Veteran Social Support Intervention for Enhancing Smoking Treatment Utilization and Cessation

提高吸烟治疗利用率和戒烟的退伍军人社会支持干预

• 批准号: 10538304
• 负责人: STEVEN FU
• 金额: --
• 依托单位: MINNEAPOLIS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538304
• 关键词: Address; Adoption; Adult; Behavioral; Biochemical; Collaborations; Communication; Communities; Counseling; Databases; Development; Electronic Health Record; Enrollment; Family; Family member; Fostering; Foundations; Friends; Future; Gender; General Population; Health Services; Health Services Accessibility; Health system; Healthcare; Intervention; Literature; Methodology; Outcome Study; Participant; Persons; Pharmacotherapy; Population; Prevalence; Professional counselor; Public Health; Randomized; Randomized, Controlled Trials; Readiness; Recommendation; Reporting; Research; Resources; Role; Sample Size; Sampling; Smoker; Smoking; Smoking Status; Smoking treatment; Social Network; Social support; Tobacco; Tobacco use; Veterans; Woman; Women' s Health; Work; Writing; cigarette smoking; comparison intervention; effectiveness evaluation; effectiveness trial; efficacy trial; evidence base; follow-up; group intervention; health disparity; implementation evaluation; implementation outcomes; innovation; interest; intervention effect; male; men; motivational enhancement therapy; non-smoking; outreach; patient oriented; peer support; process evaluation; programs; quitline; recruit; smoking abstinence; smoking cessation; social; telephone coaching; theories; tobacco cessation intervention; tobacco user; trial enrollment

Background: Enhancing access and use of evidence-based tobacco cessation treatments and eliminating tobacco-related health disparities are top national and VA health services priorities. The prevalence of tobacco use is greater among Veterans compared to non-Veterans. From 2010-2015, 29% of women and 21% of male Veterans reported current cigarette smoking. Evidence-based cessation treatments (EBCTs) such as, tobacco quitlines, behavioral counseling, and pharmacotherapy, are greatly underutilized by Veteran smokers. Gaps remain in reaching women Veterans and use of existing social support networks to enhance use of EBCTs and cessation among Veterans Innovation and Impact: This project is innovative for evaluating social support networks as a proactive outreach approach to enhance cessation treatment utilization among Veteran smokers. The role of social network influences and social support on successful smoking cessation is established. Based on Cohen’s theory of social support, our team developed a social support intervention for diverse family members, friends, and other adults who wanted to help a smoker quit. The intervention consists of written materials and a 1-call, 15-25 minute coaching session. It is expected to be especially beneficial for Veteran smokers who might not otherwise access cessation treatment. Because our prior VHA trials enrolled about 94% men and the higher smoking rates among women, we will oversample women to enroll an equal number of men and women smokers. Our study contributes to VA HSR&D’s priority initiatives for enhancing treatment access and women’s health and is significant because it will advance research on the role of partnering with Veterans’ families and/or important others to enhance access to VA healthcare and population-specific treatments, especially women Veterans. The potential reach and public health impact of an effective social support intervention for the Veteran tobacco user population is considerable. Specific Aims: (Aim 1) To evaluate the impact of the social support intervention on Veteran smokers’ use of EBCT, (Aim 2) To examine the effectiveness of the social support intervention on the biochemically confirmed 7-day point prevalence cigarette smoking abstinence, (Aim 3) To explore potential moderators (e.g., smoker gender, SP tobacco use status) of intervention effects on study outcomes, and (Aim 4) To conduct a process evaluation assessing implementation outcomes (reach, adoption, fidelity) of the social support intervention and multilevel factors that may influence implementation. Methodology: We will conduct a pragmatic randomized controlled trial (RCT) within the national VHA health system to evaluate the effectiveness of a social support intervention compared with a control condition on utilization of EBCT among VHA-enrolled smokers. Veteran smokers, regardless of level of readiness to quit, will be identified nationally using the VHA electronic health record and proactively recruited. Interested smokers will be asked to identify a support person (SP) who will enroll. Participants will be randomized as smoker-SP dyads to the intervention (n= 594 dyads) or control condition (n= 594 dyads). All smokers will receive written resources and information on EBCTs. All SP participants will receive written materials. SP participants assigned to the intervention group will additionally receive a 1-call coaching session. Assessments for dyads in both study groups will be conducted at baseline, 3-, and 6-months post-randomization. Implementation/Next Steps: Next steps depend on the actual results, but we expect findings to be important to VA leaders, the VA Women’s Health Research Consortium and the Veteran community. We will maintain communication throughout the project with VA program partners to share findings in a timely manner. We will collaborate with CCDOR’s Veteran Engagement Panel on development of patient-centered dissemination approaches and recommendations for future intervention adaptations and/or implementation.

背景：增强基于证据的戒烟治疗的访问和使用并消除 与烟草有关的健康差异是国家和VA健康服务的重点。烟草的患病率 与非退伍军人相比，退伍军人的使用量更高。从2010年至2015年，男性的29％和21％ 退伍军人报告目前吸烟。循证戒烟治疗（EBCT），例如烟草 退伍军人吸烟者大大降低了戒烟，行为咨询和药物治疗。空白 继续接触妇女退伍军人，并使用现有的社会支持网络来增强EBCT的使用和 退伍军人停止 创新和影响：该项目具有创新性，用于评估社会支持网络作为一个积极主动 推广方法，以增强退伍军人吸烟者的停止治疗利用。社会的角色 建立了网络影响和社会支持对成功戒烟的社会支持。基于科恩的 社会支持理论，我们的团队为潜水家庭成员，朋友， 以及其他想帮助吸烟者退出的成年人。干预措施由书面材料和1个呼叫组成， 15-25分钟的教练会议。预计这对于可能不的退伍军人吸烟者特别有益 否则访问停止治疗。因为我们先前的VHA试验招募了约94％的男性和较高的人 女性的吸烟率，我们将超越女性以招募相等数量的男性和女性 吸烟者。我们的研究为VA HSR＆D的优先举措做出了贡献，以增强治疗访问和 妇女的健康，之所以重要，是因为它将推进与退伍军人合作的作用的研究 家庭和/或重要的其他人，以增强获得VA医疗保健和人群特定治疗的机会， 尤其是女退伍军人。有效社会支持的潜在影响力和公共卫生影响 对资深烟草用户群体的干预是相当大的。 具体目的：（目标1）评估社会支持干预对退伍军人吸烟者使用的影响 EBCT，（AIM 2）检查社会支持干预对生物化学确认的有效性 7天患病率吸烟戒酒（目标3）探索潜在的主持人（例如吸烟者 性别，SP烟草使用状态）干预对研究结果的影响，（目标4）进行过程 社会支持干预措施的评估评估实施结果（覆盖，采用，忠诚）和 可能影响实施的多层次因素。 方法论：我们将在国家VHA Health内进行务实的随机对照试验（RCT） 与控制条件相比 VHA注册吸烟者中EBCT的利用。退伍军人，不论戒烟的水平如何 将使用VHA电子健康记录在全国范围内确定并积极招募。 将要求吸烟者确定将入学的支持人员（SP）。参与者将被随机化为 吸烟者SP二元组为干预措施（n = 594个二元组）或对照条件（n = 594个二元组）。所有吸烟者都会 接收有关EBCT的书面资源和信息。所有SP参与者都将收到书面材料。 sp 分配给干预小组的参与者还将获得1个呼叫教练课程。评估 对于两个研究组中的二元组，将在随机后的基线，3个月和6个月内进行。 实施/下一步：下一步取决于实际结果，但我们希望发现很重要 弗吉尼亚州领导人，弗吉尼亚州妇女健康研究财团和退伍军人社区。我们将维持 在整个项目中与VA计划合作伙伴进行沟通，以及时分享调查结果。我们将 与CCDOR的资深订婚小组合作，以发展为中心的传播 未来的干预改编和/或实施的方法和建议。