Family Smoking Cessation in Romania Using Pregnancy as a Window of Opportunity

罗马尼亚家庭戒烟利用怀孕作为机会之窗

• 批准号: 9182908
• 负责人: Cristian Ioan Meghea
• 金额: $ 13.95万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9182908
• 关键词: Address; Adopted; Adoption; Area; Award; Balkans; Biometry; Birth; Canada; Cessation of life; Child; Clinic; Clinical; Clinical Trials; Conceptions; Country; Couples; Disease; Drug Addiction; Eastern Europe; Effectiveness; Enrollment; Epidemiology; European; Family; Family health status; Female; Funding; Future; Gender; Goals; Health; Health Psychology; Health system; Human; Income; Institution; International; Intervention; Knowledge; Lead; Life; Longevity; Medicine; Mentors; Mentorship; Methodology; Michigan; Mission; Morbidity - disease rate; Motivation; Outcome; Perinatal Epidemiology; Policies; Population; Postnatal Care; Postpartum Period; Pregnancy; Pregnant Women; Prenatal care; Prevention; Prevention Research; Preventive Intervention; Primigravidities; Problem Solving; Public Health; Qualitative Research; Randomized Controlled Trials; Relapse; Reporting; Research; Research Personnel; Resources; Role; Romania; Scientist; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Smoking Prevention; Source; Spouses; System; Target Populations; Testing; Tobacco; Tobacco Dependence; Tobacco use; Training; Treatment Efficacy; USSR; United States National Institutes of Health; Universities; Visit; Voice; Western Europe; Woman; Work; base; behavioral health; behavioral health intervention; care delivery; career development; cigarette smoking; cohort; college; design; dissemination research; evidence base; global health; implementation research; killings; low and middle-income countries; male; maternal cigarette smoking; member; mortality; novel strategies; offspring; postnatal; prenatal; prevent; professor; programs; public health intervention; public health relevance; quitline; reproductive; research and development; research data dissemination; smoking cessation; smoking prevalence; smoking relapse; tobacco control

DESCRIPTION (provided by applicant): This IRSDA K01 resubmission advances the Fogarty mission of facilitating global health research through building partnerships between research institutions in the U.S. and abroad, and training new global health scientists. Dr. Cristian Meghea is an Assistant Professor in the College of Human Medicine, at Michigan State University (MSU) and an Associated Researcher at Babes-Bolyai University (BBU), in Cluj-Napoca, Romania where he was born and raised. This award will prepare Dr. Meghea to establish himself as an independently- funded global health researcher with capacity to develop, evaluate, and implement effective, culturally-tailored, and sustainable interventions to prevent and reduce smoking in families during the reproductive years in resource limited settings such as Central and Eastern Europe. Pregnancy smoking and postnatal relapse are highly prevalent in Romania and Central and Eastern Europe, with lifetime negative health effects for the women and their children. There are higher odds of female smoking persistence during pregnancy, and of relapse once pregnant women quit, when the male partner also smokes. It is critically important to address the smoking behavior of couples at the beginning of reproductive life. Building on ongoing pilot work led by Dr. Meghea in Cluj-Napoca, Romania, the overall objective of the proposed research, conducted through BBU in the same clinic as the ongoing pilot, is to adapt, enhance, and test the implementation feasibility and preliminary efficacy of an evidence-based pregnancy and postnatal couple intervention for smoking cessation that begins early in pregnancy and has a postnatal component. The intervention will be based on the motivation and problem solving (MAPS) approach, successful in preventing smoking relapse postpartum in the US, which will be enhanced by targeting the couples' smoking behavior by focusing on dyadic efficacy for smoking cessation. The target population is primigravida pregnant women and their partners in Cluj-Napoca, Romania. The specific aims are: (1) To develop an adapted and enhanced couple intervention to reduce pregnancy smoking and postpartum relapse in Romania based on the MAPS approach. (2) To conduct a pilot randomized controlled trial to test the fidelity of the culturally adapted MAPS intervention enhanced for couples smoking prevention during pregnancy and postpartum. (3) To examine in the pilot the implementation feasibility and initial efficacy in increasing maternal pregnancy smoking cessation and reducing postnatal relapse, with secondary hypotheses regarding maternal smoking reduction and spousal cessation, relapse, and reduction. This study proposed in this award will form the basis for a larger, multicenter clinical trial that will be submitted by Dr. Meghea as an R01 application by the end of the 4th year of this award to evaluate the effectiveness of the proposed smoking prevention intervention. If proven effective in the subsequent R01 trial, the intervention has a high potential for broad spectrum population impact and sustainability. The long-term goal is the adoption in the national Romanian health system as a proactive extension of the existing STOP SMOKING national program which includes a quitline. To pursue this long-term research agenda, Dr. Meghea will enroll in courses, trainings, and work with an outstanding team of mentors to refine and develop five areas of expertise: (1) Global health and tobacco control; (2) Behavioral health, intervention adaptation, dissemination, and implementation research; (3) Tobacco and drug dependence epidemiology; (4) Perinatal epidemiology; (5) Advanced biostatistics. Dr. Voice, the primary US mentor, will provide mentorship on conducting international research in resource limited settings, and will be an important source for networking with other colleagues. For over 15 years, he has lead a Fogarty D43 training and research program in Romania and the neighboring Balkans. Dr. Adriana Baban, the primary Romania mentor in Cluj-Napoca at BBU, is an expert in health psychology, prevention, and qualitative research. Dr. Kristie Foley, US Co-Mentor, with expertise in behavioral health and tobacco research rounds out this 3-member core mentoring team. The current and future interactions with Dr. Foley, the Fogarty R01 she currently leads building tobacco research capacity in Romania since 2012, and her collaborators in the region are extraordinary opportunities for Dr. Meghea's career development and research. Scientific advisors include: Dr. Adrian Blow (couples and family health interventions), Dr. William Wadland (smoking cessation and tobacco dependence), Dr. Jim Anthony (tobacco and drug dependence epidemiology), Dr. Nigel Paneth (perinatal epidemiology), Dr. David Wetter, one of the original MAPS developers, and Dr. Teodora Ciolompea, the national coordinator of the STOP SMOKING program in Romania. Dr. Ciolompea will have a key advisory role in the intervention adaptation, implementation and sustainability by facilitating the future adoption of the intervention in the national Romanian health system. The access to a true conception cohort with prenatal and postnatal care, delivery, and repeat pregnancies in the same clinics, and the high smoking rate and rare polydrug use, have the potential to advance health discoveries faster, cheaper, and more efficiently than we could in the US. This award addresses tobacco use, a key Fogarty and NIH priority in global health research and will provide Dr. Meghea the opportunity to engage in and maintain a strong research program with a major impact.

描述（由申请人提供）：此IRSDA K01重新提交通过建立美国和国外研究机构之间建立伙伴关系的Fogarty使命，促进全球健康研究，并培训新的全球健康科学家。克里斯蒂安·梅格（Cristian Meghea）博士是密歇根州立大学（MSU）的人类医学院的助理教授，也是他出生和长大的罗马尼亚克鲁伊·纳波卡（Cluj-Napoca）的巴布斯 - 布莱伊大学（BBU）的相关研究员。该奖项将使梅吉亚博士为自己成为一名具有独立资助的全球卫生研究人员的准备，具有开发，评估和实施有效，文化的和可持续的干预措施，以预防和减少在中欧和东欧等资源有限的环境中的繁殖年份中的吸烟。 在罗马尼亚，中欧和东欧，妊娠吸烟和产后复发非常普遍，对妇女及其子女的健康影响终生不利。怀孕期间，女性吸烟持久性的几率更高，一旦孕妇也戒烟，就会复发。在生殖生活开始时解决夫妻的吸烟行为至关重要。在罗马尼亚Cluj-Napoca的持续试点工作的基础上，该研究的总体目标是通过BBU与正在进行的飞行员在同一诊所中进行的，以适应，增强和测试实施的可行性和初步的循证怀孕和后夫妇的效率，以便早期培养临时，以早期的培训，并早期培养了一份妊娠。干预措施将基于动机和解决问题方法（地图）方法，成功地防止了美国的吸烟产后吸烟复发，这将通过针对夫妻的吸烟行为来增强，通过关注二抗吸烟的效力来戒烟。目标人群是罗马尼亚克鲁伊·纳波卡（Cluj-Napoca）的Primigravida孕妇及其伴侣。 具体目的是：（1）开发一种适应和增强的夫妇干预措施，以根据地图方法减少罗马尼亚的妊娠吸烟和产后复发。 （2）进行一项飞行员随机对照试验，以测试对夫妻在怀孕期间和产后预防夫妇的文化适应地图干预措施的保真度。 （3）在飞行员中检查实施可行性和最初的疗效在增加孕妇妊娠戒烟并减少产后复发的情况下，并有关于减少孕妇吸烟和配偶停止，复发和减少的次要假设。 该奖项提出的这项研究将构成大型多中心临床试验的基础，该试验将由Meghea博士提交为R01申请 到本奖项的第四年结束时，以评估拟议的预防干预措施的有效性。如果被证明在随后的R01试验中有效，则该干预措施对广泛的人群影响和可持续性具有很高的潜力。长期的目标是在国家罗马尼亚卫生系统中采用，作为现有停止吸烟国家计划的积极扩展，其中包括戒烟线。 为了遵循这一长期研究议程，梅格（Meghea）博士将参加课程，培训，并与杰出的导师团队合作，以完善和发展五个专业知识：（1）全球健康和烟草控制； （2）行为健康，干预适应，传播和实施研究； （3）烟草和药物依赖流行病学； （4）围产期流行病学； （5）高级生物统计学。美国主要导师语音博士将在资源有限的环境中提供有关国际研究的指导，并将成为与其他同事建立联系的重要来源。 15年来，他在罗马尼亚和邻近的巴尔干地区领导了Fogarty D43培训和研究计划。 BBU的Cluj-Napoca的主要罗马尼亚导师Adriana Baban博士是健康心理学，预防和定性研究的专家。美国联合学者克里斯蒂·弗利（Kristie Foley）博士，在行为健康和烟草研究方面具有专业知识，这使这个由3人组成的核心指导团队围起来。自2012年以来，她目前与她目前在罗马尼亚建立烟草研究能力的Fogarty R01的当前和未来互动，她在该地区的合作者为Meghea博士的职业发展和研究提供了非凡的机会。 Scientific advisors include: Dr. Adrian Blow (couples and family health interventions), Dr. William Wadland (smoking cessation and tobacco dependence), Dr. Jim Anthony (tobacco and drug dependence epidemiology), Dr. Nigel Paneth (perinatal epidemiology), Dr. David Wetter, one of the original MAPS developers, and Dr. Teodora Ciolompea, the national coordinator of the STOP罗马尼亚的吸烟计划。 Ciolompea博士将通过促进未来在国家罗马尼亚卫生系统中采用干预措施来在干预，实施和可持续性中发挥关键咨询作用。 在同一诊所获得产前和产后护理，分娩和重复怀孕以及高吸烟率和罕见的多药用使用的真正概念队列的可能性，有可能比我们能够更快，更便宜，更有效地提高健康发现。该奖项介绍了烟草使用，这是全球卫生研究中的关键Fogarty和NIH优先事项，并将为Meghea博士提供机会参与和维护具有重大影响的强大研究计划。