Reducing Tobacco Related Health Disparities

减少烟草相关的健康差异

• 批准号: 9171977
• 负责人: David W Wetter
• 金额: $ 10.71万
• 依托单位: RICE UNIVERSITY
• 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 2016-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9171977
• 关键词: Reducing; Tobacco; Related; Health; Disparities

ABSTRACT The proposed study will evaluate the efficacy and cost-effectiveness of a theoretically- and empirically- based "Motivation And Problem Solving" (MAPS) intervention for promoting and facilitating smoking cessation among low income smokers who are not ready to quit. Approximately 90% of current smokers (over 41 million people) are not ready to quit smoking at any one point in time. MAPS is a holistic, dynamic approach to facilitating behavior change that utilizes a combined motivational enhancement and social cognitive approach based on motivational interviewing (MI) the Treating Tobacco Use and Dependence Clinical Practice Guideline, and social cognitive theory. MAPS is designed for all smokers regardless of their readiness to quit or phase of the quitting process, and specifically targets motivation and intrinsic motives for change, social cognitive constructs (e.g., agency/self-efficacy), and other key factors of particular relevance to low income smokers (e.g., stressors, family issues, financial resources). Because MAPS encompasses a chronic care type approach to treating tobacco use and revolves around a "wellness program" that addresses numerous barriers and concerns that are prevalent among low income individuals, we believe it is particularly appropriate for treating such smokers. Participants (N = 900) will be cigarette smokers attending community health clinics operated by the Harris County Hospital District (HCHD). HCHD is the safety net public health care system serving Houston and Harris County, the nation's fourth largest city and third most populous county. HCHD serves only the uninsured and underinsured. All participants will be followed for a period of two years, and will be randomly assigned to one of three groups: 1) Standard Treatment [ST], 2) MAPS-4, or 3) MAPS-8. ST will consist of a letter referring smokers to Texas Quitline, and standard self-help materials. ST will occur a total of 4 times (Baseline, 6, 12, and 18 months). MAPS-4 will consist of ST plus 4 proactive MAPS telephone counseling sessions over a 2- year period. MAPS-8 will consist of ST plus 8 proactive telephone counseling sessions over a 2-year period. Assessments will occur at Baseline and at 6, 12, 18, and 24 months after Baseline. The primary outcome variables are abstinence from tobacco across the 6, 12, 18, and 24-month follow-ups, and at the 24-month follow-up. Secondary outcomes will include quit attempts and use of the Texas Quitline.

抽象的 拟议的研究将评估理论和经验上的有效性和成本效益 基于“动机和问题解决”（MAPS）的干预措施，以促进和促进戒烟 尚未准备好戒烟的低收入吸烟者。大约 90% 的当前吸烟者（超过 4100 万） 人们）在任何一个时间点都没有准备好戒烟。 MAPS 是一种整体、动态的方法 利用动机增强和社会认知相结合的方法促进行为改变 基于动机访谈（MI）的治疗烟草使用和依赖临床实践 指南和社会认知理论。 MAPS 专为所有吸烟者设计，无论他们是否准备戒烟 或戒烟过程的阶段，特别针对变革的动机和内在动机，社会 认知结构（例如代理/自我效能）以及与低收入特别相关的其他关键因素 吸烟者（例如压力源、家庭问题、财务资源）。因为 MAPS 涵盖慢性护理类型 治疗烟草使用的方法，并围绕解决众多障碍的“健康计划” 和低收入人群中普遍存在的担忧，我们认为它特别适合 治疗此类吸烟者。 参与者（N = 900）将是到哈里斯经营的社区健康诊所就诊的吸烟者 县医院区 (HCHD)。 HCHD 是为休斯顿和哈里斯提供服务的安全网公共医疗保健系统 县，全国第四大城市和第三大人口县。 HCHD 只为未参保和 保险不足。所有参与者将被跟踪两年，并被随机分配到其中之一 三组：1) 标准治疗 [ST]，2) MAPS-4，或 3) MAPS-8。 ST 将由一个字母组成，涉及 吸烟者拨打德克萨斯州戒烟热线，以及标准自助材料。 ST 总共会出现 4 次（基线、6、12、 和 18 个月）。 MAPS-4 将包括 ST 加 4 次主动 MAPS 电话咨询会议，为期 2- 年期间。 MAPS-8 将由 ST 加上为期 2 年的 8 次主动电话咨询课程组成。 评估将在基线时以及基线后 6、12、18 和 24 个月进行。主要结果 变量是 6、12、18 和 24 个月随访期间的戒烟情况，以及 24 个月的戒烟情况。 后续行动。次要结果将包括戒烟尝试和使用德克萨斯州戒烟热线。