A Family-Focused Intervention for Asian American Male Smokers

针对亚裔美国男性吸烟者的以家庭为中心的干预措施

• 批准号: 8761475
• 负责人: Janice Y Tsoh
• 金额: $ 67.29万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8761475
• 关键词: Abstinence; Address; Adult; Affect; American; Asian Americans; Asians; Attention; Behavioral; California; Chinese American; Chinese People; Conflict (Psychology); Control Groups; Counseling; Country; Data; Eating; Education; Ethnic group; FDA approved; Family; Family member; Foundations; Future; Goals; Health; Health Personnel; Health Professional; Hour; Household; Household and Family; Immigrant; Individual; Intention; Intervention; Interview; Knowledge; Language; Mediator of activation protein; Methods; Modeling; Network-based; Nicotine Dependence; Participant; Pharmaceutical Preparations; Pilot Projects; Population; Prevalence; Process; Protocols documentation; Public Health; Qualitative Research; Randomized; Randomized Controlled Trials; Readiness; Recruitment Activity; Relapse; Reporting; Research; Resources; Sample Size; Sampling; Self Efficacy; Smoker; Smoking; Smoking Cessation Intervention; Smoking History; Social Network; Social support; Staging; Subgroup; Surveys; Telephone; Testing; Theoretical model; Time; Tobacco Dependence; Tobacco use; Underrepresented Minority; Writing; arm; base; evidence base; experience; follow-up; group intervention; innovation; male; men; nicotine replacement; outreach; peer; pilot trial; population based; post intervention; programs; prospective; psychosocial; public health relevance; quitline; reduce tobacco use; smoking cessation; smoking prevalence; social; social cognitive theory; theories

DESCRIPTION (provided by applicant): A Family-Focused Intervention for Asian American Male Smokers Smoking prevalence remains high in subgroups of Asian American men, particularly among those with low English proficiency (LEP) and immigrants from cultures where smoking prevalence is high, including Chinese and Vietnamese. The 2011-12 California Health Interview Survey estimates that nearly half (46%) of all Asian male smokers in California are either Chinese or Vietnamese. The smoking prevalence's among LEP Chinese and Vietnamese men were 32% and 43%, respectively, compared to 16% of the general California male population. We developed a family-focused intervention utilizing lay health worker (LWH) outreach that integrates formative qualitative research and selected constructs from Social Network Theory, Social Cognitive Theory, and the Trans-theoretical Model. The intervention involves 2 small group education sessions with dyads of smokers and family members, and 2 follow-up individual telephone calls delivered by LHWs over 2 months. Our single-group pilot trial with 96 dyads of Chinese and Vietnamese male daily smokers and their family members showed a high feasibility of recruiting unmotivated smokers (42% were at "precontemplation"), and a promising 7-day point prevalence abstinence rate of 30% at 3 months with independent corroboration from family members. The first aim of the study is to evaluate the efficacy of the family-focused intervention in promoting smoking cessation in Chinese and Vietnamese male smokers. The second aim is to explore mediators to identify key psychosocial and behavioral processes that underlie how the intervention affects the processes of quitting and maintaining abstinence. We will conduct a 2-arm cluster randomized controlled trial (RCT) with assessments at baseline, 6 and 12 months following intervention initiation. The RCT involves 60 lay health workers (LHWs); each recruits and delivers interventions to 6 dyads of one male daily smoker and one family member from his household, for a total 360 smoker-family dyads. Half of the LHWs, stratified by Asian subgroup and smoking history, will be randomized to the family-focused intervention group and the other half will be assigned to an attention control condition receiving education on healthy eating. All participants will receive written information on smoking cessation resources. We hypothesize that, at 6 and 12 month follow-up, the intervention smokers will be more likely to achieve biochemically verified smoking abstinence (7-day point prevalence), to report having made at least one 24-hour quit attempt, and to report using at least one evidence-based smoking cessation resource (quitline, medication, health professional advice) than smokers in the control condition. Using prospective quantitative data obtained from the RCT, and post-trial dyadic and individual interviews of 30 smokers and 30 family members selected based on abstinence experiences, we will explore mediators at individual, family and social network levels that explain how the intervention affects quitting and maintaining abstinence. The long-term goal is to understand effective ways to utilize family-based and social outreach strategies to reduce tobacco use disparities in hard-to-reach populations.

描述（由申请人提供）：针对亚裔美国男性吸烟者的以家庭为中心的干预措施 亚裔美国男性亚群体的吸烟率仍然很高，特别是英语水平较低 (LEP) 的人群以及来自吸烟率较高文化背景的移民（包括中国人）和越南语。 2011-12 年加州健康访谈调查估计，加州所有亚裔男性吸烟者中近一半 (46%) 是中国人或越南人。中国和越南 LEP 男性的吸烟率分别为 32% 和 43%，而加州男性总体吸烟率为 16%。我们利用非专业卫生工作者 (LWH) 的外展活动开发了一种以家庭为中心的干预措施，该干预措施整合了形成性定性研究以及从社交网络理论、社会认知理论和跨理论模型中选择的构建。该干预措施包括 2 次由吸烟者和家庭成员组成的小组教育课程，以及 LHW 在 2 个月内拨打的 2 次后续个人电话。我们对 96 名每日吸烟的中国和越南男性及其家庭成员进行的单组试点试验表明，招募无动机的吸烟者（42% 处于“预想”状态）的可行性很高，并且 7 天点戒烟率有望达到 30 3 个月时的百分比，并得到家庭成员的独立证实。该研究的首要目的是评估以家庭为中心的干预措施在促进中国和越南男性吸烟者戒烟方面的效果。第二个目标是探索中介因素，以确定干预措施如何影响戒烟和维持禁欲过程的关键社会心理和行为过程。我们将进行一项 2 臂整群随机对照试验 (RCT)，在基线、干预开始后 6 个月和 12 个月进行评估。 RCT 涉及 60 名非专业卫生工作者 (LHW)；每个项目都招募了 6 个双人组，其中包括一名每天吸烟的男性和一名家庭成员，总共 360 个吸烟者家庭二人组。按亚洲亚组和吸烟史分层的一半 LHW 将被随机分配到以家庭为中心的干预组，另一半将被分配到接受健康饮食教育的注意力控制组。所有参与者都将收到有关戒烟资源的书面信息。我们假设，在 6 个月和 12 个月的随访中，干预吸烟者将更有可能实现生化验证的戒烟（7 天点患病率），报告至少进行过一次 24 小时戒烟尝试，并报告与对照条件下的吸烟者相比，使用至少一种循证戒烟资源（戒烟热线、药物、健康专业建议）。利用随机对照试验获得的前瞻性定量数据，以及根据戒烟经历对 30 名吸烟者和 30 名家庭成员进行试验后的二元和个人访谈，我们将探索个人、家庭和社交网络层面的中介因素，解释干预措施如何影响戒烟和戒烟。 保持禁欲。长期目标是了解利用基于家庭和社会推广策略的有效方法，以减少难以接触人群的烟草使用差异。