Preliminary Studies on Implementation of Smoking Cessation Interventions for Low-Income Women

对低收入妇女实施戒烟干预措施的初步研究

基本信息

批准号：
10557517
负责人：
Taneisha Shani Scheuermann
金额：
$ 21.32万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-11 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10557517
关键词：
Abstinence Address Administrator Behavioral Biochemical Birth Carbon Monoxide Carcinogens Caring Catalogs Cellular Phone Centers of Research Excellence Child Clinic Clinical Counseling Data Devices Educational Materials Effectiveness Electronics Enrollment Ensure Equity Exhalation Family Feedback Female of child bearing age Goals Guidelines High Risk Woman Incentives Infant Information Systems Intervention Intervention Studies Interview Low income Malignant neoplasm of lung Methods Modification Monitor Participant Persons Pilot Projects Population Pregnancy Pregnancy Outcome Pregnant Women Process Psychological reinforcement Randomized Randomized, Controlled Trials Recommendation Reduce health disparities Research Resources Risk Sampling Services Smoke Smoker Smoking Smoking Cessation Intervention Smoking Status Special Supplemental Nutrition Program for Women, Infants, and Children Structure Suggestion System Testing Text Text Messaging Time Tobacco Tobacco use Training United States Visit Woman acceptability and feasibility arm cancer risk child bearing contingency management cost design early childhood empowerment follow-up health equity hybrid type 1 study implementation facilitation implementation intervention implementation science implementation strategy improved informant innovation insight intervention program intervention refinement mobile application mortality non-smoker novel pilot trial preference pregnant prenatal cigarette smoking primary outcome programs quitline remote assessment remote delivery screening secondary outcome smoking abstinence smoking cessation smoking during pregnancy smoking initiation smoking prevalence smoking relapse support tools text messaging intervention time use trial design uptake

项目摘要

PROJECT SUMMARY/ABSTRACT: PROJECT 4 (SCHEUERMANN) Smoking is one of the leading causes of mortality in the United States. Pregnant women who smoke expose themselves and their babies to a myriad of known carcinogens and are at risk for poor pregnancy outcomes. Currently, smoking rates among pregnant women are 8% with even higher smoking prevalence among low- income women. Twelve percent of pregnant women enrolled in The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) smoke. Low-income pregnant women are also less likely to quit. Even though guidelines recommend treating tobacco use among pregnant women, most pregnant smokers do not receive smoking cessation counseling and only one in 10 receive referrals to cessation services or follow-up care. WIC clinics are an ideal venue for initiating smoking cessation interventions for pregnant women. WIC serves approximately 40% of pregnant women and clinics have existing data systems to routinely document tobacco use. Effective smoking cessation interventions have been developed for pregnant women but quit rates are modest. Only a few intervention studies have focused on pregnant women enrolled in WIC, and one achieved significant, biochemically verified quit rates. Efforts to implement smoking cessation interventions programs in WIC show low sustainment and barriers such as time constraints among WIC staff and lack of referral resources and educational materials. The goal of this research is to develop and evaluate a novel smoking cessation intervention for initiation in WIC clinics that enhances text message cessation support with remotely delivered incentives. Developing an effective and scalable intervention for the WIC context could improve health equity for low-income women. We will use implementation science in planning our intervention by conducting formative studies to ensure feasibility and acceptability among WIC stakeholders. First, we will conduct interviews to determine end-user perspectives on the intervention and implementation strategies and identify adaptations to the intervention prior to implementation, using the FRAME framework to catalogue adaptations. In Aim 1, we will interview 15 pregnant current and recent smokers including both English and Spanish-speaking women enrolled in WIC. In Aim 2, we will conduct 12- 15 interviews with WIC staff key informants to elicit suggestions and feedback for modifications to the intervention and implementation plan. Based on stakeholder input (Aims 1 and 2), we will adapt our intervention and finalize our implementation plan and toolkit for our pilot trial (Aim 3). In our pilot trial we will determine the feasibility, acceptability, and preliminary effectiveness of the text message + incentives intervention with a sample of 50 pregnant smokers enrolled in WIC. We will employ a randomized controlled trial design with a text-message only control. This research program will impact the field by developing a scalable intervention for widely used programs reaching a large proportion of low-income pregnant women.

项目概要/摘要：项目 4 (SCHEUERMANN) 吸烟是美国导致死亡的主要原因之一。孕妇吸烟暴露她们自己和她们的婴儿会受到多种已知致癌物的影响，并面临妊娠结局不佳的风险。目前，孕妇吸烟率为 8%，低收入人群吸烟率更高。有收入的女性。百分之十二的孕妇参加了特殊补充营养计划妇女、婴儿和儿童 (WIC) 吸烟。低收入孕妇戒烟的可能性也较小。甚至尽管指南建议治疗孕妇吸烟，但大多数怀孕吸烟者并不这样做接受戒烟咨询，只有十分之一的人接受戒烟服务转介或后续跟进关心。 WIC 诊所是为孕妇启动戒烟干预措施的理想场所。世界IC 为大约 40% 的孕妇提供服务，诊所拥有现有的数据系统来定期记录烟草的使用。已经为孕妇制定了有效的戒烟干预措施，但戒烟价格适中。只有少数干预研究关注参加 WIC 的孕妇，其中一项取得了显着的、经生化验证的戒烟率。努力实施戒烟干预措施 WIC 的计划表现出低维持性和障碍，例如 WIC 工作人员的时间限制和缺乏推荐资源和教育材料。这项研究的目标是开发和评估一种新颖的在 WIC 诊所启动戒烟干预措施，通过短信加强戒烟支持远程提供激励。针对 WIC 背景制定有效且可扩展的干预措施可以改善低收入妇女的健康公平。我们将利用实施科学来规划我们的干预措施通过开展形成性研究来确保 WIC 利益相关者的可行性和可接受性。首先，我们将进行访谈以确定最终用户对干预和实施策略的看法，在实施之前使用 FRAME 框架进行编目，确定对干预措施的调整适应。在目标 1 中，我们将采访 15 名目前和最近吸烟的怀孕者，其中包括英国人和西班牙语女性加入了 WIC。在目标 2 中，我们将与 WIC 工作人员进行 12-15 次访谈信息提供者征求对干预和实施计划进行修改的建议和反馈。根据利益相关者的意见（目标 1 和 2），我们将调整我们的干预措施并最终确定我们的实施计划以及我们的试点试验（目标 3）的工具包。在我们的试点试验中，我们将确定可行性、可接受性和短信+激励干预对50名怀孕吸烟者样本的初步效果已注册 WIC。我们将采用随机对照试验设计，仅使用短信作为对照。这研究计划将通过为广泛使用的计划制定可扩展的干预措施来影响该领域很大一部分是低收入孕妇。