Quit For Life (QFL): Smoking Cessation Among Chinese Smokers Living with HIV

终身戒烟（QFL）：中国艾滋病病毒感染者吸烟者的戒烟情况

• 批准号: 10155450
• 负责人: Lisa M. Quintiliani
• 金额: $ 18.55万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10155450
• 关键词: AIDS/HIV problem; Abstinence; Address; Adult; Ambulatory Care Facilities; Behavioral; Biochemical; CD4 Lymphocyte Count; Caring; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Cessation of life; China; Chinese People; Clinic; Clinical Practice Guideline; Collaborations; Communicable Diseases; Control Groups; Counseling; Data; Development; Disease; Disease Progression; Enrollment; Erectile dysfunction; Focus Groups; Frequencies; Funding Mechanisms; General Population; Goals; Guidelines; HIV; HIV Infections; Health Policy; Health care facility; Health system; Healthcare Systems; Hong Kong; Hospitals; Individual; Infrastructure; Intervention; Leadership; Letters; Life; Manuals; Mediator of activation protein; Medical Records; Morbidity - disease rate; Motivation; Outcome; Outcome Measure; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Premature Mortality; Preparation; Prevalence; Psychological reinforcement; Randomized; Randomized Controlled Trials; Reaction; Research; Resources; Risk Factors; Role; Self Efficacy; Services; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Smoking Status; Solid; System; Techniques; Telephone; Testing; Text Messaging; Time; Tobacco; Tobacco smoke; Tobacco smoking behavior; Tobacco use; Treatment outcome; Update; Work; antiretroviral therapy; arm; base; brief advice; care delivery; cigarette smoking; compliance behavior; design; effective therapy; effectiveness testing; evidence base; health care delivery; improved; innovation; interest; intervention effect; intervention program; low and middle-income countries; mHealth; medication compliance; mortality; motivational enhancement therapy; nicotine replacement; population health; post intervention; preference; prevent; programs; satisfaction; self help; smoking abstinence; smoking cessation; social cognitive theory; social culture; standard care; success; theories; tobacco cessation intervention; tobacco control; tobacco user

PROJECT SUMMARY. Cigarette smoking among people living with HIV/AIDS (PLH) is a leading preventable cause of morbidity and mortality. With an adult smoking rate of 28.1% China has 301 million smokers. Because smoking rates are 2-3 times higher in PLH than in the general population, we anticipate that more than half of the 866,000 PLH in China smoke tobacco. Tobacco use significantly impacts the progression and outcome of HIV disease, and has been identified as the leading contributor to premature mortality among PLH. Therefore, increasing access to effective cessation treatment for these smokers could reduce tobacco-related morbidity and mortality and improve HIV treatment outcome. This project proposes to adapt and test the effect of a theory-based and tailored behavioral smoking cessation intervention for Chinese PLH who smoke (PLHS). We will develop an intervention program (Quit For Life, QFL), which is based on a smoking cessation program that demonstrated efficacy in our previous trial among Chinese erectile dysfunction patients in Hong Kong. QFL will be a social cognitive theory-based cessation program that focuses on goal setting and increasing self-efficacy as important intervention targets and mediators of change. In addition, QFL will be tailored for HIV and cultural issues, include prompts about the role of tobacco use on anti-retroviral therapy (ART) treatment outcome, use mHealth platform (text messaging) to reinforce counseling and delivered using Motivational Interviewing. The Specific Aims are to: i) develop and evaluate the QFL to support smoking cessation among Chinese PLHS, and ii) assess the preliminary effect of QFL on validated smoking abstinence. The study will be implemented in two phases. Phase1, a qualitative study, will tailor PI’s previously tested smoking cessation intervention to make it appropriate for Chinese PLHS. Focus groups of PLHS will explore how to boost the outcome of the previous intervention and incorporate issues that are more relevant to PLHS, and to create QFL. Phase2 will be a randomized controlled trial of the adapted QFL intervention. Eligible PLHS who will attend the HIV clinic of the Infectious Disease Hospital to receive ART will be randomized to intervention or control group. Both groups will receive clinician delivered brief advice on quit smoking (Standard Care, SC), free NRT for up to 8 weeks and self-help manual. Upon randomization, over the period of 8 weeks, the QFL group will receive 100 minutes of counseling, delivered in four different contacts (3 in-person and 1 over phone), two 5-minute booster phone calls, and 2-3 text messages/week; the control group will receive SC reinforcement (SCR) advice (~3 minutes) in one in-person contact. All subjects will be followed for 6 months post intervention. Building on the success of our earlier studies in Chinese and our ongoing collaboration, we propose to document the initial effect of “QFL” and develop the evidence base of tailored smoking cessation intervention for PLHS in China. This project is significant because it leverages the “real world,” setting of HIV clinic’s existing healthcare delivery system, and, thus, has high potential for population, health system and policy level impact.

项目摘要。艾滋病毒/艾滋病患者 (PLH) 吸烟是一个主要的可预防疾病。 中国有 3.01 亿吸烟者，成人吸烟率为 28.1%。 PLH 中的吸烟率比一般人群高 2-3 倍，我们预计超过一半的人 中国有 866,000 名艾滋病患者吸烟，吸烟对疾病的进展和结果产生了重大影响。 HIV 疾病已被确定为 PLH 过早死亡的主要原因。 增加这些吸烟者获得有效戒烟治疗的机会可以减少与烟草相关的发病率 该项目建议调整并测试一项措施的效果。 针对中国吸烟者（PLHS）的基于理论和定制的行为戒烟干预。 将制定一项干预计划（Quit For Life，QFL），该计划以戒烟计划为基础， 我们之前在香港 QFL 的华人勃起功能障碍患者中进行的试验的疗效将得到证实。 是一个基于社会认知理论的戒烟计划，专注于目标设定和提高自我效能 此外，QFL 还将针对艾滋病毒和文化进行定制。 问题，包括提示烟草使用对抗逆转录病毒疗法 (ART) 治疗结果的作用、使用 移动医疗平台（短信）可加强咨询，并通过动机访谈进行提供。 具体目标是： i) 制定和评估 QFL 以支持中国 PLHS 戒烟， ii) 评估 QFL 对有效戒烟的初步影响 该研究将在 2017 年实施。 第一阶段是一项定性研究，将根据 PI 之前测试的戒烟干预措施进行调整。 使其适合中国 PLHS。PLHS 焦点小组将探讨如何提高该成果。 先前的干预并纳入与 PLHS 更相关的问题，并创建 QFL 将。 是一项针对将参加 HIV 诊所的合格 PLHS 的适应性 QFL 干预的随机对照试验。 接受ART的传染病医院将被随机分为干预组或对照组。 将接受临床医生提供的关于戒烟的简短建议（标准护理，SC），免费 NRT 长达 8 周 随机分组后，QFL 组将在 8 周内获得 100 分钟的时间。 咨询，通过四种不同的联系方式提供（3 次面对面，1 次通过电话），两次 5 分钟的辅助电话 电话和每周 2-3 条短信；对照组将收到 SC 强化 (SCR) 建议（约 3 分钟） 在干预成功的基础上，将在一次面对面的接触中对所有受试者进行为期 6 个月的跟踪。 我们早期的中文研究以及我们正在进行的合作，我们建议记录“QFL”的初步效果 并为中国 PLHS 制定量身定制的戒烟干预措施的证据基础。 意义重大，因为它利用了“现实世界”、艾滋病毒诊所现有医疗保健服务系统的设置，以及， 因此，对人口、卫生系统和政策层面的影响具有很大的潜力。