A Peer Navigator Model to Improve Quit Attempts, Quitline Use, and Smoking Cessation Rates among HIV-positive smokers

用于改善艾滋病毒阳性吸烟者的戒烟尝试、戒烟热线使用和戒烟率的同伴导航模型

• 批准号: 10016255
• 负责人: Patricia Ann Cioe
• 金额: $ 20.52万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-12 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10016255
• 关键词: Abstinence; Address; Adherence; Adult; Biochemical; Caring; Chronic Disease; Clinic; Clinical; Clinical Trials; Communities; Development; Early Diagnosis; Enrollment; Evidence based intervention; Feedback; Foundations; Future; General Population; HIV; HIV Infections; HIV Seropositivity; High Prevalence; Human Resources; Intervention; Link; Longevity; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Modeling; Morbidity - disease rate; Nicotine; Nicotine Dependence; Nurses; Online Systems; Outcome; Participant; Persons; Pharmaceutical Preparations; Pilot Projects; Population; Prevalence; Protocols documentation; Provider; Randomized; Randomized Clinical Trials; Readiness; Recommendation; Reporting; Research; Resources; Risk; Risk Factors; Sample Size; Self Efficacy; Services; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Social Network; Social isolation; Social support; Testing; Text Messaging; Tobacco use; antiretroviral therapy; base; cancer risk; cigarette smoking; clinical care; comparison intervention; effective intervention; follow-up; group counseling; improved; mortality; non-smoker; novel; peer; prevent; programs; quitline; satisfaction; smoking abstinence; smoking cessation; smoking prevalence; standard care

ABSTRACT Cigarette smoking is more prevalent in persons living with HIV (PLWH) in the U.S. when compared with the general population and is linked to increased morbidity and mortality in this population. Furthermore, HIV- positive smokers have increased rates of lung and other smoking-related cancers. Because of their high levels of nicotine dependence, low quit rates, and poor adherence to smoking cessation treatments, PLWH may require additional support for quitting compared with the general population of smokers. Peer Navigators (PNs) have been used in HIV care to improve rates of entry into care, adherence with treatment, and retention in care. Linking HIV-positive smokers with a PN who has quit smoking successfully may improve smoking cessation outcomes among PLWH. The primary objectives of this project is to examine the feasibility and acceptability of a peer navigation social support for smoking cessation (PNSS-S) intervention for HIV-positive smokers. We will determine whether enhanced treatment (using a PN to navigate smoking cessation, help obtain medication and treatment, improve adherence to treatment, and provide social support for quitting) will increase quit attempts and smoking cessation rates (measured by 7-day point prevalence) compared with standard care (SC; provider recommendation to quit and quit line referral using the 5A’s). We will also obtain an effect size estimate for the PNSS-S intervention compared to SC. We will test the initial protocol in an open pilot with six HIV-positive smokers and two PNs. Study participants, PNs, and the study nurse will provide ongoing feedback to revise the preliminary protocol. We will then conduct a pilot RCT with 72 HIV-positive smokers to examine the feasibility, acceptability, and initial efficacy of the novel intervention compared to standard care over 24 weeks of follow-up. This study will be the first to examine the feasibility and initial efficacy of a novel intervention using PNs to improve smoking cessation outcomes in PLWH. Given the high prevalence of smoking and the significant morbidity associated with it in PLWH, the development of effective strategies to reduce the risks related to smoking in this group is critical. If determined to be effective, this intervention could be readily disseminated in HIV clinics. Our study will provide key information on the potential benefit of engaging PNs into a smoking cessation program in a population that is highly dependent on nicotine and highly vulnerable to smoking-related morbidity and mortality.

抽象的 与其他国家相比，美国艾滋病毒感染者 (PLWH) 吸烟更为普遍 一般人群，并与该人群发病率和死亡率的增加有关。 阳性吸烟者的肺癌和其他与吸烟有关的癌症的发病率较高，因为其水平较高。 由于尼古丁依赖、戒烟率低以及戒烟治疗依从性差，PLWH 可能 与一般吸烟者相比，需要额外的戒烟支持。 已用于艾滋病毒护理，以提高进入护理的比率、治疗的依从性和保留率 将 HIV 阳性吸烟者与成功戒烟的 PN 联系起来可能会改善吸烟情况。 该项目的主要目标是检查可行性和有效性。 HIV 阳性者戒烟同伴导航社会支持 (PNSS-S) 干预的可接受性 我们将确定加强治疗（使用 PN 来引导戒烟）是否有帮助。 获得药物和治疗、提高治疗依从性并为戒烟提供社会支持） 与相比，戒烟尝试和戒烟率（以 7 天点流行率衡量）有所增加 标准护理（SC；提供者建议戒烟并使用 5A 的戒烟热线转介）。 与 SC 相比，PNSS-S 干预的效果大小估计 我们将在开放中测试初始协议。 由六名 HIV 阳性吸烟者和两名 PN 进行的试点研究参与者、PN 和研究护士将提供。 我们将持续反馈意见，以修订初步方案，然后对 72 名 HIV 阳性患者进行试点随机对照试验。 吸烟者检查新型干预措施的可行性、可接受性和初步疗效 这项研究将是第一个检验可行性和初步效果的研究。 鉴于以下情况，使用 PNs 改善 PLWH 戒烟结果的新型干预措施的功效。 艾滋病病毒感染者（PLWH）中吸烟的高流行率以及与之相关的显着发病率， 如果确定的话，采取有效的策略来降低该群体与吸烟相关的风险至关重要。 如果有效，这种干预措施可以很容易地在艾滋病毒诊所中传播，我们的研究将提供关键。 有关让 PN 参与人群戒烟计划的潜在益处的信息 它高度依赖尼古丁，并且极易发生与吸烟有关的发病率和死亡率。