Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California 94143-0610, USA.
Heart Lung. 2010 Jan-Feb;39(1):50-63. doi: 10.1016/j.hrtlng.2009.06.004. Epub 2009 Jul 22.
This article describes the process and results of a smoking cessation intervention randomized clinical trial (RCT) that was conducted as a community-based participatory research project. This RCT tested whether outcomes are improved by adding social justice and tobacco industry targeting messages to a smoking cessation program conducted among African American adults within a low-income community in San Francisco, California. This study provides lessons for future similar research projects that focus on urban low-income populations.
Participants were randomly allocated to receive a smoking-cessation program (control group [CG]) or CG care plus tobacco industry and media (IAM) messages. Primary interventions were behavioral. At intake, participants reporting severe withdrawal or smoking > or = 25 cigarettes daily were offered free nicotine replacement therapy. Baseline data were from an in-person interview. Outcome measures included self-reported smoking status; validation of quitting was by salivary cotinine assays.
Of 87 participants providing baseline data, 31% (27) did not join the RCT. Proportions quitting in the CG and IAM group were 11.5% and 13.6% at 6 months and 5.3% and 15.8% at 12 months, respectively.
African Americans in underserved inner-city neighborhoods can be recruited into RCTs with community participatory approaches. Differences between the CG and IAM in proportions who quit were 2.1% and 10.5% at 6 and 12 months, respectively. More than 3 years with adequate funding, high staffing ratios, and intense outreach and follow-up schedules are needed to achieve recruitment and study goals.
本文描述了一项作为社区参与式研究项目开展的戒烟干预随机临床试验（RCT）的过程和结果。该 RCT 旨在检验在加利福尼亚州旧金山一个低收入社区中针对非裔美国成年人开展的戒烟项目中增加社会公正和烟草业针对性信息能否改善结果。本研究为未来关注城市低收入人群的类似研究项目提供了经验教训。
参与者被随机分配接受戒烟计划（对照组[CG]）或 CG 护理加烟草业和媒体（IAM）信息。主要干预措施是行为干预。在入组时，报告严重戒断或每天吸烟≥25 支的参与者可获得免费尼古丁替代疗法。基线数据来自面对面访谈。主要结局指标包括自我报告的吸烟状况；通过唾液可替宁检测来验证戒烟情况。
在提供基线数据的 87 名参与者中，31%（27 名）未参加 RCT。CG 和 IAM 组分别在 6 个月和 12 个月时的戒烟比例为 11.5%和 13.6%，5.3%和 15.8%。
可以通过社区参与式方法招募服务不足的内城贫困非裔美国人参加 RCT。CG 和 IAM 组在 6 个月和 12 个月时的戒烟比例分别相差 2.1%和 10.5%。需要 3 年以上的充足资金、高人员配备比例以及密集的外展和随访计划才能实现招募和研究目标。
