Culturally-Tailored Smoking Cessation for American Indians

为美洲印第安人量身定制的戒烟文化

• 批准号: 8106253
• 负责人: Won S Choi
• 金额: $ 57.3万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8106253
• 关键词: Abstinence; Address; Adherence; Adoption; Affect; American Indian and Alaska Native; American Indians; Bupropion; Cigarette; Collaborations; Effectiveness; Ethnic group; Failure; Health; Individual; Intervention; Kansas; Life; Methods; Oklahoma; Participant; Persons; Pharmacotherapy; Pilot Projects; Population; Process; Public Health; Publishing; Randomized; Randomized Clinical Trials; Research Methodology; Role; Sample Size; Site; Smoke; Smoker; Smoking; Smoking Status; Telephone; Testing; Tobacco; Underserved Population; United States; Work; arm; attributable mortality; base; cigarette smoking; community based participatory research; control trial; cost effective; cost effectiveness; design; efficacy testing; enhancing factor; improved; intervention effect; intervention program; multi-site trial; programs; public health relevance; racial and ethnic; randomized trial; smoking cessation; smoking prevalence; success; varenicline

DESCRIPTION (provided by applicant): American Indians and Alaska Natives (AI/ANs) have the highest smoking rates of the major racial/ethnic groups in the United States, approaching 40% to 50%. In addition, this underserved population has very low smoking cessation and abstinence rates. The smoking-attributable mortality rate of AI/ANs is not only the highest but double that of other ethnic groups. To date, there have been almost no studies that have focused on methods to encourage smoking cessation among AI/AN smokers and no randomized clinical trials. There is a desperate need for effective, culturally tailored cessation programs. We propose a 2 arm, and group randomized clinical trial to be conducted at 2 sites in the Midwest (Kansas and Oklahoma). We have begun to address these issues through the creation of the "All Nations Breath of Life" (ANBL) smoking cessation program using community-based participatory research methods. ANBL is group-based and is culturally-sensitive in all program components. It recognizes the sacred role of tobacco among many AI/ANs and how culture affects smoking cessation among AI/AN, while still addressing recreational smoking. Our pilot work shows promise for reducing cigarette smoking in AI/AN smokers, with quit rates of 30% at six months post-baseline, compared to 8-10% quit rates in other published studies. All participants in the proposed study will be offered pharmacotherapy (e.g. Varenicline or Bupropion or NRT) then randomized into either the culturally-tailored "All Nations Breath of Life" program (ANBL) or Non- tailored (NT). ANBL consists of in-person group sessions and individual telephone calls. We have successfully conducted a pilot study of ANBL and have found very promising results. At 12 months post baseline, all participants will be assessed for smoking status and continuous abstinence. We will randomize 28 groups per site (8 smokers per group) to ANBL or NT for a total sample size of 448 AI/AN smokers. This study is the first controlled trial to examine the efficacy of a culturally-tailored smoking cessation program for AI/ANs. In collaboration with AI/AN colleagues in Oklahoma we designed and successfully piloted the intervention to be culturally-tailored and sustainable in order to enhance its potential for widespread adoption and ultimate impact among AI/AN smokers. If the intervention is successful, the potential health impact is significant because the prevalence of smoking is the highest in this population. PUBLIC HEALTH RELEVANCE: This study is a multi-site trial to test the efficacy of a culturally-tailored smoking cessation program for American Indians. It is the first randomized trial related to smoking cessation to be conducted in this underserved population. The public health impact of this intervention is highly significant because the prevalence of smoking is the highest in American Indians.

描述（由申请人提供）：美洲印第安人和阿拉斯加原住民（AI/AN）在美国主要种族/族裔群体中吸烟率最高，接近 40% 至 50%。此外，这些服务不足的人群的戒烟率和戒烟率非常低。 AI/ANs 的吸烟死亡率不仅最高，而且是其他族群的两倍。迄今为止，几乎没有研究关注鼓励 AI/AN 吸烟者戒烟的方法，也没有随机临床试验。迫切需要有效的、适合文化的戒烟计划。我们建议在中西部的 2 个地点（堪萨斯州和俄克拉荷马州）进行 2 组随机临床试验。 我们已经开始通过使用基于社区的参与性研究方法创建“万国生命之息”(ANBL) 戒烟计划来解决这些问题。 ANBL 以团体为基础，所有计划组成部分都具有文化敏感性。它认识到烟草在许多 AI/AN 中的神圣作用，以及文化如何影响 AI/AN 中的戒烟，同时仍然解决休闲吸烟问题。我们的试点工作显示出减少 AI/AN 吸烟者吸烟的希望，基线后六个月的戒烟率为 30%，而其他已发表的研究中的戒烟率为 8-10%。 拟议研究的所有参与者都将接受药物治疗（例如伐尼克兰或安非他酮或尼古丁替代疗法），然后随机分为根据文化定制的“万国生命之息”计划（ANBL）或非定制计划（NT）。 ANBL 包括面对面的小组会议和个人电话通话。我们已经成功地进行了 ANBL 的试点研究，并发现了非常有希望的结果。基线后 12 个月，将对所有参与者的吸烟状况和持续戒烟情况进行评估。我们将每个地点 28 组（每组 8 名吸烟者）随机分为 ANBL 或 NT，总样本量为 448 名 AI/AN 吸烟者。 这项研究是第一个对照试验，旨在检验针对 AI/AN 的文化定制戒烟计划的功效。我们与俄克拉荷马州的 AI/AN 同事合作，设计并成功试点了适合文化的、可持续的干预措施，以增强其在 AI/AN 吸烟者中广泛采用和最终影响的潜力。如果干预成功，潜在的健康影响将是巨大的，因为吸烟率在该人群中最高。 公共卫生相关性：这项研究是一项多中心试验，旨在测试针对美洲印第安人文化定制的戒烟计划的有效性。这是在这一服务不足的人群中进行的第一项与戒烟相关的随机试验。这种干预措施对公共卫生的影响非常重大，因为美洲印第安人的吸烟率最高。