A behavioral economic intervention for low-income smokers - Resubmission - 1 - Revision - 1

针对低收入吸烟者的行为经济干预 - 重新提交 - 1 - 修订 - 1

• 批准号: 10824702
• 负责人: Erin Rogers
• 金额: $ 22.68万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-14 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10824702
• 关键词: Address; Administrative Supplement; Adult; Behavior; Communities; Counseling; Data; Data Analytics; Data Collection; Effectiveness; Effectiveness of Interventions; Environment; Ethnic Origin; Face; Financial Hardship; Gender; Goals; Grant; Health; Health Benefit; Housing; Inadequate Sleep Hygiene; Individual; Intervention; Interview; Knowledge; Latina; Latino; Literature; Low income; Maintenance; Measures; Neighborhoods; Outcome; Parents; Participant; Persons; Population; Poverty; Procedures; Process; Qualitative Methods; Race; Randomized; Relapse; Risk; Services; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social Identification; Social Work; Stigmatization; Structure; Surveys; Tobacco use; Trauma; Woman; Work; behavior change; behavioral economics; black men; black women; contextual factors; coping mechanism; cost effectiveness; design; effectiveness evaluation; empowerment; experience; food insecurity; group intervention; improved; income disparities; insight; intersectionality; intervention participants; marginalization; men; novel; parent project; participant enrollment; resilience; response; sleep quality; smoking cessation; social; social determinants; social factors; structural determinants; theories; tobacco cessation intervention; women of color

PROJECT SUMMARY People with low income face unique barriers to cessation, including high levels of financial distress, trauma, and unmet social needs, resulting in the use of smoking as a coping mechanism. Behavioral economics further finds that people experiencing financial hardship must attend to their immediate needs for survival at the expense of delayed goals (such as the long-term health benefits of quitting smoking). Interventions that alleviate financial hardship and other social needs may improve quit rates in this population. Our parent R37 grant is evaluating the effectiveness, behavioral economic mechanisms, and cost-effectiveness of an intervention that integrates financial coaching and referral to financial empowerment services and social services into smoking cessation treatment. Recent trauma-informed theories of behavior suggest that intervention approaches that that shift the focus away from individual determinants of tobacco use to the social and structural determinants tobacco use may improve intervention engagement and effectiveness by creating a more holistic, non-judgmental and resilience-oriented smoking cessation process. Additionally, participants with multiple marginalized social identities may have unique experiences and smoking cessation processes while participating in interventions that acknowledge one’s broader lived experience and social determinants of tobacco use. Lastly, co-occurring health conditions, such as poor sleep hygiene, may interact with tobacco cessation interventions but these interactions have been under-studied in the literature. The overall objective of this administrative supplement is to use qualitative methods to identify multi-level factors not included in the original R37 proposal that may enhance or limit the intervention’s impacts on treatment engagement, initial smoking cessation, and long-term cessation maintenance. The qualitative results will be further used to inform the selection of new quantitative measures to include in the parent R37 grant’s data collection and analytic approaches to provide insights into why the intervention works, for whom, and in which contexts. The Specific Aims of the proposed supplement are to: Aim 1) Qualitatively examine intervention-related and context-related factors that may enhance or limit the intervention’s impacts on treatment engagement, initial smoking cessation, and smoking cessation maintenance, with Sub-Aim 1.1) Explore how social factors and other health conditions may interact to influence participants’ intervention experiences, behavior change processes, and the intervention’s potential mechanisms of action. Aim 2) Guided by the qualitative themes identified during Aim 1, select new multi-level quantitative measures to include in the parent R37 grant’s data collection and analytic approaches to enhance the parent project’s understanding of the intervention’s key mechanisms of action and contextual influences. The results are expected to generate important insights about interventions that address sociocontextual determinants of tobacco use in people with low income who smoke.

项目概要 低收入人群面临着独特的戒烟障碍，包括严重的经济困难、创伤和戒烟障碍。 行为经济学进一步发现，社会需求未得到满足，导致吸烟作为应对机制。 遭受经济困难的人们必须以牺牲生存为代价来满足眼前的生存需求 延迟的目标（例如戒烟的长期健康益处）。 我们的母公司 R37 补助金正在评估困难和其他社会需求可能会提高该人群的戒烟率。 整合干预措施的有效性、行为经济机制和成本效益 财务辅导和转介至财务赋权服务和社会服务以帮助戒烟 最近的创伤相关行为理论表明，干预方法可以改变行为。 将重点从烟草使用的个人决定因素转向烟草使用的社会和结构决定因素 可以通过创建更全面、非评判性和 以复原力为导向的戒烟过程。 身份在参与干预时可能有独特的经历和戒烟过程 承认一个人更广泛的生活经历和烟草使用的社会决定因素。 健康状况，例如不良的睡眠卫生，可能与戒烟干预措施相互作用，但这些 该行政补充的总体目标是： 使用定性方法来识别原始 R37 提案中未包含的多层次因素，这些因素可能会 增强或限制干预措施对治疗参与度、初始戒烟和长期戒烟的影响 定性结果将进一步用于指导新定量的选择。 将措施纳入母 R37 拨款的数据收集和分析方法，以提供洞察 干预措施为何有效、对谁有效以及在哪些情况下有效。 拟议补充的具体目标是。 目标 1) 定性检查可能增强或限制干预相关和环境相关的因素 干预对治疗参与度、初始戒烟和戒烟维持的影响， 子目标 1.1）探索社会因素和其他健康状况如何相互作用以影响参与者的 干预经验、行为改变过程以及干预的潜在作用机制。 目标 2) 在目标 1 期间确定的定性主题的指导下，选择新的多层次定量措施 将母项目 R37 拨款的数据收集和分析方法纳入其中，以增强母项目的 了解干预的关键作用机制和背景影响。 预计将产生关于解决社会背景决定因素的干预措施的重要见解 低收入吸烟者的烟草使用情况。