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Sharma P, Tranby B, Kamath C, Brockman TA, Lenhart N, Quade B, Abuan N, Halom M, Staples J, Young C, Brewer L, Patten C. Beta Test of a Christian Faith-Based Facebook Intervention for Smoking Cessation in Rural Communities (FaithCore): Development and Usability Study. JMIR Form Res 2024; 8:e58121. [PMID: 39186365 DOI: 10.2196/58121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/28/2024] [Accepted: 07/10/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Individuals living in rural communities experience substantial geographic and infrastructure barriers to attaining health equity in accessing tobacco use cessation treatment. Social media and other digital platforms offer promising avenues to improve access and overcome engagement challenges in tobacco cessation efforts. Research has also shown a positive correlation between faith-based involvement and a lower likelihood of smoking, which can be used to engage rural communities in these interventions. OBJECTIVE This study aimed to develop and beta test a social intervention prototype using a Facebook (Meta Platforms, Inc) group specifically designed for rural smokers seeking evidence-based smoking cessation resources. METHODS We designed a culturally aligned and faith-aligned Facebook group intervention, FaithCore, tailored to engage rural people who smoke in smoking cessation resources. Both intervention content and engagement strategies were guided by community-based participatory research principles. Given the intervention's focus on end users, that is, rural people who smoked, we conducted a beta test to assess any technical or usability issues of this intervention before any future trials for large-scale implementation. RESULTS No critical beta test technical and usability issues were noted. Besides, the FaithCore intervention was helpful, easy to understand, and achieved its intended goals. Notably, 90% (9/10) of the participants reported that they tried quitting smoking, while 90% (9/10) reported using or seeking cessation resources discussed within the group. CONCLUSIONS This study shows that social media platform with culturally aligned and faith-aligned content and engagement strategies delivered by trained moderators are promising for smoking cessation interventions in rural communities. Our future step is to conduct a large pilot trial to evaluate the intervention's effectiveness on smoking cessation outcomes.
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Affiliation(s)
- Pravesh Sharma
- Department of Psychiatry and Psychology, Mayo Clinic Health System, Eau Claire, WI, United States
| | - Brianna Tranby
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Celia Kamath
- Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | - Tabetha A Brockman
- Rural Health Research Core, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Ned Lenhart
- Living Water Church, Cameron, WI, United States
| | - Brian Quade
- Bethesda Lutheran Church, Eau Claire, WI, United States
| | - Nate Abuan
- Valleybrook Church, Eau Claire, WI, United States
| | - Martin Halom
- St. John's Lutheran Church (ELCA), Bloomer, WI, United States
| | | | - Colleen Young
- Mayo Clinic Connect, Health Education & Content Services, Mayo Clinic, Rochester, MN, United States
| | - LaPrincess Brewer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Christi Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Rural Health Research Core, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
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Carroll DM, Jennings D, Stately A, Kamath A, Tessier KM, Cotoc C, Egbert A, Begnaud A, Businelle M, Hatsukami D, Pickner W. Pilot randomised controlled trial of a culturally aligned smoking cessation app for American Indian persons. Tob Control 2024:tc-2024-058665. [PMID: 38964856 DOI: 10.1136/tc-2024-058665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/23/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE To pilot test QuitGuide for Natives, a culturally aligned version of the National Cancer Institute's QuitGuide smartphone app for smoking cessation. METHODS This randomised controlled trial was conducted remotely during 2022-2023. American Indian adults who smoked and resided in the Midwest (n=115) were randomised to QuitGuide for Natives or the general audience QuitGuide smartphone-based intervention. Group differences in feasibility (times the app was initiated), usability, acceptability ('How likely would you be to recommend the app to a friend?'), fit of app with culture and preliminary efficacy (24-hour quit attempts, cotinine-confirmed self-reported 7-day abstinence) outcomes were examined. RESULTS QuitGuide for Natives versus the general audience QuitGuide did not differ in the number of times the app was opened (adjusted incidence rate ratio 0.94 (95% CI 0.63 to 1.40); p=0.743) nor in usability score (adjusted mean difference (aMD) 0.73 (95% CI: -5.00 to 6.46); p=0.801) or likeliness of recommending the app to a friend (aMD 0.62 (95% CI -0.02 to 1.27); p=0.058). Differences were observed for all cultural fit outcomes such as 'The app fits my American Indian culture (aMD 0.75 (95% CI 0.35 to 1.16); p<0.001). QuitGuide for Natives versus the general audience QuitGuide resulted in an average of 6.6 vs 5.1 24-hour quit attempts (p=0.349) and cotinine-confirmed 7-day abstinence was achieved by 6.9% vs 3.5% (p=0.679). CONCLUSIONS Acceptability, cultural fit and preliminary efficacy findings are encouraging and will inform future, larger-scale evaluation of culturally aligned digital smoking cessation resources for American Indian adults.
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Affiliation(s)
- Dana Mowls Carroll
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Dylan Jennings
- Sigurd Olson Environmental Institute, Northland College, Ashland, Wisconsin, USA
| | - Antony Stately
- Native American Community Clinic, Minneapolis, Minnesota, USA
| | - Amika Kamath
- American Indian Cancer Foundation, Minneapolis, Minnesota, USA
| | - Katelyn M Tessier
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Crina Cotoc
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew Egbert
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Abbie Begnaud
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Michael Businelle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Dorothy Hatsukami
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Wyatt Pickner
- American Indian Cancer Foundation, Minneapolis, Minnesota, USA
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Hicks LJ, Toombs E, Lund J, Kowatch KR, Hopkins C, Mushquash CJ. Expanding our understanding of digital mental health interventions for Indigenous youth: An updated systematic review. J Telemed Telecare 2024:1357633X241239715. [PMID: 38584397 DOI: 10.1177/1357633x241239715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Past research has examined available literature on electronic mental health interventions for Indigenous youth with mental health concerns. However, as there have recently been increases in both the number of studies examining electronic mental health interventions and the need for such interventions (i.e. during periods of pandemic isolation), the present systematic review aims to provide an updated summary of the available peer-reviewed and grey literature on electronic mental health interventions applicable to Indigenous youth. The purpose of this review is to better understand the processes used for electronic mental health intervention development. Among the 48 studies discussed, smoking cessation and suicide were the most commonly targeted mental health concerns in interventions. Text message and smartphone application (app) interventions were the most frequently used delivery methods. Qualitative, quantitative, and/or mixed outcomes were presented in several studies, while other studies outlined intervention development processes or study protocols, indicating high activity in future electronic mental health intervention research. Among the findings, common facilitators included the use of community-based participatory research approaches, representation of culture, and various methods of motivating participant engagement. Meanwhile, common barriers included the lack of necessary resources and limits on the amount of support that online interventions can provide. Considerations regarding the standards and criteria for the development of future electronic mental health interventions for Indigenous youth are offered and future research directions are discussed.
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Affiliation(s)
- Lydia J Hicks
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Kristy R Kowatch
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Carol Hopkins
- Thunderbird Partnership Foundation, Bothwell, ON, Canada
| | - Christopher J Mushquash
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
- Thunder Bay Regional Health Sciences Centre, ON, Canada
- Thunder Bay Regional Health Research Institute, ON, Canada
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Buller DB, Sussman AL, Thomson CA, Kepka D, Taren D, Henry KL, Warner EL, Walkosz BJ, Woodall WG, Nuss K, Blair CK, Guest DD, Borrayo EA, Gordon JS, Hatcher J, Wetter DW, Kinsey A, Jones CF, Yung AK, Christini K, Berteletti J, Torres JA, Barraza Perez EY, Small A. #4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial. JMIR Res Protoc 2024; 13:e50392. [PMID: 38386396 PMCID: PMC10921336 DOI: 10.2196/50392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas. OBJECTIVE This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah. METHODS We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign. RESULTS The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management. CONCLUSIONS Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors. TRIAL REGISTRATION ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50392.
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Affiliation(s)
| | - Andrew L Sussman
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Deanna Kepka
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Douglas Taren
- Section of Nutrition, University of Colorado Denver, Aurora, CO, United States
| | - Kimberly L Henry
- Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, CO, United States
| | - Echo L Warner
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | | | - Kayla Nuss
- Klein Buendel, Golden, CO, United States
| | - Cindy K Blair
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Dolores D Guest
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Evelinn A Borrayo
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | | | - David W Wetter
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Christopher F Jones
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Angela K Yung
- College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kaila Christini
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - John A Torres
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
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Patten CA, Koller KR, Sinicrope PS, Prochaska JJ, Young C, Resnicow K, Decker PA, Hughes CA, Merritt ZT, McConnell CR, Huang M, Thomas TK. Facebook Intervention to Connect Alaska Native People With Resources and Support to Quit Smoking: CAN Quit Pilot Randomized Controlled Trial. Nicotine Tob Res 2023; 25:803-813. [PMID: 36130170 PMCID: PMC10032195 DOI: 10.1093/ntr/ntac221] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/22/2022] [Accepted: 09/19/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION There is some evidence that social media interventions can promote smoking cessation. This randomized controlled pilot study is the first to evaluate the feasibility and potential efficacy of a Facebook smoking cessation intervention among Alaska Native (AN) adults. AIMS AND METHODS Recruitment and data collection occurred from December 2019 to March 2021. Participants were recruited statewide in Alaska using Facebook advertisements with a targeted sample of 60 enrolled. Participants were stratified by gender, age, and rural or urban residence and randomly assigned to receive referral resources on evidence-based cessation treatments (EBCTs) (control, n = 30) or these resources plus a 3-month, closed (private), culturally tailored, Facebook group (intervention, n = 31) that connected participants to EBCT resources and was moderated by two Alaska Native Trained Tobacco Specialists. Assessments were conducted online post-randomization at 1, 3, and 6 months. Outcomes were feasibility (recruitment, retention, and intervention engagement), self-reported use of EBCTs, and biochemically confirmed seven-day point-prevalence smoking abstinence. RESULTS Of intervention participants, 90% engaged (eg posted, commented) more than once. Study retention was 57% at 6 months (no group differences). The proportion utilizing EBCTs was about double for intervention compared with the control group participants at 3 and 6 months. Smoking abstinence was higher for intervention than control participants at 3 months (6.5% vs. 0%, p = .16) but comparable at 6 months (6.4% vs. 6.7%, p = .97). CONCLUSIONS While additional research is needed to promote long-term cessation, this pilot trial supports recruitment feasibility during the Coronavirus Disease 2019 (COVID-19) pandemic, consumer uptake, and a signal for intervention efficacy on the uptake of cessation treatment and short-term smoking abstinence. IMPLICATIONS This study is the first evaluation of a social media intervention for smoking cessation among Indigenous people. We learned that statewide Facebook recruitment of AN adults who smoke was feasible and there was a signal for the efficacy of a Facebook intervention on the uptake of EBCT and short-term (3 months) biochemically verified smoking abstinence. Clinically, social media platforms may complement current care models by connecting AN individuals and others living in hard-to-reach communities to cessation treatment resources.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Pamela S Sinicrope
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Judith J Prochaska
- Department of Medicine, Stanford Prevention Research Center, Stanford University, 1265 Welch Road, Stanford, CA, 94305-5411, USA
| | - Colleen Young
- Division of Consumer Communications, Social and Digital Innovation, Mayo Clinic Connect, 200 First St SW, Rochester, MN, 55905, USA
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI, 48109, USA
| | - Paul A Decker
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Christine A Hughes
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Zoe T Merritt
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Ming Huang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Timothy K Thomas
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
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Protocol for iSISTAQUIT: Implementation phase of the supporting indigenous smokers to assist quitting project. PLoS One 2022; 17:e0274139. [DOI: 10.1371/journal.pone.0274139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/22/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction
About 44% of Aboriginal and/or Torres Strait Islander women smoke during pregnancy compared to 12% of their general population counterparts. Evidence-based quit smoking advice received from health care professionals (HCPs) can increase smoking cessation rates. However, HCPs lack culturally appropriate smoking cessation training, which is a major barrier to provision of smoking cessation care for this population.
Methods and analysis
iSISTAQUIT is a multicentre, single arm study aiming to implement and evaluate the evidence-based, culturally competent iSISTAQUIT smoking cessation training among health practitioners who provide support and assistance to pregnant, Aboriginal and Torres Strait Islander women in Australia. This project will implement the iSISTAQUIT intervention in Aboriginal Medical Services and Mainstream Health Services. The proposed sample size is 10 of each of these services (total N = 20), however if the demand is higher, we will aim to accommodate up to 30 services for the training. Participating sites and their HCPs will have the option to choose one of the two iSISTAQUIT packages available: a) Evaluation- research package b) Training package (with or without continued professional development points). Training will be provided via an online eLearning platform that includes videos, text, interactive elements and a treatment manual. A social media campaign will be conducted from December 2021 to September 2022 to raise brand and issue awareness about smoking cessation for Aboriginal and Torres Strait Islander women in pregnancy. This national campaign will consist of systematic advertising and promotion of iSISTAQUIT and video messages through various social media platforms.
Analysis
We will use the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to plan, evaluate and report the intervention impact of iSISTAQUIT. Effectiveness of social media campaign will be assessed via social media metrics, cross-sectional surveys, and interviews.
Discussion
This innovative research, using a multi-component intervention, aims to practically apply and integrate a highly translatable smoking cessation intervention in real-world primary care settings in Aboriginal Medical Services and Mainstream services. The research benefits Aboriginal women, babies and their family and community members through improved support for smoking cessation during pregnancy. The intervention is based on accepted Australian and international smoking cessation guidelines, developed and delivered in a culturally appropriate approach for Aboriginal communities.
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Exploring the perceived effectiveness and cultural acceptability of COVID-19 relevant social media intervention content among Alaska Native people who Smoke: The CAN Quit Study. Prev Med Rep 2022; 30:102042. [PMID: 36405042 PMCID: PMC9639382 DOI: 10.1016/j.pmedr.2022.102042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
Social media platforms have potential for reach and effectiveness to motivate smoking cessation and use of evidence-based cessation treatment, even during the worldwide COVID-19 pandemic. This study builds on our prior community participatory approach to developing content postings for the CAN Quit Facebook intervention among Alaska Native (AN) people who smoke. With input from a community advisory committee, we selected new content on COVID-19 preventive practices (e.g., masking) and evaluated them using a validated, six-item perceived effectiveness scale and a single item assessing cultural relevance. We obtained feedback on six content postings (two videos and four text/pictures) from an online survey administered to 41 AN people (14 men, 27 women; age range 22–61 years) who smoke in Alaska statewide with 49 % residing in rural Alaska. Perceived effectiveness scale scores were high across postings, ranging from 3.9 to 4.4 out of a maximum score of 5.0. Cultural relevance item scores ranged from 3.9 to 4.3. We found no appreciable differences by sex, age, or rural/urban location for either score. This study adds new information on the adaptation, acceptability, and perceived effectiveness of content on COVID-19 preventive practices for future inclusion in a social media-based intervention for smoking cessation specifically tailored for AN people.
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Patten CA, Hiratsuka VY, Nash SH, Day G, Redwood DG, Beans JA, Howard BV, Umans JG, Koller KR. Smoking Patterns Among Urban Alaska Native and American Indian Adults: The Alaska EARTH 10-Year Follow-up Study. Nicotine Tob Res 2022; 24:840-846. [PMID: 34850172 PMCID: PMC9048910 DOI: 10.1093/ntr/ntab245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Data on cigarette smoking prevalence among Alaska Native and American Indian (ANAI) people are limited to cross-sectional studies or specific subpopulations. Using data from the Alaska Education and Research toward Health (EARTH) Study 10-year follow-up, this study assessed patterns of smoking from baseline and factors associated with current use. AIMS AND METHODS EARTH Study urban south central ANAI participants (N = 376; 73% women) provided questionnaire data on smoking at baseline and 10-year follow-up. Multivariable-adjusted logistic regression assessed whether gender, cultural factors (Tribal identity, language spoken in the home), depressive symptoms (PHQ-9), baseline smoking status, and baseline cigarettes per day (CPD) were associated with current smoking at follow-up. RESULTS Current smoking was 27% and 23% at baseline and follow-up, respectively. Of baseline smokers, 60% reported smoking at follow-up (77% men, 52% women). From multivariable-adjusted analyses, the odds of current smoking at follow-up were lower among women than men, those who never or formerly smoked versus currently smoked at baseline, and smoking <10 CPD compared with ≥10 CPD at baseline. PHQ-9 score or cultural variables were not associated with smoking at follow-up. Smoking fewer baseline CPD was associated with former smoking status (ie, quitting) at follow-up among women, but not men. CONCLUSIONS Our project is among the first to longitudinally explore smoking within an ANAI cohort. While we observed persistent smoking during a 10-year period, there were important differences by gender and CPD in quitting. These differences may be important to enhance the reach and efficacy of cessation interventions for ANAI people. IMPLICATIONS This study contributes novel longitudinal information on cigarette smoking prevalence during a 10-year period among Alaska Native and American Indian (ANAI) people. Prior data on smoking prevalence among ANAI people are limited to cross-sectional studies or specific subpopulations. Our project is among the first to longitudinally explore smoking prevalence within an ANAI cohort. We observed persistent smoking during a 10-year period. The study also contributes information on differences by gender and cigarettes smoked per day in quitting. These findings have implications for enhancing the reach and efficacy of cessation interventions for ANAI people.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Vanessa Y Hiratsuka
- Center for Human Development, University of Alaska Anchorage, Anchorage, AK, USA
- Research Department, Southcentral Foundation, Anchorage, AK, USA
| | - Sarah H Nash
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Gretchen Day
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Diana G Redwood
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Julie A Beans
- Research Department, Southcentral Foundation, Anchorage, AK, USA
| | - Barbara V Howard
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Santiago-Torres M, Mull KE, Sullivan BM, Kwon DM, Nez Henderson P, Nelson LA, Patten CA, Bricker JB. Efficacy and Utilization of Smartphone Applications for Smoking Cessation Among American Indians and Alaska Natives: Results From the iCanQuit Trial. Nicotine Tob Res 2022; 24:544-554. [PMID: 34644389 PMCID: PMC8887580 DOI: 10.1093/ntr/ntab213] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION There is tremendous need for efficacious and accessible interventions for smoking cessation among American Indians and Alaska Natives. We tested the efficacy of an Acceptance and Commitment Therapy (ACT)-based smartphone application (iCanQuit) versus US Clinical Practice Guidelines-based smartphone application (QuitGuide) for smoking cessation among American Indians and Alaska Natives. AIMS AND METHODS We compared cessation, changes in ACT-based processes, engagement and satisfaction between American Indian and Alaska Native iCanQuit (n = 89) and QuitGuide (n = 80) participants enrolled in the iCanQuit trial. The primary outcome was self-reported, complete-case, 30-day point-prevalence abstinence. Follow-up timepoints were 12, 6, and 3 months. RESULTS Randomized American Indians and Alaska Natives from 31 US states (70% urban, 30% rural, with 25% of participants residing on tribal land). The outcome data retention rates were 93%, 92%, and 90% at the 12-, 6-, and 3-month follow-ups, respectively, with no differential retention between arms. The 30-day point-prevalence abstinence for iCanQuit versus QuitGuide was 30% versus 18% at 12 months (odds ratio [OR] = 1.96; 95% confidence interval [CI]: 0.90 to 4.26) 25% versus 11% at 6 months (OR = 2.62; 95% CI: 1.06 to 6.45), and 15% versus 6% at 3 months (OR = 2.93; 95% CI: 0.90 to 9.59). Increases in acceptance of internal cues to smoke mediated the effect of treatment on smoking cessation at 12 months. iCanQuit arm participants were also significantly more engaged and satisfied with their assigned application. CONCLUSIONS In a nationwide sample with high data retention and participant engagement, this is the first study to show that a digital intervention may be efficacious for helping American Indians and Alaska Natives quit smoking. IMPLICATIONS This is the first study to provide evidence of an efficacious, accessible, and engaging treatment for helping American Indians and Alaska Natives quit smoking. Compared to a US Clinical Practice Guidelines-based smartphone application (QuitGuide), an ACT-based smartphone application (iCanQuit) was more efficacious, engaging, and satisfactory among American Indians and Alaska Natives nationwide. Our results will inform the tailoring of the iCanQuit smartphone application for American Indian and Alaska Native tribal communities and organizations with potential for broad dissemination and high impact.
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Affiliation(s)
| | - Kristin E Mull
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Brianna M Sullivan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Diana M Kwon
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA,USA
| | | | - Lonnie A Nelson
- Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, WA, USA
- Washington State University College of Nursing, Spokane, WA, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, Rochester, MN, USA
| | - Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA,USA
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10
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Sinicrope PS, Young CD, Resnicow K, Merritt ZT, McConnell CR, Hughes CA, Koller KR, Bock MJ, Decker PA, Flanagan CA, Meade CD, Thomas TK, Prochaska JJ, Patten CA. Lessons Learned From Beta-Testing a Facebook Group Prototype to Promote Treatment Use in the "Connecting Alaska Native People to Quit Smoking" (CAN Quit) Study. J Med Internet Res 2022; 24:e28704. [PMID: 35175208 PMCID: PMC8895280 DOI: 10.2196/28704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/21/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022] Open
Abstract
Social media provides an effective tool to reach, engage, and connect smokers in cessation efforts. Our team developed a Facebook group, CAN Quit (Connecting Alaska Native People to Quit smoking), to promote use of evidence-based smoking cessation resources for Alaska Native people living in Alaska, which are underused despite their effectiveness. Often separated by geography and climate, Alaska Native people prefer group-based approaches for tobacco cessation that support their culture and values. Such preferences make Alaska Native people candidates for social media-based interventions that promote connection. This viewpoint discusses the steps involved and lessons learned in building and beta-testing our Facebook group prototype, which will then be evaluated in a pilot randomized controlled trial. We describe the process of training moderators to facilitate group engagement and foster community, and we describe how we developed and tested our intervention prototype and Facebook group. All parts of the prototype were designed to facilitate use of evidence-based cessation treatments. We include recommendations for best practices with the hope that lessons learned from the CAN Quit prototype could provide a model for others to create similar platforms that benefit Alaska Native and American Indian people in the context of smoking cessation.
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Affiliation(s)
- Pamela S Sinicrope
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Colleen D Young
- Division of Consumer Communications, Social and Digital Innovation, Mayo Clinic Connect, Rochester, MN, United States
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Zoe T Merritt
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Christine A Hughes
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Kathryn R Koller
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Martha J Bock
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Paul A Decker
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Christie A Flanagan
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Crystal D Meade
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Timothy K Thomas
- Clinical & Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Christi A Patten
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
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11
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Flemington T, La Hera-Fuentes G, Bovill M, Hart A, Bennett J, Ryan NM, Gould GS. Smoking Cessation Messages for Pregnant Aboriginal and Torres Strait Islander Women: A Rapid Review of Peer-Reviewed Literature and Assessment of Research Translation of Media Content. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179341. [PMID: 34501931 PMCID: PMC8430943 DOI: 10.3390/ijerph18179341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022]
Abstract
This review summarized literature about knowledge, attitudes, and beliefs of Aboriginal and Torres Strait Islander women from Australia who smoke during pregnancy, then examined the extent that existing health promotion materials and media messages aligned with evidence on smoking cessation for pregnant Aboriginal and Torres Strait Islander women. Knowledge, attitudes, and beliefs of pregnant Aboriginal women who smoke tobacco were identified in the literature. Health promotion campaigns were retrieved from a grey literature search with keywords and social and professional networks. Key themes from peer-reviewed papers were compared against the content of health promotion campaigns using the Aboriginal Social and Emotional Wellbeing Model, the Behavior Change Wheel and thematic analysis. Eleven empirical studies and 17 campaigns were included. Empirical studies highlighted women sought holistic care that incorporated nicotine replacement therapy, engaged with their family and community and the potential for education about smoking cessation to empower a woman. Health promotion campaigns had a strong focus on ‘engagement with family and community’, ‘knowledge of risks of smoking,’ ‘giving up vs cutting down’ and ‘culture in language and arts’. There were similarities and variances in the key themes in the research evidence and promotion materials. Topics highly aligned included risks from smoking and quitting related issues.
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Affiliation(s)
- Tara Flemington
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW 2006, Australia;
| | - Gina La Hera-Fuentes
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (G.L.H.-F.); (M.B.); (A.H.); (J.B.); (N.M.R.)
| | - Michelle Bovill
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (G.L.H.-F.); (M.B.); (A.H.); (J.B.); (N.M.R.)
| | - Allison Hart
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (G.L.H.-F.); (M.B.); (A.H.); (J.B.); (N.M.R.)
| | - Jessica Bennett
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (G.L.H.-F.); (M.B.); (A.H.); (J.B.); (N.M.R.)
| | - Nicole M. Ryan
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia; (G.L.H.-F.); (M.B.); (A.H.); (J.B.); (N.M.R.)
| | - Gillian Sandra Gould
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW 2480, Australia
- Correspondence:
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12
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Petkovic J, Duench S, Trawin J, Dewidar O, Pardo Pardo J, Simeon R, DesMeules M, Gagnon D, Hatcher Roberts J, Hossain A, Pottie K, Rader T, Tugwell P, Yoganathan M, Presseau J, Welch V. Behavioural interventions delivered through interactive social media for health behaviour change, health outcomes, and health equity in the adult population. Cochrane Database Syst Rev 2021; 5:CD012932. [PMID: 34057201 PMCID: PMC8406980 DOI: 10.1002/14651858.cd012932.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Social networking platforms offer a wide reach for public health interventions allowing communication with broad audiences using tools that are generally free and straightforward to use and may be combined with other components, such as public health policies. We define interactive social media as activities, practices, or behaviours among communities of people who have gathered online to interactively share information, knowledge, and opinions. OBJECTIVES We aimed to assess the effectiveness of interactive social media interventions, in which adults are able to communicate directly with each other, on changing health behaviours, body functions, psychological health, well-being, and adverse effects. Our secondary objective was to assess the effects of these interventions on the health of populations who experience health inequity as defined by PROGRESS-Plus. We assessed whether there is evidence about PROGRESS-Plus populations being included in studies and whether results are analysed across any of these characteristics. SEARCH METHODS We searched CENTRAL, CINAHL, Embase, MEDLINE (including trial registries) and PsycINFO. We used Google, Web of Science, and relevant web sites to identify additional studies and searched reference lists of included studies. We searched for published and unpublished studies from 2001 until June 1, 2020. We did not limit results by language. SELECTION CRITERIA We included randomised controlled trials (RCTs), controlled before-and-after (CBAs) and interrupted time series studies (ITSs). We included studies in which the intervention website, app, or social media platform described a goal of changing a health behaviour, or included a behaviour change technique. The social media intervention had to be delivered to adults via a commonly-used social media platform or one that mimicked a commonly-used platform. We included studies comparing an interactive social media intervention alone or as a component of a multi-component intervention with either a non-interactive social media control or an active but less-interactive social media comparator (e.g. a moderated versus an unmoderated discussion group). Our main outcomes were health behaviours (e.g. physical activity), body function outcomes (e.g. blood glucose), psychological health outcomes (e.g. depression), well-being, and adverse events. Our secondary outcomes were process outcomes important for behaviour change and included knowledge, attitudes, intention and motivation, perceived susceptibility, self-efficacy, and social support. DATA COLLECTION AND ANALYSIS We used a pre-tested data extraction form and collected data independently, in duplicate. Because we aimed to assess broad outcomes, we extracted only one outcome per main and secondary outcome categories prioritised by those that were the primary outcome as reported by the study authors, used in a sample size calculation, and patient-important. MAIN RESULTS We included 88 studies (871,378 participants), of which 84 were RCTs, three were CBAs and one was an ITS. The majority of the studies were conducted in the USA (54%). In total, 86% were conducted in high-income countries and the remaining 14% in upper middle-income countries. The most commonly used social media platform was Facebook (39%) with few studies utilising other platforms such as WeChat, Twitter, WhatsApp, and Google Hangouts. Many studies (48%) used web-based communities or apps that mimic functions of these well-known social media platforms. We compared studies assessing interactive social media interventions with non-interactive social media interventions, which included paper-based or in-person interventions or no intervention. We only reported the RCT results in our 'Summary of findings' table. We found a range of effects on health behaviours, such as breastfeeding, condom use, diet quality, medication adherence, medical screening and testing, physical activity, tobacco use, and vaccination. For example, these interventions may increase physical activity and medical screening tests but there was little to no effect for other health behaviours, such as improved diet or reduced tobacco use (20,139 participants in 54 RCTs). For body function outcomes, interactive social media interventions may result in small but important positive effects, such as a small but important positive effect on weight loss and a small but important reduction in resting heart rate (4521 participants in 30 RCTs). Interactive social media may improve overall well-being (standardised mean difference (SMD) 0.46, 95% confidence interval (CI) 0.14 to 0.79, moderate effect, low-certainty evidence) demonstrated by an increase of 3.77 points on a general well-being scale (from 1.15 to 6.48 points higher) where scores range from 14 to 70 (3792 participants in 16 studies). We found no difference in effect on psychological outcomes (depression and distress) representing a difference of 0.1 points on a standard scale in which scores range from 0 to 63 points (SMD -0.01, 95% CI -0.14 to 0.12, low-certainty evidence, 2070 participants in 12 RCTs). We also compared studies assessing interactive social media interventions with those with an active but less interactive social media control (11 studies). Four RCTs (1523 participants) that reported on physical activity found an improvement demonstrated by an increase of 28 minutes of moderate-to-vigorous physical activity per week (from 10 to 47 minutes more, SMD 0.35, 95% CI 0.12 to 0.59, small effect, very low-certainty evidence). Two studies found little to no difference in well-being for those in the intervention and control groups (SMD 0.02, 95% CI -0.08 to 0.13, small effect, low-certainty evidence), demonstrated by a mean change of 0.4 points on a scale with a range of 0 to 100. Adverse events related to the social media component of the interventions, such as privacy issues, were not reported in any of our included studies. We were unable to conduct planned subgroup analyses related to health equity as only four studies reported relevant data. AUTHORS' CONCLUSIONS This review combined data for a variety of outcomes and found that social media interventions that aim to increase physical activity may be effective and social media interventions may improve well-being. While we assessed many other outcomes, there were too few studies to compare or, where there were studies, the evidence was uncertain. None of our included studies reported adverse effects related to the social media component of the intervention. Future studies should assess adverse events related to the interactive social media component and should report on population characteristics to increase our understanding of the potential effect of these interventions on reducing health inequities.
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Affiliation(s)
| | | | | | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Jordi Pardo Pardo
- Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | - Rosiane Simeon
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Marie DesMeules
- Social Determinants and Science Integration/ Direction des déterminants sociaux et de l'intégration scientifique, Public Health Agency of Canada/Agence de santé publique du Canada, Ottawa, Canada
| | - Diane Gagnon
- Department of Communication, University of Ottawa, Ottawa, Canada
| | | | - Alomgir Hossain
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kevin Pottie
- Family Medicine, University of Ottawa, Ottawa, Canada
| | - Tamara Rader
- Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
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13
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Merculieff ZT, Koller KR, Sinicrope PS, Hughes CA, Bock MJ, Decker PA, Resnicow K, Flanagan CA, Meade CD, McConnell CR, Prochaska JJ, Thomas TK, Patten CA. Developing a Social Media Intervention to Connect Alaska Native People Who Smoke with Resources and Support to Quit Smoking: The Connecting Alaska Native Quit Study. Nicotine Tob Res 2021; 23:1002-1009. [PMID: 33674856 PMCID: PMC8248946 DOI: 10.1093/ntr/ntaa253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/30/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Face-to-face tobacco cessation has had limited reach and efficacy in Alaska Native (AN) communities. We describe our two-phased approach to develop content for Connecting Alaska Native People to Quit Smoking, a Facebook group intervention to reduce barriers to evidence-based smoking cessation treatment for AN people in Alaska. METHODS Phase 1 included semi-structured telephone interviews with 30 AN people who smoke and ten stakeholders. They provided feedback on existing content from the Centers for Disease Control and Prevention Tips campaign and AN digital stories. Phase 2 included an online survey with a new group of 40 AN smokers who provided feedback on existing content via a measure of perceived effectiveness and cultural relevance. RESULTS Phase I results revealed participants evaluated content based upon story strength, relevance to AN culture, emotional appeal, relatability to AN people, and favorite video. No single posting was rated highly across all themes. All perceived effectiveness (PE) and cultural relevance median scores fell between 3.5 and 4.4 (range 1-5). PE scores varied across participant demographic groups. CONCLUSIONS Content embodying characteristics perceived to be most appealing, effective, and culturally relevant were selected for the private Facebook group content library with refinements made to incorporate images of AN people engaged in AN activities. PE scores indicate a need for a wide variety of content that moderators could pull from when conducting the intervention. IMPLICATIONS Social media content targeting specific population sectors, such as American Indian/AN people for tobacco cessation needs to be culturally tailored. Our approach provides a model others can follow to determine what is appealing, relevant, and effective messaging. CLINICAL TRIAL REGISTRATION NCT03645941.
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Affiliation(s)
- Zoe T Merculieff
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Kathryn R Koller
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Pamela S Sinicrope
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
| | - Christine A Hughes
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
| | - Martha J Bock
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
| | - Paul A Decker
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
- Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, USA
| | - Kenneth Resnicow
- School of Public Health, University of
Michigan, Ann Arbor, MI, USA
| | - Christie A Flanagan
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Crystal D Meade
- Wellness and Prevention, Division of Community Health
Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health
Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of
Medicine, Stanford University, Stanford,
CA, USA
| | - Timothy K Thomas
- Clinical & Research Services, Division of Community
Health Services, Alaska Native Tribal Health Consortium,
Anchorage, AK, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology and Behavioral
Health Research Program, Mayo Clinic, Rochester,
MN, USA
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14
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Patten CA, Lando HA, Desnoyers CA, Bock MJ, Alexie L, Decker PA, Hughes CA, Resnicow K, Burhansstipanov L, Boyer R, Klejka J. Healthy Pregnancies Project: Cluster Randomized Controlled Trial of a Community Intervention to Reduce Tobacco Use among Alaska Native Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9302. [PMID: 33322686 PMCID: PMC7764642 DOI: 10.3390/ijerph17249302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022]
Abstract
Substantial gaps remain in the evidence base for prenatal tobacco use interventions among Indigenous women. Using a cluster randomized controlled trial (RCT), the Healthy Pregnancies Project evaluated a community-level intervention for Alaska Native (AN) women in rural western Alaska. Sixteen villages were randomly assigned to usual care (control, n = 8 villages) or usual care plus a community-level intervention delivered by local AN "Native Sisters" (n = 8 villages). Outcomes were tobacco use rate at delivery and at 2 and 6 months postpartum, with biochemical confirmation obtained at 6 months. The program had high reach, enrolling 73% of all eligible women screened. Of the 352 participants, 67% used tobacco at baseline. No significant differences emerged between study groups on follow-up in tobacco use rates. More intervention than control participants made a quit attempt at 2 months postpartum (70% vs. 51%, respectively, p = 0.012). Participants in both study groups reported the program helped to raise awareness of healthy pregnancies in the study villages. This trial supports the reach of a community-level intervention, but not its efficacy for reducing tobacco use during pregnancy or postpartum. Efforts to sustain early quit attempts appear warranted. The community involvement, and reported impact on raising awareness of the importance of healthy pregnancies, supports the value of the research program in this community.
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Affiliation(s)
- Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA; (M.J.B.); (C.A.H.)
| | - Harry A. Lando
- School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 2nd St, Ste 200, Minneapolis, MN 55454, USA;
| | - Chris A. Desnoyers
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
| | - Martha J. Bock
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA; (M.J.B.); (C.A.H.)
| | - Lucinda Alexie
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
| | - Paul A. Decker
- Department of Health Sciences Research, Mayo Clinic, Harwick 7, 200 First Street SW, Rochester, MN 55905, USA;
| | - Christine A. Hughes
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA; (M.J.B.); (C.A.H.)
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI 48109, USA;
| | - Linda Burhansstipanov
- Native American Cancer Initiatives, Inc., 3022 South Nova Road, Pine, CO 80470, USA;
| | - Rahnia Boyer
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
| | - Joseph Klejka
- Yukon-Kuskokwim Health Corporation, 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559, USA; (C.A.D.); (L.A.); (R.B.); (J.K.)
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