Pakhale Smita, Kaur Tina, Charron Catherine, Florence Kelly, Rose Tiffany, Jama Sadia, Boyd Robert, Haddad Joanne, Alvarez Gonzalo, Tyndall Mark
Ottawa Hospital, Ottawa, Ontario, Canada.
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
BMJ Open. 2018 Jan 25;8(1):e018416. doi: 10.1136/bmjopen-2017-018416.
To determine the feasibility of a Community-Based Participatory Tobacco Dependence Strategy (PROMPT) in the inner city population of Ottawa (Canada).
A feasibility mixed methods prospective cohort study following principles of community-based participatory action research.
Recruited 80 people whouse drugs, followed them for 6 months while providing access to counselling, nicotine replacement therapy and peer-support in a community setting.
Community research office in downtown Ottawa, adjacent to low-income housing, shelter services and street-based drug consumption.
Retention rate at 6-month follow-up.
Biochemically validated 7-day point prevalence smoking abstinence at 26 weeks, self-reported abstinence in the past 7 days with exhaled carbon monoxide ≤10 ppm.
The average age of participants was 43.8 years. The 6-month follow-up rate was 42.5%. The mean number of smoking years reported was 27.3 years. The participants were 70% male, 33.7% reported less than a high-school education, 21% identified as indigenous and 43.8% reported an income between US$1000 and US$1999 per month. The baseline mean daily cigarette use was 20.5 and 9.3 cigarettes at study end, with mean reduction of 11.2 cigarettes at 6 months (P=0.0001). There was a considerable reduction in self-reported illicit substance use (18.8%), including a reduction in the opioids heroin (6.3%), fentanyl (2.6%) and Oxycontin (3.8%). The study findings also reveal psycho-socioeconomic benefits such as improved health, return to work and greater community engagement.
The PROMPT project describes socioeconomic variables associated with tobacco and polysubstance use. A programme focused on tobacco dependence, easily accessible in the community and led by community peers with lived experience is feasible to implement and has the potential to support positive life changes. PROMPT's patient engagement model is an effective harm-reduction strategy for the growing opioid use crisis and can improve the health outcomes of marginalised at-risk populations worldwide.
确定基于社区的参与式烟草依赖策略（PROMPT）在加拿大渥太华市中心城区人群中的可行性。
一项遵循基于社区的参与式行动研究原则的可行性混合方法前瞻性队列研究。
招募80名吸毒者，对他们进行为期6个月的跟踪，同时在社区环境中提供咨询、尼古丁替代疗法和同伴支持。
渥太华市中心的社区研究办公室，毗邻低收入住房、庇护服务机构和街头毒品消费场所。
6个月随访时的保留率。
在26周时经生化验证的7天点患病率戒烟情况，自我报告在过去7天内戒烟且呼出一氧化碳≤10 ppm。
参与者的平均年龄为43.8岁。6个月的随访率为42.5%。报告的平均吸烟年数为27.3年。参与者中70%为男性，33.7%报告受教育程度低于高中，21%为原住民，43.8%报告月收入在1000美元至1999美元之间。基线时平均每日吸烟量为20.5支，研究结束时为9.3支，6个月时平均减少了11.2支（P = 0.0001）。自我报告的非法物质使用有显著减少（18.8%），包括阿片类药物海洛因（6.3%）、芬太尼（2.6%）和奥施康定（3.8%）的减少。研究结果还揭示了心理社会经济方面的益处，如健康改善、重返工作岗位和更多地参与社区活动。
PROMPT项目描述了与烟草和多种物质使用相关的社会经济变量。一个以烟草依赖为重点、在社区易于获得且由有实际生活经验的社区同伴主导的项目在实施上是可行的，并且有可能支持积极的生活改变。PROMPT的患者参与模式是应对日益严重的阿片类药物使用危机的有效减少伤害策略，并且可以改善全球边缘化高危人群的健康结局。
