FRESH Delivers: An Innovative Approach to Reducing Tobacco Use Among Rural Black/African American Smokers

FRESH 提供：减少农村黑人/非裔美国吸烟者烟草使用的创新方法

• 批准号: 10436493
• 负责人: Pebbles Fagan
• 金额: $ 64.58万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10436493
• 关键词: Abstinence; Acetaldehyde; Acrolein; Address; African American; Arkansas; Benzaldehyde; Biological Markers; Body mass index; COVID-19 pandemic; Cancer Etiology; Carbon Monoxide; Cessation of life; Chronic Disease; Cigarette; Community Trial; Consumption; Cotinine; Counseling; County; Discrimination; Dose; Evidence based intervention; Face; Failure; Food; Food Access; Formaldehyde; Foundations; Goals; Health; Health Food; Healthcare; Home; Income; Intervention; Knowledge; Malignant Neoplasms; Measures; Medical; Modeling; Morbidity - disease rate; Motivation; Nicotine Dependence; Population; Poverty; Prevalence; Preventable cancer cause; Research; Resources; Risk Behaviors; Role; Rural; Science; Smoker; Smoking; Social Change; Social Conditions; Social Justice; Structural Racism; Structure; System; Testing; Time; Tobacco; Transportation; Unemployment; United States; Universities; Withdrawal; arm; attributable mortality; base; cancer health disparity; cancer prevention; cancer risk; cigarette smoking; community partnership; craving; effective intervention; efficacy testing; evidence base; experience; food insecurity; food security; fruits and vegetables; health care availability; health disparity; hydroxycotinine; improved; innovation; mortality; multidisciplinary; novel; programs; randomized controlled design; recruit; reduce tobacco use; rural African American; rural counties; smoking abstinence; smoking cessation; smoking prevalence; social; social disparities; social factors; social interventions; social stressor; social structure; stressor; tobacco exposure; tobacco-free; treatment group; trend; voucher

SUMMARY – PROJECT 2 Blacks/African Americans have the highest cigarette smoking-attributable cancer mortality rates in the United States. Cigarette smoking is nearly double the national average (23%-26%) in Arkansas rural counties where more than 48% of the population is Black/African American. Social structural stressors such as persistent poverty, low educational attainment, high rates of unemployment, the COVID-19 pandemic, poor transportation, poor access to health care, and historical oppression pose tremendous barriers to successful quitting. Quitting smoking can substantially reduce cancer morbidity and mortality among African Americans, but successful quitting as well as the reach of evidence-based interventions to rural African Americans is alarmingly low. Few studies have empirically tested the efficacy of social structural interventions (home-based food delivery) that address the dynamic interplay of cancer risk behaviors, like smoking, and social factors that perpetuate disparities like food insecurity. The long-term goal of this study is to fill a critical gap in knowledge on the role of social structural interventions in the elimination of cancer health disparities in low resource rural Arkansas counties with high proportions of Blacks/African Americans and high smoking prevalence. Our aims are to 1) test the efficacy of a social change intervention (home-based food delivery) on smoking abstinence using a 3-armed randomized controlled design, 2) examine changes in measures of cigarette abuse liability, and 3) examine the extent to which home-based food delivery improves recruitment and retention of Black/African American smokers in the treatment conditions. Our academic-community partnership – the University of Arkansas for Medical Sciences, Coalition for a Tobacco Free Arkansas, and the Arkansas Foodbank – has a strong collaborative foundation and experience in working together to reduce tobacco use in rural Arkansas Delta counties with high proportions of Blacks/African Americans. Multilevel interventions are needed to address persistent social conditions that potentially increase the abuse liability of smoking and impede successful quitting. Smokers who are more food insecure are less likely to quit smoking. Our multidisciplinary team will use the Socioecological Model to test our central hypothesis: smokers who receive evidence-based real-time video-based motivational counseling and a social change intervention (home-based food delivery) will have greater cotinine-verified 7-day point prevalence abstinence than those who receive motivational counseling alone or social change alone. Social structural interventions that meet the immediate social needs of Black/African American smokers hold tremendous promise for improving Black/African American recruitment and retention into helpful cancer prevention community trials, increasing successful quitting, and reducing social disparities that perpetuate tobacco-caused cancer disparities.

摘要 – 项目 2 在美国，黑人/非裔美国人因吸烟导致的癌症死亡率最高 阿肯色州农村县的吸烟率几乎是全国平均水平的两倍（23%-26%）。 超过 48% 的人口是黑人/非裔美国人 社会结构性压力源，例如持续存在的压力。 贫困、教育程度低、失业率高、COVID-19 大流行、交通不便、 难以获得医疗保健和历史压迫对成功戒烟构成了巨大障碍。 吸烟可以显着降低非裔美国人的癌症发病率和死亡率，但成功 农村非裔美国人的戒烟率以及基于证据的干预措施的覆盖率低得惊人。 研究通过实证检验了社会结构干预措施（家庭送餐）的有效性， 解决癌症风险行为（如吸烟）与长期存在的社会因素之间的动态相互作用 这项研究的长期目标是填补关于粮食不安全等方面的知识空白。 消除资源匮乏的阿肯色州农村癌症健康差异的社会结构干预措施 黑人/非裔美国人比例高且吸烟率高的县我们的目标是 1) 进行测试。 使用三臂设备进行社会变革干预（家庭送餐）对戒烟的功效 随机对照设计，2) 检查香烟滥用倾向测量的变化，以及 3) 检查 家庭送餐在多大程度上改善了黑人/非裔美国吸烟者的招募和保留 我们的学术界合作伙伴——阿肯色大学医学院 科学、阿肯色州无烟草联盟和阿肯色州食品银行——拥有强大的合作关系 在共同努力减少阿肯色州三角洲农村高烟县烟草使用方面的基础和经验 需要采取多层次干预措施来解决持续存在的社会问题。 可能增加吸烟滥用倾向并阻碍吸烟者成功戒烟的条件。 食物不安全程度越高，戒烟的可能性就越小。我们的多学科团队将使用社会生态学方法。 测试我们中心假设的模型：接受基于证据的实时视频激励的吸烟者 咨询和社会变革干预（家庭送餐）将有更好的可替宁验证 7 天 点禁欲率高于那些单独接受动机咨询或单独接受社会变革的人。 满足黑人/非裔美国吸烟者直接社会需求的社会结构干预措施仍然有效 改善黑人/非裔美国人招募和保留有益癌症的巨大前景 预防社区试验，提高戒烟成功率，并减少长期存在的社会差距 烟草引起的癌症差异。