Implementing Tobacco Use Treatment in HIV Clinics In Viet Nam

在越南艾滋病毒诊所实施烟草使用治疗

基本信息

批准号：
10357093
负责人：
Nam Truong Nguyen
金额：
$ 9.76万
依托单位：
NEW YORK UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10357093
关键词：
Address Ambulatory Care Facilities Biochemical Carbon Caring Chronic Disease Cigarette Clinic Clinical Trials Communicable Diseases Counseling Data Enrollment Food Fostering Funding Goals Grant HIV Health Health Status High Prevalence Household Income Individual Institutes Interdisciplinary Study Intervention Link Longitudinal Studies Matched Group Measures Medical Minority Modeling Outcome Outpatients Parents Patient Self-Report Patients Policies Population Postdoctoral Fellow Prevalence Randomized Randomized Controlled Trials Research Research Personnel Resources Risk Factors Science Smoke Smoker Smoking Students Surveys Testing Tobacco Tobacco Use Cessation Tobacco smoking behavior Tobacco use Training Vietnam Vulnerable Populations arm cancer prevention career cigarette smoke compare effectiveness cost effectiveness evidence base experience follow-up food insecurity health care settings health disparity longitudinal design low and middle-income countries nicotine replacement non-smoker parent grant post intervention programs quitline recruit reduce tobacco use research study screening skills smoking abstinence smoking cessation smoking prevalence social social determinants standard care supportive environment three-arm study tobacco cessation intervention treatment program

项目摘要

Project Summary This supplement proposes a longitudinal study that will extend the parent’s grant current portfolio to examine the difference in household food insecurity among people living with HIV (PLWH) and the relationship between food insecurity and tobacco use in Vietnam. The supplement focuses on how decreased food insecurity may have significant impact in the health disparities experienced on PLWH as chronic and infectious diseases intersect; and the study is powered to assess the potential impact of smoking cessation on food insecurity. The study aims are 1) to estimate the difference in household food insecurity among PLWH who smoke compared with PLWH who are non-smokers at baseline, and 2) to examine mechanisms linking smoking and household food insecurity among PLWH at baseline and 6-months follow-up, and 3) to assess the impact of a reduction in tobacco use and tobacco cessation on measures of food Insecurity at 6-month follow-up. Using a longitudinal design with a matched comparison population we will assess and compare the prevalence of food insecurity at the household level among individual HIV+ smokers and non-smokers and explore mechanisms associated with food insecurity among PLWH (smokers and non-smokers); and assess the potential impact of smoking cessation on food insecurity. We hypothesize that HIV+ smokers who have quit smoking or reduced cigarettes smoked per day by more than 50% will on average experience lower food insecurity than HIV+ smokers who continued to smoke. Findings from this study will help to better understand how screening for food insecurity may be incorporated in multipronged treatment programs in a resource poor setting, thereby identifying food insecure patients, which may help to alleviate the negative impact of co-occurring conditions and to inform policies and programs that address cessation interventions. The supplement builds on the parent grant which addresses the high prevalence of smoking in Viet Nam among PLWH. The long-term goal of the grant is to develop a scalable model for implementing evidence-based tobacco use treatment in health care settings treating PLWH in LMICs. The objective the grant is to conduct a 3-arm randomized controlled trial that compares the effectiveness and cost-effectiveness of three practical multilevel, multicomponent tobacco cessation interventions in outpatient clinics (OPC). The three arms are: 1) 3As+R (Standard Care): Ask (screen all patients), Advise (advice to quit), Assist (brief counseling), and Refer to Viet Nam’s national Quitline; 2) SC+Counsel: Counsel= 6-session onsite cessation counseling intervention tailored to PLWH and delivered by trained, onsite clinic staff; and 3) SC+Counsel+N: N= 4 weeks of nicotine replacement therapy. Patients (n=672) will be recruited at 14 HIV OPCs in Viet Nam and randomized into one of the three study arms. The study will compare the 3As+R (standard care (SC) with Quitline referral) to SC plus two tobacco treatment model enhancements. Both the parent grant and supplement makes use of a well- established partnership between NYU and the Institute for Social Medical Sciences.

项目概要本补充提出了一项纵向研究，该研究将扩大父母目前的资助组合以检查 HIV 感染者 (PLWH) 家庭粮食不安全的差异以及两者之间的关系越南的粮食不安全和烟草使用该增刊重点关注如何减少粮食不安全。作为慢性病和传染病，对感染者的健康差异产生重大影响相交；该研究旨在评估戒烟对粮食不安全的潜在影响。研究目的是 1) 估计吸烟的 PLWH 中家庭粮食不安全的差异与基线时不吸烟的 PLWH 合作，以及 2) 研究吸烟与家庭之间的联系机制 3) 评估感染者的基线和 6 个月随访期间的粮食不安全状况 6 个月随访时烟草使用和戒烟对粮食不安全措施的影响。设计与匹配的比较人群，我们将评估和比较粮食不安全的普遍程度 HIV+吸烟者和非吸烟者的家庭水平，并探索相关机制艾滋病病毒感染者（吸烟者和非吸烟者）的粮食不安全问题，并评估吸烟的潜在影响；我们勇敢地面对那些已戒烟或减少吸烟量的艾滋病毒吸烟者。平均而言，每天吸烟超过 50% 的吸烟者所经历的粮食不安全程度低于艾滋病病毒感染者吸烟者这项研究的结果将有助于更好地了解如何筛查食品不安全。可以纳入资源贫乏环境中的多管齐下的治疗计划，从而确定食物缺乏安全感的患者，这可能有助于减轻同时发生的情况的负面影响并告知解决戒烟干预措施的政策和计划该补助以家长补助金为基础。该赠款的长期目标是解决越南艾滋病病毒感染者中吸烟率较高的问题。开发一个可扩展的模型，用于在医疗保健机构中实施循证烟草使用治疗治疗中低收入国家的 PLWH 这笔赠款的目的是进行一项 3 臂随机对照试验，比较三种实用的多层次、多组分烟草的有效性和成本效益门诊戒烟干预 (OPC) 的三个分支是：1) 3As+R（标准护理）：询问。（筛查所有患者）、建议（建议戒烟）、协助（简短咨询）以及参考越南国家戒烟热线；2) SC+Counsel：Counsel= 针对 PLWH 的 6 次现场戒烟咨询干预由经过培训的现场诊所工作人员提供；以及 3) SC+顾问+N：N= 4 周的尼古丁替代品患者 (n=672) 将在越南的 14 个 HIV OPC 中招募，并随机分入三个中的一个。该研究将比较 3As+R（标准护理 (SC) 和戒烟热线转诊）与 SC 加两个。烟草治疗模型的增强。纽约大学与社会医学科学研究所建立了合作伙伴关系。