Community-based navigators for tobacco cessation treatment: a proof-of-concept pilot study among low-income smokers

BMC Public Health

Research Article

Karen Albright¹  Patricia Valverde¹  Kathleen Garrett¹  Arnold H. Levinson²  Debra Flynn³  Emily K. Burns⁴  Michele Kimminau⁵ 

[1] Department of Community & Behavioral Health, Colorado School of Public Health, Aurora, CO, USA;Department of Community & Behavioral Health, Colorado School of Public Health, Aurora, CO, USA;University of Colorado Cancer Center, Mail Stop F542, 13001 East 17th Place, 80045, Aurora, CO, USA;Head Start, City of Oakland, CA, USA;Mercy Family Medicine, Mercy Regional Medical Center, Centura Health, Durango, CO, USA;University of Colorado Cancer Center, Mail Stop F542, 13001 East 17th Place, 80045, Aurora, CO, USA;

关键词: Smoking Cessation;    Motivational Interview;    Nicotine Replacement Therapy;    Head Start;    Cessation Treatment;   

DOI  :  10.1186/s12889-015-1962-4

 received in 2014-12-17, accepted in 2015-06-23,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundA majority of continuing smokers in the United States are socioeconomically disadvantaged (SED) adults, who are less likely than others to achieve and maintain abstinence despite comparable quit-attempt rates. A national research initiative seeks effective new strategies for increasing successful smoking cessation outcomes among SED populations. There is evidence that chronic and acute stressors may interfere with SED smokers who try to quit on their own. Patient navigators have been effectively used to improve adherence to chronic disease treatment. We designed and have pilot-tested an innovative, non-clinical community-based intervention – smoking cessation treatment navigators – to determine feasibility (acceptance, adherence, and uncontrolled results) for evaluation by randomized controlled trial (RCT).MethodsThe intervention was developed for smokers among parents and other household members of inner city pre-school for low-income children. Smoking cessation treatment navigators were trained and deployed to help participants choose and adhere to evidence-based cessation treatment (EBCT). Navigators provided empathy, resource-linking, problem-solving, and motivational reinforcement. Measures included rates of study follow-up completion, EBCT utilization, navigation participation, perceived intervention quality, 7-day point abstinence and longest abstinence at three months. Both complete-case and intent-to-treat analyses were performed.ResultsEighty-five percent of study participants (n = 40) completed final data collection. More than half (53 %) enrolled in a telephone quitline and nearly three-fourths (71 %) initiated nicotine replacement therapy. Participants completed a mean 3.4 navigation sessions (mean 30 min duration) and gave the intervention very high quality and satisfaction ratings. Self-reported abstinence was comparable to rates for evidence-based cessation strategies (21 % among study completers, 18 % using intent-to-treat analysis; median 21 days abstinent among relapsers).ConclusionsThe pilot results suggest that smoking cessation treatment navigators are feasible to study in community settings and are well-accepted for increasing use of EBCT among low-income smokers. Randomized controlled trial for efficacy is warranted.

【 授权许可】

CC BY   
© Levinson et al. 2015