Estreet Anthony, Apata Jummai, Kamangar Farin, Schutzman Christine, Buccheri Jane, O'Keefe Anne-Marie, Wagner Fernando, Sheikhattari Payam
Master of Social Work Program, School of Social Work, Morgan State University, Baltimore, MD, USA.
Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA.
Int J Prev Med. 2017 Dec 19;8:106. doi: 10.4103/ijpvm.IJPVM_303_17. eCollection 2017.
This study compares participant' sretention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community-based settings.
Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profiles and high rates of smoking ( = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence.
Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was significantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confidence intervals [CI] = 4.6, 9.8). In addition to the intervention in community venues, predictors of retention included age and unemployment. Higher retention was significantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8).
Conducting the intervention in community settings using trained peer motivators rather than health-care providers resulted in significantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specific populations and improving the quality of the intervention based on feedback from participants and community partners.
本研究比较了戒烟干预三个阶段参与者的留存率，其中一个阶段在健康诊所进行，后两个阶段在社区环境中进行。
2008年至2015年期间，在两个社会经济状况不佳、吸烟率高的城市社区（n = 951）分三个阶段开展了戒烟干预。第一阶段在诊所进行；第二和第三阶段在社区场所进行。在第二和第三阶段，根据前一阶段吸取的经验教训进行了渐进式改变。留存率（参加六次或更多次课程）是戒烟的主要预测指标，并在控制包括年龄、性别、种族、就业、教育和尼古丁依赖等相关因素的同时进行了分析。
在三个阶段中，留存率大幅提高，第一、二、三阶段参加六次或更多次课程的比例分别为13.8%、51.9%和67.9%。社区环境中的留存率显著高于诊所环境（调整后的优势比[OR] = 6.7；95%置信区间[CI] = 4.6, 9.8）。除了在社区场所进行干预外，留存率的预测因素还包括年龄和失业情况。较高的留存率与较高的戒烟率显著相关（调整后的OR = 2.4；95% CI = 1.5, 3.8）。
使用经过培训的同伴激励者而非医疗保健提供者在社区环境中进行干预，导致留存率和戒烟率显著提高。这部分归因于能够在社区为特定人群量身定制戒烟课程，并根据参与者和社区伙伴的反馈提高干预质量。
