Reducing Tobacco Related Health Disparities

减少烟草相关的健康差异

基本信息

批准号：
7742103
负责人：
David W Wetter
金额：
$ 64.39万
依托单位：
UNIVERSITY OF TX MD ANDERSON CAN CTR
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-01 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7742103
关键词：
Abstinence Address Advocate Affect Alcohol dependence American Cancer Society Behavior Therapy Chronic Care Cigarette Smoker Cities Clinic Clinical Practice Guideline Cognitive Community Health Counseling County County Hospitals Dependence Disease Family Guidelines Healthcare Systems Individual Intervention Letters Low income Mediating Motivation Participant Phase Problem Solving Process Public Health Randomized Readiness Resources Role Self Efficacy Services Smoker Social Change Staging Stress Telephone Texas Time Tobacco Tobacco use Underinsured Uninsured Wellness Program base behavior change cost effectiveness depression design disorder later incidence prevention follow-up health disparity motivational enhancement therapy primary outcome public health relevance quitline safety net secondary outcome self help smoking cessation social social cognitive theory standard care stressor theories tobacco abstinence

项目摘要

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: 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.

描述（由申请人提供）：拟议的研究将评估理论上和基于经验的“动机和解决问题”（地图）干预措施的效力和成本效益，以促进和促进低收入吸烟者的戒烟，而低收入的吸烟者却不准备退出。目前约有90％的吸烟者（超过4100万人）尚未准备好在任何时间点戒烟。地图是一种促进行为变化的整体，动态的方法，它利用基于动机访谈（MI）的综合动机增强和社会认知方法（MI）治疗烟草使用和依赖性临床实践指南以及社会认知理论。地图都是为所有吸烟者而设计的，无论他们准备退出或退出过程的阶段，特别是针对变化的动机和内在动机，社会认知构造（例如，代理/自我效能感）以及与低收入吸烟者（例如压力，家庭问题，家庭问题，财务资源）特别相关的其他关键因素。由于地图涵盖了一种慢性护理类型的方法来治疗烟草使用，并围绕着“健康计划”旋转，该计划解决了低收入人群中普遍存在的许多障碍和关注点，因此我们认为这特别适合治疗此类吸烟者。参与者（n = 900）将是哈里斯县医院区（HCHD）经营的社区健康诊所的吸烟者。 HCHD是为休斯顿和哈里斯县服务的安全网公共卫生保健系统，该系统是美国第四大城市和人口大多的县。 HCHD仅服务于未保险和保险不足。所有参与者将被遵循两年的时间，并将随机分配给三组之一：1）标准治疗[ST]，2）MAPS-4或3）MAPS-8。 ST将包括一封信，将吸烟者推荐给德克萨斯州Quitline和标准的自助材料。 ST将总共发生4次（基线，6、12和18个月）。 MAPS-4将在2年的时间内由ST加4个主动地图电话咨询会议组成。 MAPS-8将在2年内由ST加8个主动电话咨询会议组成。评估将在基线后的基线和基线后的6、12、18和24个月进行。主要结果变量是在6、12、18和24个月的随访中戒酒，以及24个月的随访。次要结果将包括退出尝试和使用德克萨斯Quitline。公共卫生相关性：拟议的研究将评估理论上和基于经验的“动机和解决问题”（地图）干预措施的效力和成本效益，以促进和促进尚未准备好戒烟的低收入吸烟者的戒烟。目前约有90％的吸烟者（超过4100万人）尚未准备好在任何时间点戒烟。