A pilot randomized trial examining the feasibility and acceptability of a culturally tailored and adherence-enhancing intervention for Latino smokers in the U.S

Cultural Tailoring and Targeting of Messages: A Systematic Literature Review

Cultural targeting and tailoring are different, yet they remain intertwined in the literature inhibiting theory development and limiting the possibility of determining their effects. This preregistered systematic literature review describes these constructs and provides a framework for cultural tailoring with evidence from a review of 63 studies, published from 2010 to 2020, to characterize the processes, elements, and theories used in the existing literature. The results show that 86% of studies self-defined as cultural tailoring, but coding revealed relatively few tailoring studies (25%) with 31% including both tailoring and targeting elements. Most studies used outreach and consultation as processes for tailoring or targeting with participatory approaches used in a fifth of the studies. Surface-level features of message content were commonly used to tailor or target with deep-cultural-values found in only a quarter of the studies. We argue from theories of communication accommodation and persuasion that cultural tailoring or targeting may provide gains in attention, recall, or source evaluation.

[Smoking and smoking cessation among migrants in France: A qualitative study]

INTRODUCTION

The aim of this study is to identify factors related to smoking and smoking cessation as well as preferences for cessation methods reported by migrants in France.

METHODS

Qualitative study using semi-directive interviews with migrants in the Parisian area thematically analyzed using an inductive approach.

RESULTS

Sixteen interviews conducted. The stress and isolation induced by migration favor the increase of tobacco consumption. These two factors, as well as the lack of information on the resources available for quitting smoking, were identified as obstacles to cessation. The main motivations for quitting are the identified or experienced effects of smoking on their health and pressure from family members, especially children. Quitting is essentially a personal strategy centered on the true will to quit. The most popular method identified by the participants as the most effective in helping them to quit, is follow-up or therapy by a health professional combining listening and psychological support.

DISCUSSION

For migrants, smoking is a resource to combat stress that increases during the migration process and upon arrival in the host country and presents a psychosocial dimension for the most isolated individuals. Smoking cessation must be accompanied and must take into account the specificities of this population as well as the expressed need for psychosocial support, as suggested by our results, to be most effective.

Can a smartphone application help Hispanic/Latinx adults quit smoking? A randomized trial secondary analysis

Introduction

There are no known efficacious digital smoking cessation interventions for Hispanic/Latinx adults who smoke. This study is a secondary analysis using data from a randomized trial to evaluate whether Acceptance and Commitment Therapy (ACT) delivered via a smartphone app (iCanQuit) would be more efficacious for smoking cessation than the US Clinical Practice (USCPG)-based app (QuitGuide) in a sample of Hispanic/Latinx participants.

Methods

A total of 210 Hispanic/Latinx adults who smoke were randomized to receive the iCanQuit or QuitGuide app for 12-months. Participants self-reported on 30-day abstinence from cigarette smoking at the 3-month, 6-month, and 12-month follow-ups; 7-day abstinence at all follow-ups; abstinence from other nicotine/tobacco products at 12-months; and continuous prolonged abstinence from 3 to 12-months. Participants also reported on their willingness to accept cues to smoke without smoking and satisfaction with their apps.

Results

A total of 176 (84%) participants reported on study outcomes at the 12-month follow-up. Compared to QuitGuide participants, iCanQuit participants were significantly more likely to report 30-day abstinence from cigarette smoking at 12-months (34% iCanQuit, 20% QuitGuide; p=0.026). iCanQuit participants utilized their app more frequently and reported greater satisfaction with their assigned app than those who received the QuitGuide app. Increases in participants' willingness to accept cues to smoke mediated the intervention effect on abstinence from cigarette smoking at 12-months.

Conclusions

Acceptance and Commitment Therapy-delivered via a smartphone app may be efficacious for helping Hispanic/Latinx adults abstain from cigarette smoking. Replication in a fully powered randomized trial that focuses on an independent sample of Hispanic/Latinx adults is now needed.

Flavored Tobacco Product Use Among Young Adults by Race and Ethnicity: Evidence From the Population Assessment of Tobacco and Health Study

PURPOSE

Describe racial/ethnic patterns of flavored tobacco use to illuminate equity implications of flavored tobacco policies.

METHODS

Using data on US young adults (ages 18-34; n = 8,114) in the Population Assessment of Tobacco and Health Study Wave 5 (2018-2019) and survey-weighted logistic regression, we estimated any flavors (regular brand) and mint/menthol (vs. other flavors) use by race/ethnicity among cigarette, e-cigarette, cigar, blunt, hookah, smokeless tobacco, and any tobacco product users.

RESULTS

Any flavored tobacco use was common and was significantly higher for Black (75.1%; OR: 1.4; 95% CI: 1.2, 1.7) and Hispanic/Latinx (77.2%; OR: 1.4; 95% CI: 1.1, 1.7) users than White users (73.5%). The most pronounced difference across products was in menthol cigarette use between Black and White smokers (OR: 4.5; 95% CI: 3.5, 5.9). Among flavored product users, mint/menthol use was significantly higher for Latinx blunt and hookah users.

DISCUSSION

Racial/ethnic disparities in flavored tobacco use include and extend beyond menthol cigarettes. Comprehensive flavored tobacco restrictions that include mint/menthol and non-cigarette products will likely have more equitable impact.

Association of psychological distress and current cigarette smoking among Native Hawaiian and Pacific Islander adults and compared to adults from other racial/ethnic groups: Data from the National Health Interview Survey, 2014

Cigarette smoking is the leading cause of preventable deaths worldwide. Research has documented an association between psychological distress and smoking among certain racial/ethnic groups but has not examined this association among Native Hawaiian and Pacific Islander (NHPI) adults. Data from the 2014 general and the NHPI-specific National Health Interview Surveys were analyzed at the University of Arkansas for Medical Sciences Regional Campus (Fayetteville, AR) in April 2021 to determine the association between current cigarette smoking and levels of psychological distress among NHPI adults and to assess the difference in the magnitude of that association among NHPI adults compared to adults of other racial/ethnic groups in the United States. The final analytic sample (n = 34,782) included 1,916 NHPI, 20,430 White, 4,725 Black, 2,001 Asian, and 5,710 Hispanic adults. A significant association between current cigarette smoking and psychological distress levels was found among NHPI adults as well as among adults from other racial/ethnic groups. There was no significant difference in the magnitude of the detected association among NHPI adults compared to the magnitude of the same association detected among adults of other racial/ethnic groups. However, this finding indicates race/ethnicity does not moderate the association between psychological distress and current cigarette smoking. Future studies should explore factors that may further explain the variation in current cigarette smoking within and across all racial/ethnic groups.

Evaluating the feasibility and acceptability of a mobile-based health technology for smoking cessation: Mobile Anxiety Sensitivity Program

OBJECTIVES

Cigarette smoking is the leading preventable cause of death and disability. Although most US smokers want to quit, more than 95% of cessation attempts end in relapse within 6 months. To improve cessation outcomes, research has turned to targetable mechanisms, such as anxiety sensitivity (AS), which maintain smoking behaviour, impede cessation success, and can be effectively targeted in the context of psychosocial interventions. Although integrated treatment programmes that address AS reduction in the context of smoking cessation have demonstrated promising results, presently, no mobile, technology-based integrated treatment exists to expressly address smoking and AS. The current study evaluated the initial feasibility and acceptability of a mobile smoking cessation intervention, Mobile Anxiety Sensitivity Program for smoking (MASP).

METHODS

Participants were 15 daily adult combustible cigarette smokers (females n = 6, M_age  = 46.5 years, SD = 13.3) who completed a 6-week total intervention period (baseline visit, 2 weeks pre-quit, 4 weeks post-quit, follow-up visit).

RESULTS

Most participants (N = 12) completed the full 6-week intervention, and participant engagement with MASP was high. Participants reported that MASP was acceptable. Biochemical verification of smoking abstinence indicated 25% of smokers were abstinent for at least 24 hr prior to the in-person 4 weeks post-quit follow-up visit.

CONCLUSIONS

Findings indicated that MASP has the potential to provide effective assistance to those wanting to quit cigarettes.

PRACTITIONER POINTS

Mobile-based smoking cessation interventions may be a promising treatment option, particularly for those of lower socio-economic status. Targeting AS in the context of a mobile-based smoking cessation app may be a viable way to improve smoking cessation success and treatment outcome. Due to the pilot nature of this study, there was no control group. Thus, comparative conclusions and generalizability based on the current study must be made with caution.

Culturally tailored interventions for ethnic minorities: A scoping review

AIM

This scoping review identifies strengths and weakness of culturally tailored interventions for ethnic minorities' care in the United States. It reviews recently published studies to improve understanding of these interventions for future research and practice.

DESIGN

Scoping review.

METHODS

By searching five electronic databases-CINAHL, PubMed, Ovid, Scopus and Web of Science, this review located 58 empirical studies published between 2015-2019. This review was guided by the PRISMA statements.

RESULTS

The review identified four weaknesses and five strengths of culturally tailored interventions. Weaknesses included unclear guidelines, low attention and retention rates, failure to measure processes and inadequate training for healthcare providers. The intervention strengths were culturally respectful and patient-centred care, healthy lifestyle promotion, increased family and community supports, technology use for efficient and timely care and increased knowledge of disease by participants.

Personalized Feedback for Smoking and Anxiety Sensitivity: A Randomized Controlled Trial

BACKGROUND

Cigarette smoking is the leading preventable cause of death and disability globally. Most smokers want to quit, and most make a serious quit attempt each year. Nevertheless, more than 95% of cessation attempters relapse within six months. Thus, alternative interventions are needed to combat this major public health concern. Objective: The current study was conducted to develop and test a smoking treatment among 95 (63.2% male; M_age = 46.20 years, SD = 10.90) adult daily cigarette smokers that targets a known risk factor for smoking maintenance and relapse: anxiety sensitivity (AS). Methods: The current study employed a randomized controlled trial design to test an integrated, brief, computer-delivered smoking and AS intervention among current, daily smokers. Participants completed four appointments: (a) phone-screener; (b) baseline (pre-intervention assessment, intervention [personalized feedback intervention (PFI) versus smoking information control], and post-intervention assessment); (c) 2-week follow-up; and (d) 4-week follow-up. Results: Participants indicated highly positive evaluations of both the PFI and control intervention. Between the baseline and 2-week follow-up, 44.2% [PFI: 46.9% (n = 23); control: 41.3% (n = 19)] of participants reported a quit attempt. At the 4-week follow-up, 49.5% [PFI: 57.1% (n = 28); control: 41.3% (n = 19)] of participants reported a quit attempt since their previous laboratory session. Conclusion: Within the context of an intervention development approach, the present investigation provides descriptive data on the feasibility, acceptability, and initial efficacy of a single-session, computer-delivered, AS/smoking PFI.

Comparing Methods of Recruiting Spanish-Preferring Smokers in the United States: Findings from a Randomized Controlled Trial

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.

A randomized controlled trial of a smoking cessation self-help intervention for Spanish-speaking Hispanic/Latinx smokers: Study design and baseline characteristics

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.