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Cartujano-Barrera F, Cox LS, Catley D, Cai X, Diaz FJ, Arana-Chicas E, Chávez-Iñiguez A, Ogedegbe C, Graves KD, Rivera MP, Ponce A, Ellerbeck EF, Cupertino AP. Decídetexto: Mobile Cessation Support for Latino Adults Who Smoke: A Randomized Clinical Trial. Chest 2024:S0012-3692(24)04904-3. [PMID: 39134144 DOI: 10.1016/j.chest.2024.07.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 07/01/2024] [Accepted: 07/25/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Latino adults experience multiple barriers to health care access and treatment that result in tobacco-related disparities. Mobile interventions have the potential to deliver smoking cessation treatment among Latino adults, the highest users of mobile technologies. RESEARCH QUESTION Is Decídetexto, a culturally accommodated mobile health intervention, more effective for smoking cessation compared with standard care among Latinx adults who smoke? STUDY DESIGN AND METHODS A two-arm parallel group randomized clinical trial (RCT) was conducted in Kansas, New Jersey, and New York between October 2018 and September 2021. Eligible Latino adults who smoke (n = 457) were randomly assigned to Decídetexto or a standard care group. The primary outcome was biochemically verified 7-day smoking abstinence at week 24. Secondary outcomes included self-reported 7-day smoking abstinence at weeks 12 and 24 and uptake and adherence of nicotine replacement therapy (NRT). RESULTS Participants' mean age was 48.7 (SD, 11.1) years, 45.2% were female, and 50.3% smoked ≥10 cigarettes per day. Two hundred twenty-nine participants were assigned to Decídetexto and 228 to standard care. Treating those lost to follow-up as participants who continued smoking, 14.4% of participants in the Decídetexto group were biochemically verified abstinent at week 24 compared with 9.2% in the standard care group (OR, 1.66; 95% CI, 0.93-2.97; P = .09). Treating those lost to follow-up as participants who continued smoking, 34.1% of the participants in the Decídetexto group self-reported smoking abstinence at week 24 compared with 20.6% of participants in the standard care group (OR, 1.99; 95% CI, 1.31-3.03; P < .001). Analyzing only participants who completed the assessment at week 24, 90.6% (174/192) of participants in the Decídetexto group self-reported using NRT for at least 1 day compared with 70.2% (139/198) of participants in standard care (OR, 4.10; 95% CI, 2.31-7.28; P < .01). INTERPRETATION Among Latino adults who smoke, the Decídetexto intervention was not associated with a statistically significant increase in biochemically verified abstinence at week 24. However, the Decídetexto intervention was associated with a statistically significant increase in self-reported 7-day smoking abstinence at weeks 12 and 24 and uptake of NRT. This RCT provides encouragement for the use of Decídetexto for smoking cessation among Latino adults. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03586596.
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Affiliation(s)
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO
| | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | - Francisco J Diaz
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, MO
| | - Evelyn Arana-Chicas
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ
| | - Arlette Chávez-Iñiguez
- Emergency and Trauma Center, Hackensack University Medical Center (C. O.), Hackensack, NJ
| | - Chinwe Ogedegbe
- Department of Oncology, Georgetown University, Washington, DC
| | - Kristi D Graves
- Department of Oncology, Georgetown University, Washington, DC
| | - M Patricia Rivera
- Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | | | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY; Department of Surgery, University of Rochester Medical Center, Rochester, NY
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Alaniz-Cantú EI, Goodwin K, Smith L, Acosta E, Chávez-Iñiguez A, Evans MJ, Gaitán M, Lei F, Yousefi-Nooraie R, Fiscella KA, Rivera MP, Cupertino AP, Cartujano-Barrera F. Understanding the perceived benefits, barriers, and cues to action for lung cancer screening among Latinos: A qualitative study. Front Oncol 2024; 14:1365739. [PMID: 38571494 PMCID: PMC10987732 DOI: 10.3389/fonc.2024.1365739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Rates of lung cancer screening among Latinos remain low. The purpose of the study was to understand the perceived benefits, barriers, and cues to action for lung cancer screening among Latinos. Methods Participants (N=20) were recruited using community-based recruitment strategies. Eligibility criteria included: 1) self-identified as Hispanic/Latino, 2) spoke English and/or Spanish, and 3) met the USA Preventive Services Task Force eligibility criteria for lung cancer screening. Interviews were conducted in Spanish and English, audio recorded, and transcribed verbatim. Using the health belief model, a qualitative theoretical analysis was used to analyze the interviews. Results Participants' mean age was 58.3 years old (SD=5.8), half of the participants were female, 55% had completed high school or lower educational level, and 55% reported speaking more Spanish than English. All participants were currently smoking. Fourteen participants (70%) were unaware of lung cancer screening, and eighteen (90%) did not know they were eligible for lung cancer screening. Regarding lung cancer screening, participants reported multiple perceived benefits (e.g., smoking cessation, early detection of lung cancer, increased survivorship) and barriers (e.g., fear of outcomes, cost, lung cancer screening not being recommended by their clinician). Lastly, multiple cues to actions for lung cancer screening were identified (e.g., family as a cue to action for getting screened). Conclusions Most Latinos who were eligible for lung cancer screening were unaware of it and, when informed, they reported multiple perceived benefits, barriers, and cues to action. These factors provide concrete operational strategies to address lung cancer screening among Latinos.
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Affiliation(s)
- Edgar I. Alaniz-Cantú
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Kalese Goodwin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - London Smith
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Eliany Acosta
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Arlette Chávez-Iñiguez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Mary Jo Evans
- Imaging Population Health Programs, University of Rochester Medical Center, Rochester, NY, United States
| | - Marcela Gaitán
- National Alliance for Hispanic Health, Washington, DC, United States
| | - Fang Lei
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | - Reza Yousefi-Nooraie
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Kevin A. Fiscella
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - M. Patricia Rivera
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States
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Orfin RH, Siddalingaiah S, Dontu V, Estrada B, Martinez C, Guerra D, Carrillo H, Cervantes-Díaz MJ, Rodríguez-Rojas DV, Rahman I, McIntosh S, Ossip DJ, Cupertino AP, Cartujano-Barrera F. Development of a Vaping Cessation Text Messaging Intervention for Latino Young Adults: A Participatory Research Approach. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024:2752535X231225928. [PMID: 38183157 DOI: 10.1177/2752535x231225928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
OBJECTIVE Describe the participatory research procedures of developing Kick Vaping, a vaping cessation text messaging intervention for Latino young adults, available in English and Spanish. METHODS Using community-based recruitment strategies, we convened a Community Advisory Board (CAB) of eight Latino young adults (ages 18-25) with different vaping experiences (never users, ex-users, and current users of e-cigarettes). Members held a series of working meetings to adapt Decídetexto, a smoking cessation text messaging intervention, for vaping cessation. Members provided iterative feedback on the text messages until reaching a consensus on content. Messages were translated from English to Spanish following a committee approach. Readability assessments were used to evaluate the legibility of the text messages. RESULTS At baseline, members' mean age was 22.6 years old (SD 3.1), 75% were female, and 50% used both English and Spanish equally. Three members (37.5%) were ex-users and one member (12.5%) was a current user of e-cigarettes. 18 meetings provided sufficient opportunities for iterative feedback on the text messages for developing the intervention. The Kick Vaping intervention consists of 208 text messages. Readability scores of the text messages in English were equivalent to fourth and fifth grade, and in Spanish were equivalent to easy and somewhat easy. CONCLUSION It is feasible and practical to build participatory research among Latino young adults focused on vaping cessation. Members of the CAB added innovation and creativity to the development of the vaping cessation text messaging intervention. Future research is needed to evaluate the impact of the intervention on vaping cessation.
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Affiliation(s)
- Rafael H Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Simran Siddalingaiah
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Vignya Dontu
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Bianca Estrada
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Chabeli Martinez
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Darcy Guerra
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - Hanzell Carrillo
- The Kick Vaping Latino Advisory Board, Rochester, NY, United States of America
| | - María José Cervantes-Díaz
- Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosi, Mexico
- Residencia de Medicina Preventiva, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Irfan Rahman
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
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Hernández-Torres R, Alaniz-Cantu E, Bautista Rojas MV, Lara D, Merritt S, DeJesus E, D’Abundo ML, McIntosh S, Ossip DJ, Fuller D, Rivera MP, Cupertino AP, Cartujano-Barrera F. Understanding the Perspectives of Latino Adults Who Smoke on Physical Activity: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3128. [PMID: 36833833 PMCID: PMC9964119 DOI: 10.3390/ijerph20043128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/09/2023]
Abstract
Smoking and sedentary lifestyle frequently co-occur among Latinos. Evidence suggests that moderate to vigorous physical activity (MVPA) may enhance smoking cessation rates. However, this synergistic phenomenon has not been studied among Latinos, the largest minority group in the United States. This qualitative study consisted of semi-structured interviews in English or Spanish with Latino adults who smoke (n = 20) to understand their perspectives on physical activity. Participants were recruited using community-based recruitment strategies. The Health Belief Model was used as a framework for qualitative theoretical analysis. Multiple perceived benefits (e.g., mood management, strategy to quit smoking), susceptibility (e.g., risk of cardiovascular diseases, physical impairment), and barriers (e.g., lack of social support, low financial resources) of being physically active were identified. Moreover, multiple cues to action to do physical activity (e.g., being a role model, spending time with family and friends) were identified. These factors provide concrete operational strategies to address smoking cessation and physical activity among Latinos. Further research is needed on how best to integrate these perspectives into smoking cessation interventions.
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Affiliation(s)
| | - Edgar Alaniz-Cantu
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | | | - Daimarelys Lara
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Sarah Merritt
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Elisa DeJesus
- Health Literacy & Language Services, Ibero-American Action League, Inc., Rochester, NY 14605, USA
| | - Michelle Lee D’Abundo
- Department of Interprofessional Health Sciences and Health Administration, Seton Hall University, Nutley, NJ 07110, USA
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Daniel Fuller
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - M. Patricia Rivera
- Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA
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Cartujano-Barrera F, Hernández-Torres R, Orfin RH, Chávez-Iñiguez A, Alvarez Lopez O, Azogini C, Bermudez D, Arana-Chicas E, Cai X, McIntosh S, Ossip DJ, Cupertino AP. Proactive and Reactive Recruitment of Black and Latino Adolescents in a Vaping Prevention Randomized Controlled Trial. CHILDREN (BASEL, SWITZERLAND) 2022; 9:937. [PMID: 35883921 PMCID: PMC9321256 DOI: 10.3390/children9070937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to assesses the effectiveness of proactive and reactive methods in the recruitment of Black and Latino adolescents into a vaping-prevention randomized controlled trial (RCT). This study also assessed the characteristics of study participants by recruitment method. Proactive recruitment strategies included study presentations at community-based events (e.g., festivals, health fairs), school-based events (e.g., back-to-school events, after-school programs), and recreational centers (e.g., fitness centers, malls). Reactive recruitment strategies included study advertisements via social media (e.g., Facebook posts shared by local community-based organizations), word of mouth, and an academic-based research hub. Using proactive and reactive methods, in a 4-month period, 362 Black and Latino adolescents were successfully enrolled into the RCT. Compared to the proactive method, adolescents screened reactively were equally likely to be eligible but significantly more likely to enroll in the study. However, both proactive and reactive strategies made notable contributions to the overall recruitment effort. Moreover, proactive and reactive methods attracted adolescents with different characteristics (e.g., age, gender, sexual orientation, etc.). These findings suggest that both proactive and reactive recruitment strategies should be implemented for studies interested in recruiting a diverse sample of Black and Latino adolescents.
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Affiliation(s)
- Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Ruthmarie Hernández-Torres
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Rafael H. Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Arlette Chávez-Iñiguez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Olga Alvarez Lopez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Chiamaka Azogini
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Diana Bermudez
- Hackensack High School, Hackensack Public Schools, Hackensack, NJ 07601, USA;
| | - Evelyn Arana-Chicas
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.H.-T.); (R.H.O.); (A.C.-I.); (O.A.L.); (C.A.); (E.A.-C.); (S.M.); (D.J.O.); (A.P.C.)
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Arana-Chicas E, Cartujano-Barrera F, Ogedegbe C, Ellerbeck EF, Cox LS, Graves KD, Diaz FJ, Catley D, Cupertino AP. Feasibility and Effectiveness of Recruiting Latinos in Decídetexto-A Smoking Cessation Clinical Trial from an Emergency Department Patient Registry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10859. [PMID: 34682601 PMCID: PMC8535914 DOI: 10.3390/ijerph182010859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 12/19/2022]
Abstract
There is an underrepresentation of Latinos in smoking cessation clinical trials. This study describes the feasibility and effectiveness of recruiting Latino smokers in the U.S. from an emergency department (ED) patient registry into a randomized smoking cessation clinical trial. Recruitment occurred from the Hackensack University Medical Center ED. Potential participants were contacted from a patient registry. The primary outcome was whether the participant responded to a call or text. Secondary outcomes included the best day of the week, week of the month, and time of day to obtain a response. Of the 1680 potential participants, 1132 were called (67.5%), while 548 (32.5%) were texted. For calls, response rate was higher compared to text (26.4% vs 6.4%; p < 0.001). More participants were interested in the study when contacted by calls compared to text (11.4% vs. 1.8%) and more participants were enrolled in the study when contacted by calls compared to text (1.1% vs. 0.2%). Regression models showed that ethnicity, age, time of day, and week of the month were not significantly associated with response rates. Recruitment of Latinos from an ED patient registry into a smoking cessation clinical trial is feasible using call and text, although enrollment may be low.
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Affiliation(s)
- Evelyn Arana-Chicas
- Department of Surgery and Public Health Sciences, School of Medicine, University of Rochester, Rochester, NY 14642, USA
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, School of Medicine, University of Rochester, Rochester, NY 14642, USA; (F.C.-B.); (A.P.C.)
| | - Chinwe Ogedegbe
- Emergency Trauma Department, Hackensack University Medical Center, Hackensack, NJ 07601, USA;
| | - Edward F. Ellerbeck
- Department of Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA; (E.F.E.); (L.S.C.)
| | - Lisa Sanderson Cox
- Department of Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA; (E.F.E.); (L.S.C.)
| | - Kristi D. Graves
- Department of Oncology, School of Medicine, Georgetown University, Washington, DC 20007, USA;
| | - Francisco J. Diaz
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Delwyn Catley
- Department of Pediatrics, Children’s Mercy Hospital, School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA;
| | - Ana Paula Cupertino
- Department of Public Health Sciences, School of Medicine, University of Rochester, Rochester, NY 14642, USA; (F.C.-B.); (A.P.C.)
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Cartujano-Barrera F, Lee D’Abundo M, Arana-Chicas E, Chock S, Valera P, Kamen CS, Cupertino AP. Barriers and Facilitators of Smoking Cessation among Latinos Living with HIV: Perspectives from Key Leaders of Community-Based Organizations and Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073437. [PMID: 33810269 PMCID: PMC8036939 DOI: 10.3390/ijerph18073437] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to identify the perspectives from key leaders of community-based organizations (CBOs) and clinics serving people living with HIV on barriers and facilitators of smoking cessation among Latino smokers living with HIV. Semi-structured interviews were conducted in English and Spanish with 10 key leaders. Using a social ecological model, qualitative theoretical analysis was used to analyze the results. Participants identified barriers at the individual (e.g., low education level, HIV, and financial stress), interpersonal (e.g., language barriers, low social support), organizational (e.g., lack of smoking cessation resources and targeted interventions), community (e.g., HIV and mental health stigma), and policy (e.g., paperwork for insurance) level. Participants identified facilitators at the individual (e.g., high participation in trials, good medication adherence), interpersonal (e.g., no smoking in social circles), organizational (e.g., bilingual staff, culturally competent care), community (e.g., providing transportation, the coronavirus disease 2019 as an opportunity for smoking cessation), and policy level (e.g., existence of funding, comprehensive insurance programs). These results provide operational strategies to address smoking disparities among Latino smokers living with HIV. Further research is needed on how to integrate these perspectives into effective smoking cessation interventions.
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Affiliation(s)
- Francisco Cartujano-Barrera
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
- Correspondence: ; Tel.: +1-585-353-0035
| | - Michelle Lee D’Abundo
- Department of Interprofessional Health Sciences and Health Administration, Seton Hall University, Nutley, NJ 07110, USA;
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Surina Chock
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Pamela Valera
- Department of Urban-Global Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Charles S. Kamen
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
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Cartujano-Barrera F, Sanderson Cox L, Arana-Chicas E, Ramírez M, Perales-Puchalt J, Valera P, Díaz FJ, Catley D, Ellerbeck EF, Cupertino AP. Feasibility and Acceptability of a Culturally- and Linguistically-Adapted Smoking Cessation Text Messaging Intervention for Latino Smokers. Front Public Health 2020; 8:269. [PMID: 32714891 PMCID: PMC7344180 DOI: 10.3389/fpubh.2020.00269] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/26/2020] [Indexed: 11/18/2022] Open
Abstract
Objective: Assess the feasibility and acceptability of a culturally- and linguistically-adapted smoking cessation text messaging intervention for Latino smokers. Methods: Using a community-based strategy, 50 Latino smokers were recruited to participate in a smoking cessation pilot study. Participants received a 12-week text messaging intervention and were offered Nicotine Replacement Therapy (NRT) at no cost. We assessed biochemically verified abstinence at 12 weeks, text messaging interactivity with the program, NRT utilization, self-efficacy, therapeutic alliance, and satisfaction. Results: Participants were 44.8 years old on average (SD 9.80), and they were primarily male (66%) and had no health insurance (78%). Most of the participants were born in Mexico (82%) and were light smokers (1–10 CPD) (68%). All participants requested the first order of NRT, and 66% requested a refill. Participants sent an average of 39.7 text messages during the 12-week intervention (SD 82.70). At 12 weeks, 30% of participants were biochemically verified abstinent (88% follow-up rate) and working alliance mean value was 79.2 (SD 9.04). Self-efficacy mean score increased from 33.98 (SD 10.36) at baseline to 40.05 (SD 17.65) at follow-up (p = 0.04). The majority of participants (90.9%, 40/44) reported being very or extremely satisfied with the program. Conclusion: A culturally- and linguistically-adapted smoking cessation text messaging intervention for Latinos offers a promising strategy to increase the use of NRT, generated high satisfaction and frequent interactivity, significantly increased self-efficacy, produced high therapeutic alliance, and resulted in noteworthy cessation rates at the end of treatment. Additional testing as a formal randomized clinical trial is warranted.
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Affiliation(s)
- Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Evelyn Arana-Chicas
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Mariana Ramírez
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jaime Perales-Puchalt
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Pamela Valera
- Department of Urban-Global Public Health, Rutgers University, Newark, NJ, United States
| | - Francisco J Díaz
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, United States
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, United States
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States
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