Neighborhood and individual-level determinants of smoking cessation among Hispani

西班牙裔戒烟的社区和个人层面的决定因素

• 批准号: 7294550
• 负责人: David W Wetter
• 金额: $ 0.22万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7294550
• 关键词: Acute; Address; Adult; Calculi; Cause of Death; Cessation of life; Cohort Studies; Counseling; Daily; Disease; Distal; Health; Health Personnel; Health Services Accessibility; Heart Diseases; Hispanics; Individual; Individual Differences; Intervention; Knowledge; Malignant Neoplasms; Marketing; Measures; Mediating; Methods; Mexican Americans; Minority; Neighborhoods; Nicotine Dependence; Not Hispanic or Latino; Outcome Measure; Outcome Study; Participant; Persons; Pharmacotherapy; Population; Procedures; Process; Public Health; Questionnaires; Recommendation; Recruitment Activity; Relapse; Reporting; Research; Science; Smoke; Smoker; Smoking; Standards of Weights and Measures; Stroke; Summary Reports; Telephone; Tobacco; Tobacco use; Underserved Population; Week; Withholding Treatment; base; disorder prevention; experience; health disparity; nicotine patch; reduce tobacco use; self help; smoking cessation

Tobacco is the leading cause of preventable death and disease among adults in the U.S. and one-third of all cancers are directly attributable to tobacco use. Minority and underserved populations experience profound tobacco-related disparities because of inequities in access to treatment, the health consequences of tobacco, marketing by tobacco companies, and many other factors. For example, Hispanics are less likely than non-Hispanic whites to receive help from their health care provider during a quit attempt or to have access to pharmacotherapy. Moreover, tobacco is a major public health problem among Hispanics as 3 of the 4 leading causes of death among Hispanics are related to smoking (i.e., cancer, heart disease, stroke). Thus, a cornerstone of disease prevention among Hispanics in the U.S. is reducing tobacco use. Despite the critical importance of reducing smoking in Hispanic populations, the search for effective methods to do so is hampered by the paucity of research on the mechanisms underlying smoking cessation in this population. As noted in one prominent report, "underlying the challenge to eliminate health disparities is the inadequate empirical understanding of the proximal and distal determinants of tobacco use, nicotine addiction, and related consequences among understudied and historically underserved populations" (Eliminating Tobacco- Related Health Disparities: Summary Report). The proposed study addresses this gap. This longitudinal cohort study will examine the influence of neighborhood, individual, and acute intrapersonal and contextual determinants of smoking cessation among adult, Spanish-speaking, Hispanic smokers recruited from the Mexican-American (MA) Cohort Study (N=200). All study procedures, treatment materials, and assessments will be conducted in Spanish. Participants will be tracked from 2 weeks prior to their quit date through 26 weeks post-quit date. They will be assessed for 4 contiguous weeks (1 week precessation through 3 weeks postcessation) using state-of-the-science ecological momentary assessment (EMA) procedures. All participants will receive smoking cessation treatment consisting of nicotine patch therapy, self-help materials, and brief in-person and telephone counseling based on our empirically-validated intervention for Spanish-speaking Hispanic smokers (Wetter et al., in press). There have been exceedingly few studies examining the mechanisms underlying smoking cessation among Spanish-speaking or Hispanic smokers, and to the best of our knowledge, none that that have: (a) investigated the influence of neighborhoods, or (b) included the use of EMA to investigate the acute intrapersonal and contextual influences on the process of quitting. Thus, the proposed study will make a unique contribution to the field, as well as address key recommendations from major reports on smoking among minorities (USDHHS, 1998) and reducing health disparities (USDHHS.2002).

烟草是美国成年人可预防死亡和疾病的主要原因和三分之一 所有癌症都是直接归因于烟草使用的。少数民族和服务不足的人口经验 由于无法获得治疗的不平等，与烟草有关的差距很大，健康后果 烟草，烟草公​​司的营销以及许多其他因素。例如，西班牙裔不太可能 比非西班牙裔白人在戒烟期间从其医疗保健提供者那里获得帮助或 获得药物疗法。此外，烟草是西班牙裔的一个主要公共卫生问题，因为 西班牙裔中的四种主要死亡原因与吸烟有关（即癌症，心脏病，中风）。 因此，美国西班牙裔疾病预防的基石正在减少烟草的使用。尽管有 减少西班牙裔人群中吸烟的重要性，寻找有效的方法是 由于缺乏研究该人群中吸烟的机制的研究所阻碍。作为 在一份突出的报告中指出：“消除健康差异的挑战是不足 对烟草使用，尼古丁成瘾和远端决定因素和远端决定因素的经验理解 研究不足和历史欠佳的人群之间的相关后果”（消除烟草 相关的健康差异：摘要报告）。拟议的研究解决了这一差距。 这项纵向队列研究将研究邻里，个人和急性的影响 成人，西班牙语，西班牙裔戒烟的人际和情境决定因素 从墨西哥裔美国人（MA）队列研究中招募的吸烟者（n = 200）。所有研究程序，治疗 材料和评估将以西班牙语进行。参与者将从前2周开始跟踪 他们退出的日期是在问世后的26周。他们将评估4个连续的星期（1周进攻 在3周后至后）使用科学的生态瞬时评估 （EMA）程序。所有参与者都将接受由尼古丁补丁组成的戒烟治疗 基于我们的经验验证的治疗，自助材料以及简短的面对面和电话咨询 讲西班牙语的西班牙裔吸烟者的干预措施（Wetter等人，印刷中）。 很少有研究检查戒烟的机制 在说西班牙语或西班牙裔吸烟者中，据我们所知，没有一个：（a） 研究了社区的影响，或（b）包括使用EMA调查急性 人际和上下文对退出过程的影响。因此，拟议的研究将使 对该领域的独特贡献，以及有关吸烟的主要报告的关键建议 在少数民族中（USDHHS，1998年）和减少健康差异（USDHHS.2002）。