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Herrmann AK, Ferullo SL, Hernandez M, Barriga VA, Leggis B, Ruiz J, Glenn BA, Bastani R. Adapting E-cigarette prevention programming to reach the latinx community. Cancer Causes Control 2024; 35:405-416. [PMID: 37812335 PMCID: PMC10838817 DOI: 10.1007/s10552-023-01796-7] [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] [Received: 12/29/2022] [Accepted: 09/06/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE E-cigarettes are the most commonly used tobacco product among youth in the United States. Yet evidence-based prevention programming is limited due to the rapid onset of this threat. Community-based efforts to address vaping largely target youth in school settings. Although parents can play an important role in youth tobacco control efforts, messages about the dangers of vaping, use among adolescents, and strategies for intervening have not reached many Spanish-speaking parents in low-income Latinx communities. Our community-academic team developed e-cigarette prevention programming for use by promotor/as de salud to address this unmet need. METHODS During the 1-year project, the team worked closely with a Project Advisory Committee to: review existing evidence-informed materials; conduct focus groups with parents, youth and promotor/as to guide program development; develop a curriculum to prepare promotor/as to educate low-literacy, Spanish-speaking parents about vaping; craft Spanish language resources for promotor/as to use in community education sessions; train 61 promotor/as to deliver the program; and support program delivery to 657 community members. RESULTS Focus groups with promotor/as and community members, key-informant interviews, and brief surveys informed program development and assessment. Community member feedback was essential to development of appropriate materials. Promotor/as demonstrated significant pre- to post- training increases in e-cigarette knowledge and confidence in delivering vaping prevention education. Community members demonstrated a mastery of basic e-cigarette concepts and expressed intention to discuss vaping with their children. CONCLUSIONS Promotor/a-led programming for parents represents a promising approach to vaping prevention and control in the Latinx community.
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Affiliation(s)
- Alison K Herrmann
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA.
| | - Sylvia Lopez Ferullo
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Miriam Hernandez
- Visión y Compromiso, 1000 Alameda Street, Los Angeles, CA, 90012, USA
| | | | - Bernadett Leggis
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Julissa Ruiz
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Beth A Glenn
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
| | - Roshan Bastani
- UCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, 650 Charles E Young Dr. S, Los Angeles, CA, 90095-6900, USA
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Farran D, Salloum RG, El Jardali F, Abla R, Abu Rmeileh N, Al Sheyab N, Awaw-da S, Chalak A, Jawad M, Khader Y, Mostafa A, Nakkash R. From knowledge production to knowledge translation: Waterpipe tobacco control research in the Eastern Mediterranean Region. Tob Prev Cessat 2024; 10:TPC-10-03. [PMID: 38250221 PMCID: PMC10797642 DOI: 10.18332/tpc/175953] [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: 08/30/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
Waterpipe tobacco smoking (WTS) rates in the Eastern Mediterranean Region (EMR) are the highest worldwide, particularly among young people. Although fiscal policies to curb tobacco use have been recommended by the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), implementation has been suboptimal. The Eastern Mediterranean Consortium on the Economics of Waterpipe Tobacco Smoking (ECON-WTS) was formed in response to this need to produce knowledge on the economics of WTS in the EMR and apply a comprehensive Knowledge translation (KT) framework. The KT framework comprised priority setting, evidence synthesis, knowledge translation, and knowledge uptake. In this article, we discuss the approaches followed in applying the KT framework to WTS control, providing examples and noting challenges and lessons learned where possible.
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Affiliation(s)
- Dina Farran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ramzi G. Salloum
- Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Fadi El Jardali
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Ruba Abla
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Niveen Abu Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Nihaya Al Sheyab
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Sameera Awaw-da
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
- Economics Department, Faculty of Business and Economics, Birzeit University, Birzeit, Palestine
| | - Ali Chalak
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London School of Public Health, London, UK
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Aya Mostafa
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Lebanon
- Global and Community Health Department, George Mason University, Virginia, USA
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Kim-Mozeleski JE, Castele MC, Nambiar P, Chagin KM, Pike Moore S, Hardy P, Cook K, Sehgal AR. A Randomized Trial to Address Food Insecurity and Promote Smoking Cessation Among Low-Income Adults. J Prim Care Community Health 2024; 15:21501319241245275. [PMID: 38584453 PMCID: PMC11003330 DOI: 10.1177/21501319241245275] [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] [Received: 12/23/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Many low-income adults who smoke also have unmet social needs, such as food insecurity, which can serve as a barrier to smoking cessation. We developed a novel intervention to jointly address smoking cessation and food insecurity and assessed its feasibility, acceptability, and preliminary outcomes. We enrolled participants who screened for food insecurity, reported smoking daily, and were ready to quit. All participants received 3 months of resources navigation from a community health worker through monthly telephone calls for referrals and check-ins for smoking cessation and food access resources. Participants randomized to the intervention group received an economic intervention equivalent to the cost of 1 week of groceries/month for 3 months. We randomized 55 participants who were smoking on average 13 cigarettes/day. The trial was feasible and acceptable based on 3-month retention rates (80%) and end-of-study qualitative feedback (91% would recommend the study to others). At 3 months, participants in the intervention versus control group reported a longer length of abstinence from smoking and had a higher proportion of serious quit attempts. Results from this pilot study suggest the importance of attending to social needs, particularly food insecurity, as a strategy to promote smoking cessation among low-income adults who smoke.
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Affiliation(s)
| | | | | | - Kevin M. Chagin
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
| | | | - Patricia Hardy
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
| | - Karen Cook
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
| | - Ashwini R. Sehgal
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
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Agaku I, Odani S, Nkosi L, Gwar J, Tsafa T. Dentist versus physician cessation counselling: A
secondary analysis of the US Tobacco Use Supplement to
the Current Population Survey. POPULATION MEDICINE 2023. [DOI: 10.18332/popmed/160299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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Bringing Treatment to the Patients: Community-Based Tobacco-Dependence Treatment and Interventions. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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Bridges KM, LeMaster JW, Parente DJ, Pacheco CM, Schultz C, Morrow E, Corriveau E, Miras Neira T, Greiner KA, Woodward J, Anders- Rumsey J, Cirotski D, Finocchario-Kessler S, Ellerbeck EF. Assessing Social Needs and Engaging Community Health Workers in Underserved Kansas Counties: Insights From Primary Care Providers and Clinic Managers. J Prim Care Community Health 2023; 14:21501319231214513. [PMID: 38041409 PMCID: PMC10693805 DOI: 10.1177/21501319231214513] [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] [Received: 09/10/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 12/03/2023] Open
Abstract
INTRODUCTION Rural and under-resourced urban communities face unique challenges in addressing patients' social determinants of health needs (SDoH). Community health workers (CHWs) can support patients experiencing social needs, yet little is known about how rural and under-resourced primary care clinics are screening for SDoH or utilizing CHWs. METHODS Interviews were conducted with primary care clinic providers and managers across a geographically large and predominately rural state to assess screening practices for SDoH and related community resources, and perspectives on using CHWs to address SDoH. Interviews were conducted by phone, recorded, and transcribed. Data were analyzed using thematic analysis. We completed interviews with 27 respondents (12 providers and 15 clinic managers) at 26 clinics. RESULTS Twelve (46.1%) clinics had a standardized process for capturing SDoH, but this was primarily limited to Medicare wellness visits. Staffing and time were identified as barriers to proper SDoH screening. Lack of transportation and affordable medication were the most cited SDoH. While respondents were all aware of CHWs, only 8 (30.8%) included a CHW on their care team. Perceived barriers to engaging CHWs included cost, space, and availability of qualified CHWs. Perceived benefits of engaging CHWs in their practice were: assisting patients with navigating resources and programs, relieving clinical staff of non-medical tasks, and bridging language barriers. CONCLUSIONS Rural and under-resourced primary care clinics need help in identifying and addressing SDoH. CHWs could play an important part in addressing social needs and promoting preventive care if financial constraints could be addressed and local CHWs could be trained.
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Affiliation(s)
| | | | | | | | | | - Emily Morrow
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Erin Corriveau
- University of Kansas Medical Center, Kansas City, KS, USA
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Qin T, Jin Q, Li X, Bai X, Qiao K, Gu M, Wang Y. A Cost-Effectiveness Analysis of Comprehensive Smoking-Cessation Interventions Based on the Community and Hospital Collaboration. Front Public Health 2022; 10:853438. [PMID: 35937255 PMCID: PMC9354545 DOI: 10.3389/fpubh.2022.853438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown.MethodsWe conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model.ResultsA total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention.ConclusionCI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.
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Umnuaypornlert A, Dede AJO, Pangtri S. Community Health Workers Improve Smoking Cessation When They Recruit Patients in Their Home Villages. J Prim Care Community Health 2021; 12:21501327211048363. [PMID: 34634974 PMCID: PMC8516386 DOI: 10.1177/21501327211048363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION/OBJECTIVE Community health workers (CHWs) can play a vital role in many aspects of healthcare, particularly for underserved communities, but it is unclear what factors are most important in determining the success of CHW-based programs. We wanted to assess what factors contribute to the effectiveness of CHWs in a smoking cessation program. METHODS We trained CHWs in 3 areas regarding smoking cessation: knowledge, attitude, and practice (KAP). The training program utilized the 5A's as approach. CHWs actively sought out people addicted to cigarettes to participate. Patients received support from CHWs and a team of medical professionals for a year. At the conclusion of the program, focus group discussions with a group of CHWs, a group of patients, and a group of medical professionals were conducted. RESULTS On average, patients reduced their cigarettes/day by 7.2% and 29% of patients were completely cigarette free at a 1-year follow-up. Patients marginally decreased exhalation CO levels and increased lung capacity. CHWs gained a good understanding of health risks associated with smoking and common methods to help quit. Their attitude became more sympathetic and caring. CHWs exhibited patient-specific solutions to help with smoking cessation and actively sought out people to participate in the smoking cessation program. CONCLUSIONS A smoking cessation program combining CHWs and pharmacists was effective. Key factors were having CHWs that are respected and established in their communities, using CHWs who know their patients and can provide individually tailored solutions, and empowering CHWs with intensive training.
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Affiliation(s)
- Adinat Umnuaypornlert
- Department of School of Pharmaceutical Sciences, University of Phayao, Muang, Thailand
| | - Adam J O Dede
- Department of School of Pharmaceutical Sciences, University of Phayao, Muang, Thailand
| | - Sudarat Pangtri
- Department of School of Pharmaceutical Sciences, University of Phayao, Muang, Thailand
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