Evans Shenell D, Sheffer Christine E, Bickel Warren K, Cottoms Naomi, Olson Mary, Pitì Luana Panissidi, Austin Tekeshia, Stayna Helen
HIV Centre for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA.
Sophie Davis School of Biomedical Education, City College of New York, New York, USA.
J Addict Res Ther. 2015 Mar;6(1). doi: 10.4172/2155-6105.1000219. Epub 2015 Mar 20.
Tobacco use is the leading cause of preventable death and disease and contributes significantly to socioeconomic health disparities. The prevalence of smoking among individuals of lower socioeconomic status (SES) in the US, many of whom are African American (AA), is three to four times greater than the prevalence of smoking among individuals of higher SES. The disparity in tobacco dependence treatment outcomes between lower and higher SES smokers contributes to tobacco-related health disparities and calls for adapting evidence-based treatment to more fully meet the needs of lower SES smokers.
We sought to adapt the evidence-based treatment for tobacco dependence using recommended frameworks for adapting evidence-based treatments.
We systematically applied the recommended steps for adapting evidence-based treatments described by Barrera and Castro and Lau. The steps included information gathering, preliminary adaptation design, preliminary adaptation tests, and adaptation refinement. We also applied the PEN-3 Model for incorporating AA values and experiences into treatment approaches and a community-engaged approach.
RESULTS/FINDINGS: Findings from each step in the process contributed to the results. The final results were incorporated into a revised treatment called the RITCh Study Tobacco Dependence Treatment Manual and Toolkit.
To our knowledge, this is the first adaptation of evidence-based treatment for tobacco dependence that has systematically applied these recommended frameworks. The efficacy of the treatment to reduce treatment outcome disparities is now being examined in a randomized controlled trial in which the revised treatment is being compared with a standard, individualized cognitive-behavioral approach.
烟草使用是可预防死亡和疾病的主要原因，对社会经济健康差距有重大影响。在美国，社会经济地位较低（SES）的人群中吸烟率较高，其中许多是非裔美国人（AA），其吸烟率是社会经济地位较高人群的三到四倍。社会经济地位较低和较高的吸烟者在烟草依赖治疗结果上的差异导致了与烟草相关的健康差距，因此需要调整循证治疗方法，以更充分地满足社会经济地位较低的吸烟者的需求。
我们试图使用推荐的循证治疗调整框架，对烟草依赖的循证治疗进行调整。
我们系统地应用了巴雷拉、卡斯特罗和刘所描述的循证治疗调整的推荐步骤。这些步骤包括信息收集、初步调整设计、初步调整测试和调整完善。我们还应用了PEN-3模型，将非裔美国人的价值观和经验纳入治疗方法，并采用社区参与方法。
结果/发现：该过程中每个步骤的发现都对结果有所贡献。最终结果被纳入一个修订后的治疗方案，即RITCh研究烟草依赖治疗手册和工具包。
据我们所知，这是首次对烟草依赖的循证治疗进行调整，并系统地应用了这些推荐框架。目前正在一项随机对照试验中检验该治疗方法减少治疗结果差异的疗效，在该试验中，将修订后的治疗方法与标准的个体化认知行为方法进行比较。
