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Meade CD, Stanley NB, Arevalo M, Tyson DM, Chavarria EA, Aguado Loi CX, Rivera M, Gutierrez L, Abdulla R, Christy SM, Gwede CK. Transcreation matters: A learner centric participatory approach for adapting cancer prevention messages for Latinos. PATIENT EDUCATION AND COUNSELING 2023; 115:107888. [PMID: 37463555 DOI: 10.1016/j.pec.2023.107888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Advancing health equity requires innovative patient education approaches for adapting English-language evidence-based interventions (EBIs) to resonate with multicultural, multilingual audiences. OBJECTIVE Examine the benefit, functionality, and practical considerations of transcreation (translation + cultural adaptation) as a critical and salient learner-centric process for developing a Spanish-language intervention (photonovella + video): Un examen sencillo para un colon saludable (A simple test for a healthy colon). PATIENT/COMMUNITY INVOLVEMENT We involved patients/community members in a participatory reflective process, from problem identification to intervention design, development, delivery, and impact measurement. METHODS A community-based participatory research (CBPR) approach involving formative research plus systematic iterative pretesting and learner verification checks augmented by a community advisory board guided the transcreation processes. RESULTS Data collected using a learner-centric approach effectively produced a new Spanish-language EBI and substantiated the value of co-learner/co-design methods. Learner-centric methods identified cultural nuances that were treated as knowledge and integrated into the intervention materials and study design. Pilot testing of the intervention among Latinos receiving care at community clinics demonstrated improved initial colorectal cancer screening uptake, awareness, and perceived susceptibility. DISCUSSION Inherent in the transcreation process was learner involvement that informed essential modification and adaptation of the materials. The transcreation methods led to the development of a culturally salient intervention that maintained theoretical integrity and message intent as well as behavioral activation. Findings have broad implications for the creation and transfer of EBIs to new audiences for greater adoption, engagement, and 'reach' of interventions. PRACTICAL VALUE Transcreation aligns with a growing paradigm shift in health communication science that brings to light the beneficial effect that construction and application of cultural knowledge has on patient education toward health equity.
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Affiliation(s)
- Cathy D Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA.
| | - Nathanael B Stanley
- Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA
| | - Mariana Arevalo
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA
| | | | - Enmanuel A Chavarria
- Behavioral, Social, and Health Education Sciences Department, Emory University, Atlanta, GA, USA
| | - Claudia X Aguado Loi
- Department of Health Science and Human Performance, University of Tampa, Tampa, FL, USA
| | | | | | - Rania Abdulla
- NTRO Non-Therapeutic Research Office, Moffitt Cancer Center, Tampa, USA
| | - Shannon M Christy
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, USA
| | - Clement K Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA
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2
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Casas L, Medina-Ramirez P, Carreno V, Calixte-Civil P, Martinez U, Brandon TH, Simmons VN. Hispanic/Latinx individuals' attributions for abstinence and smoking: A content analysis of open-ended responses from a randomized cessation trial. Addict Behav Rep 2023; 17:100478. [PMID: 36619608 PMCID: PMC9816900 DOI: 10.1016/j.abrep.2022.100478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 12/26/2022] Open
Abstract
Introduction Little is known about facilitators and barriers to smoking cessation among Hispanics seeking treatment. This secondary analysis examined attributions for abstinence or smoking among participants in a nationwide randomized controlled trial testing a self-help smoking cessation intervention among Spanish-speaking Hispanics in the United States (US). Methods At each follow-up assessment (6, 12, 18, and 24 months), participants (N = 1,417) responded to open-ended items regarding reasons for either abstinence or smoking. A content analysis was conducted using NVivo on the responses from 1,035 participants. Results Mood Management (e.g., stress and anxiety) was the most frequent reason for smoking across all timepoints. Concern for personal health and wellbeing was the most frequent reason cited for abstinence across all timepoints. Important barriers (e.g., financial stressors, environmental disasters) and facilitators (e.g., family, faith) were also identified. Quantitative subgroup analyses revealed differences in the frequency of abstinence and smoking attributions by sex, marital status, and annual household income. Conclusion The identified facilitators and barriers to abstinence support and expand findings from previous studies by using a geographically and ethnically diverse sample of treatment seeking, Spanish-preferring smokers. They also provide specific targets for tailoring cessation and relapse prevention interventions designed to improve cessation outcomes and reduce tobacco-related health disparities among Hispanics in the US.
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Affiliation(s)
- Laura Casas
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Vanesa Carreno
- St. George’s University School of Medicine, West Indies, Grenada
| | | | - Ursula Martinez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Gómez-Trillos S, Graves KD, Fiallos K, Schwartz MD, Peshkin BN, Hamilton H, Sheppard VB, Vadaparampil ST, Campos C, Cupertino AP, Alzamora MC, Lynce F, Hurtado-de-Mendoza A. Cultural adaptations to a telephone genetic counseling protocol and booklet for Latina breast cancer survivors at risk for hereditary breast and ovarian cancer. Transl Behav Med 2023; 13:297-308. [PMID: 36694918 PMCID: PMC10182423 DOI: 10.1093/tbm/ibac106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Telephone genetic counseling (TGC) is accepted as standard clinical care for people seeking hereditary cancer risk assessment. TGC has been shown to be non-inferior to in-person genetic counseling, but trials have been conducted with a predominantly highly educated, non-Hispanic White population. This article describes the process of culturally adapting a TGC protocol and visual aid booklet for Spanish-preferring Latina breast cancer survivors at risk for hereditary breast and ovarian cancers. The adaptation process included two phases. Phase 1 involved a review of the literature and recommendations from an expert team including community partners. Phase 2 included interviews and a pilot with the target population (n = 14) to collect feedback about the adapted protocol and booklet following steps from the Learner Verification and Revision Framework. We describe the adaptation process and report the main adaptations following the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions (FRAME). Adaptations in Phase 1 were responsive to the target population needs and characteristics (e.g., delivered in Spanish at an appropriate health literacy level, addressing knowledge gaps, targeting cultural values). Phase 2 interviews were crucial to refine details (e.g., selecting words) and to add components to address GCT barriers (e.g., saliva sample video). Cultural adaptations to evidence-based TGC protocols can increase the fit and quality of care for historically underserved populations. As TGC visits become routine in clinical care, it is crucial to consider the needs of diverse communities to adequately promote equity and justice in cancer care.
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Affiliation(s)
- Sara Gómez-Trillos
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
| | - Kristi D Graves
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
| | - Katie Fiallos
- Kimmel Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marc D Schwartz
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
| | - Beth N Peshkin
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
| | - Heidi Hamilton
- Department of Linguistics, Georgetown University, Washington, DC, USA
| | - Vanessa B Sheppard
- Department of Health Behavior and Policy, Virginia Commonwealth University, VA, USA
| | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Ana Paula Cupertino
- School of Medicine and Dentistry, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Maria C Alzamora
- Department of Obstetrics and Gynecology, MedStar Washington Hospital Center/Georgetown University Hospital, Washington, DC, USA
| | | | - Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
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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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Simmons VN, Sutton SK, Medina-Ramirez P, Martinez U, Brandon KO, Byrne MM, Meade CD, Meltzer LR, Brandon TH. Self-help smoking cessation intervention for Spanish-speaking Hispanics/Latinxs in the United States: A randomized controlled trial. Cancer 2021; 128:984-994. [PMID: 34679188 DOI: 10.1002/cncr.33986] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Hispanic/Latinx smokers living in the United States face unique challenges in quitting smoking. This study evaluated the efficacy of a culturally relevant, Spanish-language, extended self-help smoking cessation intervention among Hispanic smokers. METHODS A 2-arm parallel randomized controlled trial was conducted with Hispanic/Latinx smokers living in the United States who preferred health information in Spanish and smoked 5 or more cigarettes per week. Participants were randomly allocated to receive Libre del Cigarrillo (LDC), which consisted of 11 booklets and 9 pamphlets mailed monthly over 18 months, or the usual care (UC), which was a single Spanish-language self-help booklet from the National Cancer Institute. The primary outcome was self-reported 7-day point prevalence smoking abstinence assessed 6, 12, 18, and 24 months after the baseline. Eight prespecified moderators of the intervention were evaluated. Cost-effectiveness was also evaluated. All statistical tests were 2-sided. RESULTS Data from all participants randomized to LDC (n = 714) or UC (n = 703) were used for analyses after multiple imputation to manage missing data. Generalized estimating equation analyses indicated that LDC abstinence rates were higher (P < .001) across all assessments. Logistic regression analyses revealed that at 24 months, the abstinence rate was greater for LDC (33.1%) than UC (24.3%; odds ratio, 1.54; 95% confidence interval, 1.18-2.02; P = .002). Men exhibited a strong intervention effect at all assessments (P values < .001), whereas the intervention effect for women was observed only at 6 and 12 months (P values < .018). In comparison with UC, the incremental cost per quitter in the LDC arm was $648.43 at 18 months and $683.93 at 24 months. CONCLUSIONS A culturally relevant, Spanish-language intervention was efficacious and cost-effective for smoking cessation. LAY SUMMARY Research is needed to develop interventions for ethnic minority smokers. The aim of the current study was to test a Spanish-language adaptation of a validated and easily implemented self-help smoking cessation intervention in a nationwide randomized controlled trial. The findings demonstrated that the intervention produced greater smoking abstinence in comparison with a standard self-help booklet. Participants also were more satisfied with the intervention, and it was cost-effective. Efforts aimed at promoting tobacco abstinence in this underserved population could have significant public health implications, including potential reductions in cancer health disparities associated with tobacco smoking.
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Affiliation(s)
- Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | - Steven K Sutton
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | | | - Ursula Martinez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Margaret M Byrne
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
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Urquia ML, Juarez S, Wall-Wieler E, Hjern A. Smoking During Pregnancy Among Immigrant Women With Same-Origin and Swedish-Born Partners. Nicotine Tob Res 2021; 23:349-356. [PMID: 32772082 PMCID: PMC7822112 DOI: 10.1093/ntr/ntaa145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/03/2020] [Indexed: 12/17/2022]
Abstract
Introduction Although ethnically mixed couples are on the rise in industrialized countries, their health behaviors are poorly understood. We examined the associations between partner’s birthplace, age at immigration, and smoking during pregnancy among foreign-born women. Methods Population-based register study including all pregnancies resulting in a livebirth or stillbirth in Sweden (1991–2012) with complete information on smoking and parental country of birth. We compared the prevalence of smoking during pregnancy between women in dual same-origin foreign-born unions (n = 213 111) and in mixed couples (immigrant women with a Swedish-born partner) (n = 111 866) using logistic regression. Swedish-born couples were used as a benchmark. Results The crude smoking rate among Swedish women whose partners were Swedish was 11%. Smoking rates of women in dual same-origin foreign-born unions varied substantially by birthplace, from 1.3% among women from Asian countries to 23.2% among those from other Nordic countries. Among immigrant groups with prevalences of pregnancy smoking higher than that of women in dual Swedish-born unions, having a Swedish-born partner was associated with lower odds of smoking (adjusted odds ratios: 0.72–0.87) but with higher odds among immigrant groups with lower prevalence (adjusted odds ratios: 1.17–5.88). These associations were stronger among women immigrating in adulthood, whose smoking rates were the lowest. Conclusions Swedish-born partners “pull” smoking rates of immigrant women toward the level of smoking of Swedish-born women, particularly among women arrived during adulthood. Consideration of a woman’s and her partner’s ethnic background and life stage at migration may help understand smoking patterns of immigrant women. Implications We found that having a Swedish-born partner is associated with higher rates of smoking during pregnancy among immigrants from regions where women smoke less than Swedish women, but with lower smoking rates among immigrants from regions where women smoke more. This implies that prevention efforts should concentrate on newly arrived single women from low prevalence regions, such as Africa and Asia, whereas cessation efforts may target women from high prevalence regions, such as other European countries. These findings suggest that pregnancy smoking prevention or cessation interventions may benefit from including partners and approaches culturally tailored to mixed unions.
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Affiliation(s)
- Marcelo L Urquia
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Sol Juarez
- Centre for Health Equity Studies, Stockholm University/Karolinska Institute, Stockholm, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Elizabeth Wall-Wieler
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Anders Hjern
- Centre for Health Equity Studies, Stockholm University/Karolinska Institute, Stockholm, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Department of Medicine, Clinical Epidemiology Division, Karolinska Institute, Stockholm, Sweden
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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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Akiyama MJ, Muller A, Huang O, Lizcano J, Nyakowa M, Riback L, Ross J, Bundi H, Kulabi ES, Mwangi AM, Musyoki H, Cherutich P, Kurth A. Hepatitis C-related knowledge, attitudes and perceived risk behaviours among people who inject drugs in Kenya: A qualitative study. Glob Public Health 2021; 17:1016-1028. [PMID: 33689563 DOI: 10.1080/17441692.2021.1896763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Despite disproportionately high rates of Hepatitis C (HCV) among people who inject drugs (PWID) in low- and middle-income countries (LMICs), understanding of HCV-related knowledge, attitudes and perceived risk behaviours among this population remains limited. We aimed to elucidate knowledge, attitudes and experiences that could minimise transmission risk and maximise HCV treatment engagement among PWID in Kenya following the integration of HCV screening and education with needle and syringe programmes in drop-in-centres (DICs). We recruited 40 PWID with chronic HCV attending DICs in Nairobi and Coastal Kenya. Semi-structured interviews revealed a general understanding of HCV and awareness of HCV risk behaviours among participants; however, many felt limited control over their transmission risk due to factors such as 'local doctors', or individuals who perform a high volume of high-risk injections. Financial barriers, distance to clinic, poor health status and HCV-related stigma were all noted as barriers to HCV treatment. In conclusion, basic knowledge of and motivation for HCV treatment among PWID accessing DICs in Kenya was high; however, structural barriers and stigma complicate access to care. Local education programmes can address knowledge gaps, and behavioural and structural interventions can maximise the impact of HCV care in LMICs.
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Affiliation(s)
- Matthew J Akiyama
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - Abbe Muller
- Yale University, Yale School of Nursing, Orange, CT, USA
| | - Owen Huang
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - John Lizcano
- Yale University, Yale School of Nursing, Orange, CT, USA
| | - Mercy Nyakowa
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Lindsey Riback
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - Jonathan Ross
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY, USA
| | - Henry Bundi
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | | | - Ann Muthoni Mwangi
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Helgar Musyoki
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Peter Cherutich
- Kenya Ministry of Health, National AIDS & STI Control Program (NASCOP), Nairobi, Kenya
| | - Ann Kurth
- Yale University, Yale School of Nursing, Orange, CT, USA
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9
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Chavarria EA, Christy SM, Simmons VN, Vadaparampil ST, Gwede CK, Meade CD. Learner Verification: A Methodology to Create Suitable Education Materials. Health Lit Res Pract 2021; 5:e49-e59. [PMID: 34251862 PMCID: PMC8075101 DOI: 10.3928/24748307-20210201-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Learner verification and revision (LV&R) is a research methodological approach to inform educational message design with the aim of producing suitable, actionable, and literacy appropriate messages to aid in awareness, adoption of healthy behaviors, and decision-making. It consists of a series of participatory steps that engage users throughout materials development, revision, and refinement. This approach is congruent with Healthy People 2030 communication objectives to improve access to information among diverse, multicultural, multilingual populations, and enhance health care quality toward health equity. Brief description of activity: To illustrate LV&R, we describe its use in three cancer education projects that produced targeted information about (1) inherited breast cancer among African Americans (brochure); (2) colorectal cancer screening among Latinos (photo novella and DVD); and (3) smoking-relapse prevention among patients receiving cancer treatment (video). We discuss rationale for its application in the three exemplars and extrapolate lessons learned from our experiences when using this approach. Implementation: A qualitative approach entailing individual or group-based discussions helped to examine the elements of learner verification (i.e., attraction, comprehension, self-efficacy, cultural acceptability, persuasion). The following steps are reported: (1) preparation of materials, interview guide, and recruitment; (2) interviewing of participants; and (3) evaluation of responses. Data were analyzed by use of a coding system that placed participant responses from each of the elements into data summary matrices. Findings informed revisions and refinement of materials. Results: LV&R was effectively applied across the three cancer education projects to enhance the suitability of the materials. As a result, the materials were improved by using clearer, more salient language to enhance comprehension and cultural acceptability, by integrating design elements such as prompts, headers, and stylistic edits to reduce text density, incorporating preferred colors and graphics to improve aesthetic appeal, and including actionable terms and words to bolster motivation and self-efficacy. Lessons learned: Results suggest that LV&R methodology can improve suitability of education materials through systematic, iterative steps that engage diverse, multicultural, multilingual populations. This approach is a critical participa-tory strategy toward health equity, and is appropriate in a variety of education, research, and clinical practice settings to improve health communications. [HLRP: Health Literacy Research and Practice. 2021;5(1):e49–e59.] Plain Language Summary: This article describes the use of a systematic approach called “learner verification” used for developing educational materials. This approach involves obtaining feedback from audience members to ensure that the information is understandable, attractive in design, motivating, and culturally relevant.
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Affiliation(s)
| | | | | | | | | | - Cathy D. Meade
- Address correspondence to Cathy D. Meade, PhD, RN, FAAN, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, MFC-EDU, Tampa, FL 33612;
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10
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Cartujano-Barrera F, Arana-Chicas E, Catley D, Cox LS, Diaz FJ, Ellerbeck EF, Graves KD, Ogedegbe C, Cupertino AP. Decídetexto: Mobile cessation support for Latino smokers. Study protocol for a randomized clinical trial. Contemp Clin Trials 2020; 99:106188. [PMID: 33080379 PMCID: PMC8315307 DOI: 10.1016/j.cct.2020.106188] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/02/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Latinos, the largest minority group in the U.S., experience tobacco-related disparities, including limited access to cessation resources. Evidence supports the efficacy of mobile interventions for smoking cessation, which may be greater among Latinos, the highest users of text messaging. OBJECTIVES To describe the methodology of a randomized clinical trial to evaluate the impact of Decídetexto, a culturally appropriate mobile smoking cessation intervention versus standard care on smoking abstinence (cotinine-verified 7-day point prevalence abstinence) at Month 6 among Latino smokers. METHODS Latino smokers (N = 618) will be randomized to one of two conditions: 1) Decídetexto or 2) standard of care. Decídetexto is a mobile smoking cessation intervention (available in English and Spanish) that incorporates three integrated components: 1) a tablet-based software that collects smoking-related information to develop an individualized quit plan, 2) a 24-week text messaging counseling program with interactive capabilities, and 3) pharmacotherapy support. Decídetexto follows the Social Cognitive Theory as theoretical framework. Standard of care consists of printed smoking cessation materials along with referral to telephone quitline. Participants in both groups are given access to free pharmacotherapy (nicotine patches or gum) by calling study phone number. Promotores de Salud will rely on community-based approaches and clinical settings to recruit smokers into the study. All participants will complete follow-up assessments at Week 12 and Month 6. DISCUSSION If successful, Decídetexto will be ready to be implemented in different community- and clinic-based settings to reduce tobacco-related disparities.
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Affiliation(s)
- Francisco Cartujano-Barrera
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States of America.
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, United States of America
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Francisco J Diaz
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Kristi D Graves
- Department of Oncology, Georgetown University, Washington, D.C., United States of America
| | - Chinwe Ogedegbe
- Emergency and Trauma Center, Hackensack University Medical Center, Hackensack, NJ, United States of America
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States of America
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Simmons VN, Sutton SK, Meltzer LR, Martinez U, Palmer AM, Meade CD, Jacobsen PB, McCaffrey JC, Haura EB, Brandon TH. Preventing smoking relapse in patients with cancer: A randomized controlled trial. Cancer 2020; 126:5165-5172. [PMID: 32902856 DOI: 10.1002/cncr.33162] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Abstaining from smoking after a cancer diagnosis is critical to mitigating the risk of multiple adverse health outcomes. Although many patients with cancer attempt to quit smoking, the majority relapse. The current randomized controlled trial evaluated the efficacy of adapting an evidence-based smoking relapse prevention (SRP) intervention for patients with cancer. METHODS The trial enrolled 412 patients newly diagnosed with cancer who had recently quit smoking. Participants were randomized to usual care (UC) or SRP. Participants in the UC group received the institution's standard of care for treating tobacco use. Participants in the SRP group in addition received a targeted educational DVD plus a validated self-help intervention for preventing smoking relapse. The primary outcome was smoking abstinence at 2 months, 6 months, and 12 months. RESULTS Abstinence rates for participants in the SRP and UC groups were 75% versus 71% at 2 months and 69% versus 64% at 6 months (Ps > .20). At 12 months, abstinence rates among survivors were 68% for those in the SRP group and 63% for those in the UC group (P = .38). Post hoc analyses revealed that across 2 months and 6 months, patients who were married/partnered were more likely to be abstinent after SRP than UC (P = .03). CONCLUSIONS A smoking relapse prevention intervention did not reduce relapse rates overall, but did appear to have benefited those participants who had the social support of a partner. Future work is needed to extend this effect to the larger population of patients.
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Affiliation(s)
- Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Steven K Sutton
- Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Ursula Martinez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Amanda M Palmer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Nursing, University of South Florida, Tampa, Florida
| | - Paul B Jacobsen
- Healthcare Delivery Research Program, National Cancer Institute, Bethesda, Maryland
| | - Judith C McCaffrey
- Department of Otolaryngology, University of South Florida, Tampa, Florida.,Department of Otolaryngology-Head and Neck Surgery, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Eric B Haura
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
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12
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Medina-Ramirez P, Calixte-Civil P, Meltzer LR, Brandon KO, Martinez U, Sutton SK, Meade CD, Byrne MM, Brandon TH, Simmons VN. Comparing Methods of Recruiting Spanish-Preferring Smokers in the United States: Findings from a Randomized Controlled Trial. J Med Internet Res 2020; 22:e19389. [PMID: 32795986 PMCID: PMC7455877 DOI: 10.2196/19389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background There is a pressing need to address the unacceptable disparities and underrepresentation of racial and ethnic minority groups, including Hispanics or Latinxs, in smoking cessation trials. Objective Given the lack of research on recruitment strategies for this population, this study aims to assess effective recruitment methods based on enrollment and cost. Methods Recruitment and enrollment data were collected from a nationwide randomized controlled trial (RCT) of a Spanish-language smoking cessation intervention (N=1417). The effectiveness of each recruitment strategy was evaluated by computing the cost per participant (CPP), which is the ratio of direct cost over the number enrolled. More effective strategies yielded lower CPPs. Demographic and smoking-related characteristics of participants recruited via the two most effective strategies were also compared (n=1307). Results Facebook was the most effective method (CPP=US $74.12), followed by TV advertisements (CPP=US $191.31), whereas public bus interior card advertising was the least effective method (CPP=US $642.50). Participants recruited via Facebook had lower average age (P=.008) and had spent fewer years in the United States (P<.001). Among the participants recruited via Facebook, a greater percentage of individuals had at least a high school education (P<.001) and an annual income above US $10,000 (P<.001). In addition, a greater percentage of individuals were employed (P<.001) and foreign born (P=.003). In terms of subethnicity, among the subjects recruited via Facebook, a lower percentage of individuals were of Mexican origin (P<.001) and a greater percentage of individuals were of Central American (P=.02), South American (P=.01), and Cuban (P<.001) origin. Conclusions Facebook was the most effective method for recruiting Hispanic or Latinx smokers in the United States for this RCT. However, using multiple methods was necessary to recruit a more diverse sample of Spanish-preferring Hispanic or Latinx smokers.
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Affiliation(s)
- Patricia Medina-Ramirez
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Patricia Calixte-Civil
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Lauren R Meltzer
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Karen O Brandon
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Ursula Martinez
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL, United States.,Biostatistics and Bioinformatics Department, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Cathy D Meade
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,College of Nursing, University of South Florida, Tampa, FL, United States
| | - Margaret M Byrne
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, United States
| | - Thomas H Brandon
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Vani N Simmons
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
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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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Medina-Ramírez P, Sutton SK, Martínez Ú, Meade CD, Byrne MM, Brandon KO, Meltzer LR, Gonzales FM, Brandon TH, Simmons VN. A randomized controlled trial of a smoking cessation self-help intervention for Spanish-speaking Hispanic/Latinx smokers: Study design and baseline characteristics. Contemp Clin Trials 2019; 85:105836. [PMID: 31473331 DOI: 10.1016/j.cct.2019.105836] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 11/24/2022]
Abstract
Although the current smoking prevalence among Hispanics/Latinxs (10%) is lower than in non-Hispanic whites (15%), higher prevalence is observed among certain subgroups (e.g., Puerto Rican males, 19%). Hispanic/Latinx smokers face unique challenges such as lower awareness and acceptability of nicotine replacement aids, lower prevalence of using counseling or medication, and receiving less advice to quit by their health care providers. Despite these barriers to smoking cessation, few interventions specifically targeted to Hispanic/Latinx smokers have been developed and evaluated. This paper summarizes the design, methods, analysis plan, and sample baseline characteristics of an ongoing randomized controlled trial to assess the efficacy of a Spanish-language self-help smoking cessation intervention among Hispanics/Latinxs. Current smokers who prefer health education materials in Spanish were randomized to one of two conditions. The usual care group received a standard smoking cessation booklet developed by the National Cancer Institute. The intervention group received 10 booklets, 9 pamphlets and a booklet for family and friends mailed monthly over 18 months. All participants complete self-report surveys every 6 months over 2 years. Smoking abstinence is biochemically verified at 12- and 24-month follow-up. A total of 2387 smokers were screened, 2056 were eligible and 1417 were enrolled in the study. The primary outcome is self-reported 7-day point prevalence abstinence. If the intervention is deemed efficacious, it has potential to have a large public health impact with respect to reducing smoking rates and smoking related morbidity and mortality among a large underserved minority population.
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Affiliation(s)
| | - Steven K Sutton
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | | | - Cathy D Meade
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | - Margaret M Byrne
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | | | | | | | - Thomas H Brandon
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA
| | - Vani N Simmons
- H. Lee Moffitt Cancer Center, Tampa, FL, USA; University of South Florida, USA.
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Increasing access to smoking cessation treatment among Latino smokers using case management. J Smok Cessat 2019; 14:168-175. [PMID: 31673297 DOI: 10.1017/jsc.2019.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AbstractIntroductionDisparities exist among Latino smokers with respect to knowledge and access to smoking cessation resources. This study tested the feasibility of using case management (CM) to increase access to pharmacotherapy and quitlines among Latino smokers.MethodsLatino smokers were randomized to CM (n = 40) or standard care (SC, n = 40). All participants received educational materials describing how to utilize pharmacy assistance for cessation pharmacotherapy and connect with quitlines. CM participants received four phone calls from staff to encourage pharmacotherapy and quitline use. At 6-months follow-up, we assessed the utilization of pharmacotherapy and quitline. Additional outcomes included self-reported smoking status and approval for pharmacotherapy assistance.ResultsUsing intention-to-treat analysis, CM produced higher utilization than SC of both pharmacotherapy (15.0% versus 2.5%; P = 0.108) and quitlines (12.5% versus 5.0%; P = 0.432), although differences were not statistically significant. Approval for pharmacotherapy assistance programs (20.0% versus 0.0%; P = 0.0005) was significantly higher for CM than SC participants. Self-reported point-prevalence smoking abstinence at 6-months were 20.0% and 17.5% for CM and SC, respectively (P = 0.775).ConclusionsCM holds promise as an effective intervention to connect Latino smokers to evidence-based cessation treatment.
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