Helping the poor quit smoking: specialized quitlines and meeting basic needs

帮助穷人戒烟：专门的戒烟热线和满足基本需求

基本信息

批准号：
9175766
负责人：
MATTHEW W. KREUTER
金额：
$ 62.18万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-07-01 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9175766
关键词：
Abstinence Address American Behavioral Biochemical Communication Research Costs and Benefits Counseling Demographic Factors Disadvantaged Education Effectiveness Enrollment Evidence based intervention Face Food Food Safety Health Health Communication Hour Housing Income Individual Industry Internet Intervention Laboratories Life Low Income Population Low income Methods Missouri Outcome Study Participant Patient Self-Report Physicians Poverty Prevalence Printing Provider Randomized Reporting Research Safety Sampling Services Smoke Smoker Smoking Social Work Telephone Testing Text Time Tobacco Training Use Effectiveness Validation Vulnerable Populations Work cancer health disparity demographics design economic evaluation evidence base follow-up improved innovation meetings member navigator intervention nicotine replacement novel strategies population based programs psychological distress quitline self help smoking cessation socioeconomics success

项目摘要

Smoking in the U.S. follows a clear socio-economic gradient: low-income Americans smoke more and quit less than those with more education and income. Evidence-based interventions like tobacco quitlines are designed to make effective smoking cessation services available on a population basis to all smokers, regardless of financial means. Yet these interventions were not designed specifically for economically vulnerable populations, and therefore don't address many of the unique challenges faced by low- income smokers. As the demographics of smoking in the U.S. continue to shift, so too must the strategies employed to control smoking, including helping smokers quit. The proposed study will test the effects of two innovations to help low-income smokers quit: a Specialized Quitline and Basic Needs navigation. In low-income populations, basic needs like food, housing, personal safety and money for necessities supersede health needs. We have demonstrated that among low-income smokers, those with multiple unmet basic needs are significantly less likely to contact a quitline referral they received, and less likely to remember even getting the referral. But when basic needs problems are resolved, the odds of calling a quitline increase. Addressing basic needs should therefore increase low-income smokers' participation in quit smoking programs. However, those programs will have limited effectiveness if they are not made relevant to economically vulnerable populations. Thus proven approaches like quitlines should be more beneficial when they are adapted to the context and life circumstances of the poor. Using a 2x2 randomized factorial design, we will compare the effects of Standard and Specialized Quitlines with and without a Basic Needs navigator on smoking cessation among 2000 low-income smokers. The primary study outcome is self-reported 7-day point prevalence abstinence at 6-month follow up, with biochemical validation. This statewide field trial will draw smokers from United Way 2-1-1 Missouri and refer them to the Missouri Tobacco Quitline, provided by Alere Wellbeing, Inc. Both are key members of the study team. Embedding the study in these practice agencies will accelerate the path to application should our findings support it.

美国的吸烟遵循明显的社会经济梯度：低收入美国人与受教育程度较高、收入较高的人相比，吸烟较多，戒烟较少。循证戒烟热线等干预措施旨在有效戒烟以人口为基础向所有吸烟者提供的服务，无论经济状况如何。然而，这些干预措施并不是专门针对经济弱势群体而设计的人口，因此无法解决低收入人群面临的许多独特挑战收入吸烟者。随着美国吸烟人口结构的不断变化，吸烟人群也在不断变化必须采取控制吸烟的策略，包括帮助吸烟者戒烟。拟议的研究将测试两项创新对帮助低收入吸烟者的效果戒烟：专业戒烟热线和基本需求导航。在低收入人群中，食物、住房、人身安全和必需品金钱等基本需求取代健康需求。我们已经证明，在低收入吸烟者中，那些患有多种未满足的基本需求极不可能联系戒烟热线转介收到，甚至不太可能记得得到推荐。但当有基本需求时问题得到解决后，拨打戒烟热线的可能性就会增加。满足基本需求因此，应该增加低收入吸烟者参与戒烟计划。然而，如果这些计划与以下领域无关，其效果将有限：经济弱势群体。因此，像戒烟热线这样经过验证的方法应该是当它们适应穷人的背景和生活环境时，就会更加有益。使用 2x2 随机因子设计，我们将比较标准和带或不带戒烟基本需求导航器的专业戒烟热线 2000 名低收入吸烟者。主要研究结果是自我报告的 7 天 6 个月随访时的点禁欲率，并进行生化验证。这全州范围内的现场试验将吸引来自 United Way 2-1-1 Missouri 的吸烟者，并将他们推荐给密苏里州烟草戒烟热线，由 Alere Wellbeing, Inc. 提供。两人都是主要成员研究小组的成员。将研究嵌入这些实践机构将加速如果我们的研究结果支持的话，应用路径。