Ending Tobacco Use through Interactive Tailored Messaging for Cambodian People Living with HIV/AIDS (EndIT)

通过为柬埔寨艾滋病毒/艾滋病感染者提供交互式定制信息来结束烟草使用 (EndIT)

• 批准号: 10697333
• 负责人: Thanh C. Bui
• 金额: $ 69.94万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-17 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10697333
• 关键词: Abstinence; Address; Adoption; Adult; Behavior Therapy; Biochemical; Cambodia; Cambodian; Cancer Center; Caring; Cellular Phone; Clinic; Collaborations; Complement; Comprehensive Health Care; Confidence Intervals; Control Groups; Country; Data; Developed Countries; Development; Enrollment; Evaluation; Female; HIV; HIV/AIDS; Health Promotion; Health Sciences; Healthcare; Income; Influentials; Intervention; Life; Literature; Mediator; Modeling; Morbidity - disease rate; Oklahoma; Participant; Patient Self-Report; Persons; Pharmacological Treatment; Phase; Pilot Projects; Prevalence; Proliferating; Public Health; Randomized; Randomized, Controlled Trials; Relative Risks; Reporting; Research; Research Personnel; Resource-limited setting; Smoke; Smoking Cessation Intervention; Special Population; Surveys; Tobacco; Tobacco Use Cessation; Tobacco use; Tobacco-Related Carcinoma; Treatment Efficacy; Universities; University of Texas M D Anderson Cancer Center; Wireless Technology; Woman; World Health Organization; Writing; antiretroviral therapy; brief advice; care delivery; cigarette smoke; comparative cost effectiveness; cost effective; economic evaluation; efficacy evaluation; follow-up; high risk; improved; low income country; mHealth; male; men; mobile computing; mortality; nicotine replacement; novel; primary outcome; randomized trial; recruit; secondary outcome; self help; sexual identity; smoking cessation; smoking prevalence; standard care; tailored messaging; text messaging intervention; tobacco cessation intervention; tobacco control; treatment group; treatment program

PROJECT SUMMARY Although the prevalence of tobacco use has declined in developed nations in recent decades, the prevalence of smoking remains strikingly high in many low-income countries. In Cambodia, recent national surveys have indicated that 33%–43% of adult men and 3% of adult women smoke cigarettes. Certain special populations, such as people living with HIV (PLWH), are confronted with disproportionately high risks associated with tobacco use. Available estimates indicate that 43%–65% of male PLWH and 3%–5% of female PLWH smoke cigarettes. Although Cambodia has widespread coverage for antiretroviral treatment (ART), no known efforts have been made to provide tobacco treatment to ART recipients who smoke. Thus, complementing ART with efficacious tobacco cessation treatment offers tremendous potential to improve HIV care and to prolong life for PLWH. To address this need, we propose a randomized controlled trial with pharmacological and behavioral treatment components, including a fully automated, interactive smartphone-delivered intervention. Mobile health (mHealth) interventions are proliferating in the US, but efforts to utilize similar approaches in Cambodia are extremely limited. The World Health Organization acknowledges that mHealth is cost-effective, scalable, and sustainable, including for the least developed countries. We have already developed the mHealth platform and intervention approach proposed for this study, and we have completed a pilot study with 50 Cambodian PLWH who smoked and received care at an ART clinic. Results from this pilot indicated that the biochemically confirmed, 7-day point prevalence abstinence rates at 2-months follow-up were 40% in the group receiving the mHealth intervention vs. 8% in a standard care control group (relative risk: 5.0). In this proposed study, Cambodian PLWH of all sexual identities will be recruited through the 6 largest ART clinics in Phnom Penh, which provide comprehensive care to more than 14,000 PLWH. Participants (n=800) will be randomized to one of 2 treatment groups: Standard Care (SC; n=400), or Automated Messaging (AM; n=400). SC consists of brief advice to quit smoking delivered by research staff, self-help written materials, and an 8-week supply of nicotine replacement therapy (NRT) in the form of transdermal patches. AM consists of the SC components plus a fully automated smartphone-based treatment program that involves interactive and tailored proactive messaging. The primary outcome is biochemically confirmed self-reported 7-day point prevalence abstinence at 12-months post-study enrollment. Secondary outcomes include abstinence at 3- and 6-months post-enrollment. The primary aims are to evaluate the efficacy of AM for Cambodian PLWH who smoke and to compare the cost- effectiveness of AM vs. SC. If our findings indicate that AM is efficacious and cost-effective, our collaboration with influential Cambodian governmental agencies will facilitate wide-scale implementation to HIV clinics across the country. Thus, the project has the potential to transform HIV care delivery throughout the country and to reduce tobacco-induced cancer morbidity and mortality significantly.

项目概要 尽管近几十年来发达国家的烟草使用流行率有所下降，但 在柬埔寨，最近的全国调查显示，许多低收入国家的吸烟率仍然高得惊人。 表明 33%–43% 的成年男性和 3% 的成年女性吸烟， 例如艾滋病毒感染者（PLWH），面临着与艾滋病相关的不成比例的高风险 现有估计表明，43%–65% 的男性感染者和 3%–5% 的女性感染者吸烟。 尽管柬埔寨广泛开展抗逆转录病毒治疗（ART），但尚无已知的努力。 已为吸烟的 ART 接受者提供烟草治疗，从而补充了 ART。 有效的戒烟治疗为改善艾滋病毒护理和延长生命提供了巨大的潜力 为了满足这一需求，我们提出了一项药理学和行为学随机对照试验。 治疗组件，包括全自动、交互式智能手机提供的干预措施。 美国的健康（移动医疗）干预措施正在激增，但柬埔寨也在努力采用类似的方法 世界卫生组织承认移动医疗具有成本效益、可扩展、 和可持续的，包括为最不发达国家开发移动医疗平台。 以及本研究提出的干预方法，我们已经完成了一项针对 50 名柬埔寨人的试点研究 吸烟并在 ART 诊所接受护理的感染者该试点结果表明，生化检查结果显示， 经证实，在 2 个月的随访中，接受治疗组的 7 天点戒烟率为 40% 移动健康干预与标准护理对照组的 8%（相对风险：5.0）。 所有性别身份的柬埔寨艾滋病病毒感染者将通过金边6家最大的ART诊所招募， 为超过 14,000 名 PLWH 参与者（n=800）提供全面护理，该项目将被随机分配到一名。 2 个治疗组：标准护理（SC；n=400）或自动消息传递（AM；SC；n=400）。 研究人员提供的戒烟建议、自助书面材料以及 8 周的尼古丁供应 AM 透皮贴剂形式的替代疗法 (NRT) 由 SC 成分和完全成分组成。 基于智能手机的自动化治疗计划，涉及交互式和定制的主动消息传递。 主要结局是生化证实的 12 个月时自我报告的 7 天点流行率戒断率 次要结果包括入学后 3 个月和 6 个月的禁欲。 主要目的是评估 AM 对吸烟的柬埔寨艾滋病病毒感染者的疗效，并比较成本 AM 与 SC 的有效性 如果我们的研究结果表明 AM 有效且具有成本效益，那么我们的合作 与有影响力的柬埔寨政府机构合作将促进艾滋病毒诊所的大规模实施 因此，该项目有可能改变全国范围内的艾滋病毒护理服务。 并显着降低烟草引起的癌症发病率和死亡率。

项目成果

Ending Tobacco Use Through Interactive Tailored Messaging for Cambodian People With HIV (Project EndIT): Protocol for a Randomized Controlled Trial.

通过为柬埔寨艾滋病毒感染者提供交互式定制信息来结束烟草使用（EndIT 项目）：随机对照试验方案。

• 发表时间: 2023-06-29
• 影响因子: 1.7
• 作者: Bui, Thanh Cong;Hoogland, Charles E;Chhea, Chhorvann;Sopheab, Heng;Ouk, Vichea;Samreth, Sovannarith;Hor, Bunleng;Vidrine, Jennifer I;Businelle, Michael S;Shih, Ya Chen Tina;Sutton, Steven K;Jones, Sarah R;Shorey Fennell, Bethany;Cottrell
• 通讯作者: Cottrell