Mobile Health Technology for Personalized Tobacco Cessation Support among Cancer Survivors in Laos

移动健康技术为老挝癌症幸存者提供个性化戒烟支持

• 批准号: 10428082
• 负责人: Thanh C. Bui
• 金额: $ 9.98万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10428082
• 关键词: Abstinence; Address; Adoption; Adult; Behavior Therapy; Biochemical; Cambodia; Cancer Center; Cancer Hospital; Cancer Patient; Cancer Survivor; Cancer Survivorship; Caregivers; Cellular Phone; Cigarette; Communication; Confidence Intervals; Control Groups; Data; Data Analyses; Developed Countries; Development; Enrollment; Ensure; Focus Groups; Health Promotion; Health Technology; Hospitals; Income; Institution; Intervention; Interview; Joints; Language; Laos; Link; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Medical Records; Methods; Mobile Health Application; Outcome; Participant; Patient Self-Report; Patients; Phase; Pilot Projects; Population; Prevalence; Primary Neoplasm; Proliferating; Province; Public Health; Public Hospitals; Randomized; Randomized Controlled Trials; Recurrence; Relative Risks; Research; Research Personnel; Sampling; Smoke; Smoker; Smoking Cessation Intervention; Subgroup; Surveys; Target Populations; Testing; Time; Tobacco; Tobacco Use Cessation; Tobacco smoke; Tobacco smoking behavior; Treatment Efficacy; Treatment outcome; Underserved Population; Wireless Technology; Woman; World Health Organization; base; brief advice; cancer therapy; cost effective; design; digital; efficacy evaluation; follow-up; improved; insight; interest; low and middle-income countries; mHealth; men; mobile computing; mortality; nicotine replacement; novel; parent project; recruit; response; self help; sex; smoking cessation; smoking prevalence; social culture; standard care; tobacco cessation intervention; tobacco control; treatment group; treatment program

PROJECT SUMMARY: This application is being submitted in response to the Notice of Special Interest (NOSI): NOT-CA-21-058. In Lao People's Democratic Republic (Lao PDR), tobacco smoking prevalence among cancer patients is high: 60% in men and 15% in women. Evidence from developed countries suggests that smoking cessation offers considerable benefits for cancer survivors, including improving cancer treatment outcomes, reducing recurrence rates, reducing second primary tumor development, and reducing overall cancer mortality rates. Despite, no tobacco treatment programs are available in major (public) hospitals in Lao PDR, including in cancer hospitals/institutions. The parent project (1R21CA253600-01, R21 phase: 9/1/2020–8/31/2022, R33 phase: 9/1/2022–8/31/2025) aims to adapt and evaluate the efficacy of our theoretically and empirically based mobile health (mHealth) technology to help Lao general patients quit smoking cigarettes. This mHealth automated treatment (AT) approach includes a fully automated, interactive, personalized, smartphone-based intervention for behavioral treatment, delivered through our Insight platform. In year 1 of the parent project, we have been adapting our intervention content to the sociocultural context, language, and communication styles of Laotians. The purpose of this application is to expand our mHealth- based AT to address the pressing need for smoking cessation among cancer survivors and their caregivers in Lao PDR. In this project, we will conduct 4 focus group discussion to ensure that our revised materials are comprehensible and relevant to these target populations. Next, we will conduct a pilot randomized controlled trial (RCT, N=80) to evaluate the preliminary efficacy of the intervention. Cancer survivors (n=40) and caregivers (n=40) of both sexes who smoke will be recruited at Setthathirath Hospital and Lao National Cancer Center. Similar to the parent project’s design, participants will be randomized to 1 of 2 treatment groups: standard care (SC) or AT (20 cancer survivors and 20 caregivers in each group). SC consists of brief advice to quit smoking, self-help written materials, and a 2-week supply of NRT (transdermal patches). AT consists of all SC components plus our fully-automated interactive smartphone-based treatment program, personalized and tailored to cancer survivors or caregivers. The primary RCT outcome is biochemically confirmed self-reported 7-day point prevalence abstinence at 3 months post-study enrollment. After the RCT, we will conduct in-depth interviews (IDIs) with a diverse sample of 20 cancer survivors and 20 caregivers in the RCT to explore why and how they could or could not stay abstinent. The specific aims are: 1) to evaluate the feasibility of AT in cancer survivors and caregivers, 2) to evaluate the preliminary efficacy of AT in each cancer survivor/caregiver subgroup, and 3) to use mixed methods linked data (i.e., RCT and IDIs) and joint displays to explore why participants did or did not quit smoking and to understand facilitators and barriers to smoking cessation in these understudied and underserved populations.

项目摘要：本申请是为了响应特别兴趣通知而提交的 (NOSI)：NOT-CA-21-058 在老挝人民民主共和国 (老挝人民民主共和国)，吸烟率 发达国家的证据表明，癌症患者的这一比例很高：男性为 60%，女性为 15%。 戒烟为癌症幸存者提供了相当大的好处，包括改善癌症治疗 结果，降低复发率，减少第二原发肿瘤的发展，并减少总体 尽管如此，主要（公立）医院没有提供烟草治疗方案。 老挝人民民主共和国，包括癌症医院/机构 父项目（1R21CA253600-01，R21 阶段： 9/1/2020–8/31/2022，R33阶段：9/1/2022–8/31/2025）旨在适应和评估我们的功效 基于理论和实证的移动医疗（mHealth）技术帮助老挝普通患者戒烟 这种 mHealth 自动化治疗 (AT) 方法包括全自动、交互式、 通过我们的 Insight 平台提供基于智能手机的个性化行为治疗干预。 在父项目的第一年，我们一直在根据社会文化背景调整我们的干预内容， 该应用程序的目的是扩展我们的移动医疗。 基于 AT 来解决癌症幸存者及其戒烟的迫切需要 老挝人民民主共和国的护理人员 在这个项目中，我们将进行 4 次焦点小组讨论，以确保我们的修订结果。 材料易于理解并且与这些目标人群相关。接下来，我们将进行试点。 随机对照试验（RCT，N=80）评估癌症干预的初步效果。 Setthathirath 医院将招募吸烟的幸存者 (n=40) 和护理人员 (n=40) 老挝国家癌症中心与父项目的设计类似，参与者将被随机分配到 2 人中的 1 人。 治疗组：标准护理 (SC) 或 AT（每组 20 名癌症幸存者和 20 名护理人员）。 包括简短的戒烟建议、自助书面材料以及为期 2 周的 NRT（透皮疗法）供应 AT 由所有 SC 组件以及我们基于智能手机的全自动交互式治疗组成 为癌症幸存者或护理人员量身定制的个性化计划，主要随机对照试验结果是。 研究入组后 3 个月时经生化证实的自我报告 7 天点流行率戒断。 RCT 结束后，我们将对 20 名癌症幸存者和 20 名癌症幸存者等不同样本进行深度访谈 (IDI) 随机对照试验中的护理人员探讨他们能够或不能保持禁欲的原因和方式，具体目标是： 1) 评估 AT 在癌症幸存者和护理人员中的可行性，2) 评估 AT 的初步疗效 AT 在每个癌症幸存者/护理人员亚组中，以及 3) 使用混合方法关联数据（即 RCT 和 IDI） 以及联合展示，探索为什么戒烟或没有戒烟，并了解促进者和 这些研究不足和服务不足的人群的戒烟障碍。

项目成果

Factors Associated with Cigarette Smoking Cessation in Lao People's Democratic Republic: Results from the 2015 National Adult Tobacco Survey.

老挝人民民主共和国戒烟相关因素：2015 年全国成人烟草调查结果。

• 发表时间: 2020
• 作者: Bui, Thanh Cong;Xangsayarath, Phonepadith;Douangvichith, Daovieng;Siengsounthone, Latsamy;Phandouangsy, Khatthanaphone;Tran, Ly Thi;Businelle, Michael S
• 通讯作者: Businelle, Michael S

Secondhand Smoke Exposure in Lao People's Democratic Republic: Results From the 2015 National Adult Tobacco Survey.

老挝人民民主共和国的二手烟暴露：2015 年全国成人烟草调查结果。

• 发表时间: 2021
• 作者: Kulkarni, Shweta Vishwas;Xangsayarath, Phonepadith;Douangvichith, Daovieng;Siengsounthone, Latsamy;Phandouangsy, Khatthanaphone;Tran, Ly Thi;Le, Phuc Hong;Bui, Thanh Cong
• 通讯作者: Bui, Thanh Cong