Smoking Cessation Program for Lao People With HIV

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A vizsgálat olyan felnőtteket keres, akik HIV-vel élnek és dohányoznak, hogy két módszert hasonlítson össze a leszokás segítésére laoszi klinikákon.

Életkor

18 éves vagy idősebb

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• Akit nem lehet elérni a célzott értékelési időpontot követő 30 napon belül
• Aki nem egyezik bele, hogy 6 hónap után felvegyék vele a kapcsolatot
• Aki nem tud írásos beleegyezést adni

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Tobacco use remains the leading modifiable risk factor for preventing cancer globally, particularly among people with HIV (PWH). In Laos, 61-80% of male PWH and 3-10% of female PWH smoke cigarettes. PWH who smoke in Laos have no reliable smoking cessation support. Thus, implementing sustainable and evidence-based smoking cessation interventions for PWH in Laos is needed. The investigators developed a scalable and affordable mHealth-based automated treatment program (MAP) to support Lao and Cambodian smokers to quit smoking. MAP involves interactive, tailored, personalized content (text messages, photos, and videos) delivered via a smartphone app. Along with effective cessation treatments, it is imperative to implement procedures to identify patients who smoke and to connect them to treatment. Our team pioneered the Ask-Advise-Connect (AAC, asking patients about smoking at every visit, briefly advising those who smoke to quit, and connecting them to treatment) approach, which showed great impact in our previous US studies. The purpose of this study is to compare 2 smoking cessation implementation strategies in 8 antiretroviral therapy (ART) clinics in the 6 most populous regions in Laos, using a hybrid type-2 pragmatic effectiveness-implementation study and a parallel cluster randomized trial design. Specifically, the investigators will compare an AAC approach paired with our previously developed MAP (AA-MAP) to an AAC approach paired with less resource-intensive printed self-help material (AA-SH). The investigators will use the Practical, Robust Implementation and Sustainability Model (PRISM), which expands the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to include more contextual factors relevant to program implementation. Aim 1 is to evaluate the reach and effectiveness of AA-MAP versus AA-SH. Reach is the proportion of PWH who smoke and are willing to make a quit attempt that enroll in treatment. Effectiveness is the proportion of enrolled participants who achieve biochemically confirmed point prevalence abstinence 6 months after enrollment. The investigators will also estimate the real-world impact (impact = reach × effectiveness) of each intervention. Aim 2 is to determine other implementation outcomes of AA-MAP and AA-SH. Aim 3 is to assess the resource use and costs of implementing AA-MAP and AA-SH. The project has the potential to transform HIV care and to reduce tobacco-related cancers and other morbidities.

A vizsgálat 2 csoportja

• AA-SH (Ask-Advise-Connect paired with self-help material)Már használt kezelés, összehasonlításként

  Participants will receive advice to quit smoking and be provided with a self-help guide to support smoking cessation.

  Kezelés: Smoking Cessation Self Help Guide

• AA-MAP (Ask-Advise-Connect paired with mHealth-based automated treatment program)A vizsgált kezelés

  Participants will receive advice to quit smoking and be connected to the mHealth-based automated treatment program (MAP). MAP is a fully automated smartphone-based treatment program that involves interactive and personalized proactive messages, images, or videos.

  Kezelés: Smartphone-delivered Automated Messaging