencies HIV Health Promotion Health Sciences Healthcare Income Influentials Intervention Life Literature Mediator of activation protein Modeling Morbidity - disease rate Oklahoma Participant Patient Self-Report Persons Pharmacological Treatment Phase Pilot Projects Prevalence Proliferating Public Health Randomized Randomized Controlled Trials Relative Risks Reporting Research Research Personnel Resource-limited setting Smoke Smoking Cessation Intervention Special Population Surveys Tobacco Tobacco Use Cessation Tobacco use Tobacco-Related Carcinoma Treatment Efficacy Universities University of Texas M D Anderson Cancer Center Wireless Technology Woman World Health Organization antiretroviral therapy base brief advice care delivery cigarette smoke comparative cost effectiveness cost effective economic evaluation efficacy evaluation follow-up high risk improved low income country mHealth male men mobile computing mortality nicotine replacement novel primary outcome randomized trial recruit secondary outcome self help sexual identity smoking cessation smoking prevalence standard care tailored messaging text messaging intervention tobacco cessation intervention tobacco control treatment group treatment program

项目摘要

PROJECT SUMMARY Although the prevalence of tobacco use has declined in developed nations in recent decades, the prevalence of smoking remains strikingly high in many low-income countries. In Cambodia, recent national surveys have indicated that 33%–43% of adult men and 3% of adult women smoke cigarettes. Certain special populations, such as people living with HIV (PLWH), are confronted with disproportionately high risks associated with tobacco use. Available estimates indicate that 43%–65% of male PLWH and 3%–5% of female PLWH smoke cigarettes. Although Cambodia has widespread coverage for antiretroviral treatment (ART), no known efforts have been made to provide tobacco treatment to ART recipients who smoke. Thus, complementing ART with efficacious tobacco cessation treatment offers tremendous potential to improve HIV care and to prolong life for PLWH. To address this need, we propose a randomized controlled trial with pharmacological and behavioral treatment components, including a fully automated, interactive smartphone-delivered intervention. Mobile health (mHealth) interventions are proliferating in the US, but efforts to utilize similar approaches in Cambodia are extremely limited. The World Health Organization acknowledges that mHealth is cost-effective, scalable, and sustainable, including for the least developed countries. We have already developed the mHealth platform and intervention approach proposed for this study, and we have completed a pilot study with 50 Cambodian PLWH who smoked and received care at an ART clinic. Results from this pilot indicated that the biochemically confirmed, 7-day point prevalence abstinence rates at 2-months follow-up were 40% in the group receiving the mHealth intervention vs. 8% in a standard care control group (relative risk: 5.0). In this proposed study, Cambodian PLWH of all sexual identities will be recruited through the 6 largest ART clinics in Phnom Penh, which provide comprehensive care to more than 14,000 PLWH. Participants (n=800) will be randomized to one of 2 treatment groups: Standard Care (SC; n=400), or Automated Messaging (AM; n=400). SC consists of brief advice to quit smoking delivered by research staff, self-help written materials, and an 8-week supply of nicotine replacement therapy (NRT) in the form of transdermal patches. AM consists of the SC components plus a fully automated smartphone-based treatment program that involves interactive and tailored proactive messaging. The primary outcome is biochemically confirmed self-reported 7-day point prevalence abstinence at 12-months post-study enrollment. Secondary outcomes include abstinence at 3- and 6-months post-enrollment. The primary aims are to evaluate the efficacy of AM for Cambodian PLWH who smoke and to compare the cost- effectiveness of AM vs. SC. If our findings indicate that AM is efficacious and cost-effective, our collaboration with influential Cambodian governmental agencies will facilitate wide-scale implementation to HIV clinics across the country. Thus, the project has the potential to transform HIV care delivery throughout the country and to reduce tobacco-induced cancer morbidity and mortality significantly.

项目摘要尽管近几十年来，发达国家的烟草使用率却有所下降，但流行率在许多低收入国家中，吸烟仍然很高。在柬埔寨，最近的国家调查有表明33％–43％的成年男性和3％的成年妇女抽烟。某些特殊人群例如患有艾滋病毒（PLWH）的人面临着不成比例的高风险烟草使用。可用估计表明，男性PLWH的43％–65％和女性PLWH烟雾的3％–5％尽管柬埔寨具有抗逆转录病毒治疗（ART）的广泛覆盖范围，但尚无已知的努力已成为为吸烟的艺术接受者提供烟草治疗。那就完成艺术有效的烟草戒烟治疗具有改善艾滋病毒护理和延长寿命的巨大潜力 plwh。为了满足这种需求，我们提出了一项具有药物和行为的随机对照试验治疗组件，包括全自动，交互式智能手机提供的干预措施。移动的在美国，健康（MHealth）干预措施正在激增，但努力利用柬埔寨的类似方法非常有限。世界卫生组织承认MHealth具有成本效益，可扩展性，和可持续性，包括最不发达国家。我们已经开发了MHealth平台和为这项研究提出的干预方法，我们已经完成了一项使用50个柬埔寨的试点研究在艺术诊所吸烟并接受护理的PLWH。该飞行员的结果表明生化确认，在2个月的随访中，7天的戒酒率在接受该小组中为40％ MHealth干预措施在标准护理对照组中为8％（相对风险：5.0）。在这项拟议的研究中，所有性别身份的柬埔寨PLWH将通过金边的6个最大的艺术诊所招募为14,000多个PLWH提供了全面的护理。参与者（n = 800）将随机分为一个 2个治疗组的：标准护理（SC; n = 400）或自动消息传递（AM; n = 400）。 SC包括简短戒烟的建议，由研究人员提供的吸烟，自助书面材料和8周的尼古丁供应替代疗法（NRT）的透皮斑块形式。 AM由SC组件以及完全基于智能手机的自动化治疗计划涉及交互式和量身定制的主动消息传递。主要结果是生化确认的自我报告的7天点在12个月时的戒酒。研究后入学。次要结果包括在注册后3个月和6个月的节制。这主要目的是评估AM对吸烟并比较成本的柬埔寨PLWH的效率。 AM与SC的有效性。如果我们的发现表明是高效且具有成本效益的，那么我们的合作通过有影响力的柬埔寨政府机构，将促进艾滋病毒诊所的广泛实施在全国范围内。那就是该项目有可能改变全国的艾滋病毒护理递送并显着降低烟草诱导的癌症发病率和死亡率。