Hejjaji Vittal, Khetan Aditya, Hughes Joel W, Gupta Prashant, Jones Philip G, Ahmed Asma, Mohan Sri Krishna Madan, Josephson Richard A
Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, University of Missouri Kansas City, Kansas, United States.
Department of Cardiovascular Medicine, McMaster University Medical Center, Hamilton, Canada.
Tob Prev Cessat. 2021 Mar 29;7:23. doi: 10.18332/tpc/132469. eCollection 2021.
We sought to evaluate the effectiveness of a community health worker (CHW) led smoking cessation intervention, supplemented by text messages, and tailored to an individual's readiness to quit.
We conducted a cluster randomized controlled trial (April 2018-August 2019) in adult smokers residing in a semi-urban region of India. Participants in the intervention arm received CHW-led home visits and had the option of choosing to receive regular text messages. The dose and content of CHW counseling and text messages were tailored to the participant's readiness to quit. The control group received brief education only. Primary outcome was biochemically verified smoking cessation at the end of 12 months. Both intention-to-treat and as-treated analyses were performed.
A total of 238 (mean age 43±12.3 years, male 96.2%) participants were enrolled; 151 (64%) in the intervention arm and 83 (35.4%) in the control arm. At 12 months, 31 (20.5%) participants in the intervention arm and 9 (10.8%) in the control arm quit smoking (absolute risk difference=9.7%; RR=1.69; 95% CI: 0.04-71.33, p=0.74). In the as-treated analysis, 17 (36.9%) of the 46 participants who received optimal dose of the intervention quit smoking.
CHW-led home-based counseling, supplemented by regular text messages, led to an increase in quit rates for smoking, especially among those exposed to a higher dose of the intervention. However, the difference in cessation rates was not statistically significant. Future studies should consider testing mobile application-based multimedia messaging with larger populations, as a supplement to CHW-based counseling.
我们旨在评估由社区卫生工作者（CHW）主导、辅以短信并根据个人戒烟意愿量身定制的戒烟干预措施的有效性。
我们在印度半城市地区的成年吸烟者中进行了一项整群随机对照试验（2018年4月至2019年8月）。干预组的参与者接受由社区卫生工作者主导的家访，并可选择接收定期短信。社区卫生工作者咨询和短信的剂量及内容根据参与者的戒烟意愿进行调整。对照组仅接受简短教育。主要结局是12个月末经生化验证的戒烟情况。进行了意向性分析和实际治疗分析。
共纳入238名参与者（平均年龄43±12.3岁，男性占96.2%）；干预组151名（64%），对照组83名（35.4%）。12个月时，干预组31名（20.5%）参与者戒烟，对照组9名（10.8%）参与者戒烟（绝对风险差异=9.7%；RR=1.69；95%CI：0.04 - 71.33，p = 0.74）。在实际治疗分析中，接受最佳剂量干预的46名参与者中有17名（36.9%）戒烟。
由社区卫生工作者主导的家庭咨询，辅以定期短信，可提高戒烟率，尤其是在接受较高剂量干预的人群中。然而，戒烟率的差异无统计学意义。未来研究应考虑测试基于移动应用的多媒体信息传递，并纳入更多人群，作为社区卫生工作者咨询的补充。
