Patten Christi A, Fadahunsi Oluwole, Hanza Marcelo M K, Smith Christina A, Decker Paul A, Boyer Rahnia, Ellsworth Laura, Brockman Tabetha A, Hughes Christine A, Bronars Carrie A, Offord Kenneth P
Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, Rochester, MN;
Nicotine Tob Res. 2014 Jun;16(6):836-45. doi: 10.1093/ntr/ntu004. Epub 2014 Feb 14.
Tobacco cessation treatments have not been evaluated among Alaska Native (AN) adolescents. This pilot study evaluated the feasibility and the potential efficacy of a targeted cessation intervention for AN youth using a group randomized design.
Eight villages in western Alaska were randomly assigned to receive the intervention (n = 4 villages) or a delayed treatment control condition (written materials only; n = 4 villages). Ten adolescents aged 12-17 years were targeted from each village with a planned enrollment of 80. The intervention was held over a weekend, and youth traveled from their villages to quit tobacco use with other teens. The intervention comprised 8 hr of group-based counseling. Talking circles, personal stories from elders, and recreational activities were included to enhance cultural acceptability and participation. Newsletters were mailed weekly for 5-weeks postprogram. Assessments were conducted at baseline, week 6 (end-of-treatment), and 6 months. Self-reported tobacco abstinence was confirmed with salivary cotinine.
Recruitment targets were met in the intervention (41 enrolled) but not in control villages (27 enrolled). All intervention participants attended the weekend program. Retention was high; 98% of intervention and 86% of control participants completed 6-month follow-up. The 7-day point-prevalence self-reported tobacco abstinence rates for intervention and control participants were 10% (4/41) and 0% (0/27) at both week 6 and 6 months (p = .15). Only 1 adolescent in the intervention condition was biochemically confirmed abstinent at week 6 and none at 6 months.
The intensive individual-focused intervention used in this study was feasible but not effective for tobacco cessation among AN youth. Alternative approaches are warranted.
阿拉斯加原住民(AN)青少年群体尚未接受过戒烟治疗评估。本试点研究采用群组随机设计,评估了针对AN青少年的靶向戒烟干预措施的可行性和潜在效果。
阿拉斯加西部的八个村庄被随机分配接受干预(n = 4个村庄)或延迟治疗对照条件(仅提供书面材料;n = 4个村庄)。每个村庄选定10名12 - 17岁的青少年,计划招募80人。干预活动在一个周末进行,青少年从各自村庄赶来与其他青少年一起戒烟。干预包括8小时的小组咨询。活动中加入了交流圈、长者的个人故事以及娱乐活动,以提高文化接受度和参与度。项目结束后每周邮寄时事通讯,持续5周。在基线、第6周(治疗结束时)和6个月时进行评估。自我报告的戒烟情况通过唾液可替宁进行确认。
干预组达到了招募目标(41人登记),但对照组村庄未达到(27人登记)。所有干预参与者都参加了周末项目。留存率很高;干预组98%的参与者和对照组86%的参与者完成了6个月的随访。在第6周和6个月时,干预组和对照组参与者自我报告的7天点流行率戒烟率分别为10%(4/41)和0%(0/27)(p = 0.15)。在干预组中,只有1名青少年在第6周经生化确认戒烟,6个月时无人戒烟。
本研究中使用的强化个体聚焦干预措施可行,但对AN青少年戒烟无效。需要采用其他方法。