Washington University, School of Medicine, Department of Medicine, United States of America; Washington University, Brown School, Health Communication Research Laboratory, United States of America.
Washington University, Brown School, Health Communication Research Laboratory, United States of America.
Contemp Clin Trials. 2019 May;80:40-47. doi: 10.1016/j.cct.2019.03.009. Epub 2019 Mar 20.
Smoking in the United States follows a clear socioeconomic gradient: low-income Americans smoke more and quit less than those with more education and income. Evidence-based interventions like tobacco quitlines are designed to make effective cessation services available on a population basis to all smokers. However, these interventions do not address many of the unique challenges faced by low-income smokers, including unmet basic needs like food, housing, personal safety and money for necessities that often supersede health needs. Research is needed to maximize the use and effectiveness of tobacco quitlines in low-income populations. This paper details the rationale, design and methods for a 2 × 2 randomized controlled trial currently underway comparing the effects of Standard and Specialized Tobacco Quitlines with and without Basic Needs Navigation on intervention engagement and smoking cessation among low-income smokers. Smokers are recruited from United Way 2-1-1 in Missouri and all participants receive tobacco quitline services from Optum. Quitline and navigation services are provided for 3 months. Participants complete telephone surveys at baseline, 3- and 6-month follow up. The primary study outcome is self-reported 7-day point prevalence abstinence at 6-month follow up. Embedding the study in practice agencies will accelerate dissemination and scalability should our findings demonstrate intervention effectiveness.
低收入的美国人比受教育程度和收入较高的人吸烟更多，戒烟率更低。基于证据的干预措施，如戒烟热线，旨在为所有吸烟者提供有效的戒烟服务，普及到人群中。然而，这些干预措施并没有解决低收入吸烟者所面临的许多独特挑战，包括未满足的基本需求，如食物、住房、人身安全和基本生活必需品的资金，这些需求往往优先于健康需求。需要研究如何最大限度地利用和提高戒烟热线在低收入人群中的效果。本文详细介绍了一项正在进行的 2×2 随机对照试验的原理、设计和方法，该试验比较了标准和专门的戒烟热线以及是否提供基本需求导航对低收入吸烟者干预参与度和戒烟效果的影响。吸烟者是从密苏里州的“统一之路 2-1-1”招募的，所有参与者都从 Optum 获得戒烟热线服务。戒烟热线和导航服务提供 3 个月。参与者在基线、3 个月和 6 个月的随访时完成电话调查。主要研究结果是在 6 个月随访时自我报告的 7 天点流行率戒断。将研究嵌入实践机构将加速传播和扩大规模，如果我们的研究结果表明干预措施有效。
