Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States of America; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States of America.
Contemp Clin Trials. 2021 Nov;110:106435. doi: 10.1016/j.cct.2021.106435. Epub 2021 May 14.
Smoking prevalence in persons with HIV (PWH) is high (40%) and cessation rates remain low. Lack of social support and poor adherence to nicotine replacement therapy (NRT) are related to poor cessation outcomes; thus, both factors represent possible targets for smoking cessation interventions. Peer navigators (PNs) have been integrated into HIV care with great success to improve engagement and adherence to antiretroviral therapy. However, no clinical trial has evaluated the potential for PNs to provide social support and improve NRT adherence for smoking cessation. We developed a treatment protocol that targets social support, adherence, and self-efficacy for quitting by incorporating PNs into a smoking cessation program. This randomized trial will test whether this approach results in higher rates of 7-day point prevalence abstinence at 12- and 24-weeks, compared to standard treatment.
Seventy-two smokers with HIV will be randomized to either Peer Navigation Social Support for smoking cessation (PNSS-S) or standard cessation counseling. All participants will meet with a nurse for a smoking cessation counseling session, which will include discussion of FDA-approved cessation pharmacotherapy. Participants assigned to PNSS-S will receive weekly phone calls from the PN for 12 weeks. The PN will address readiness to quit, using medication to quit, common barriers to cessation, high risk situations, slip management, and maintaining abstinence. Smoking cessation outcomes will be measured at 4, 12, and 24 weeks following the baseline appointment.
Results from this study will provide preliminary evidence of whether incorporating a peer navigator-based intervention into smoking cessation treatment can improve smoking cessation outcomes in PWH.
HIV 感染者（PWH）的吸烟率很高（40%），戒烟率仍然很低。缺乏社会支持和尼古丁替代疗法（NRT）的依从性差与戒烟效果差有关；因此，这两个因素都可能成为戒烟干预的目标。同伴导航员（PN）已经成功地融入到 HIV 护理中，以提高对艾滋病病毒治疗的参与度和依从性。然而，还没有临床试验评估 PN 为戒烟提供社会支持和改善 NRT 依从性的潜力。我们制定了一个治疗方案，通过将 PN 纳入戒烟计划来针对社会支持、依从性和戒烟自我效能进行治疗。这项随机试验将测试这种方法是否能在 12 周和 24 周时提高 7 天点患病率的戒烟率，与标准治疗相比。
72 名 HIV 感染者将被随机分配到同伴导航社会支持戒烟（PNSS-S）或标准戒烟咨询组。所有参与者将与护士进行一次戒烟咨询，其中包括讨论 FDA 批准的戒烟药物治疗。被分配到 PNSS-S 的参与者将在 12 周内每周接到 PN 的电话。PN 将解决戒烟准备情况、使用药物戒烟、常见戒烟障碍、高危情况、失误管理和保持戒烟状态。戒烟结果将在基线就诊后的第 4、12 和 24 周进行测量。
这项研究的结果将提供初步证据，证明将基于同伴导航员的干预措施纳入戒烟治疗是否可以改善 HIV 感染者的戒烟效果。
