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The purpose of this research is to study a smoking cessation program for adult smokers in Northeast Ohio. The study will also look at how different people respond to the program.
The study includes completing surveys and receiving text messages to help participants become tobacco free.
OBJECTIVES Specific Aim 1: Translate a culturally specific video-based tobacco use intervention into a scalable mobile health (mhealth) format.
Specific Aim 2: Conduct a pilot study of the video-text intervention.
Study Design:
2-arm semi-pragmatic randomized design among current tobacco users
Cuyahoga Metropolitan Housing Authority residents will be randomly assigned to receive (1) the newly translated Path2Quit or (2) SmokeFreeText (NCI's publicly available, standard text messaging program) combined with brief behavioral counseling session plus 2 weeks of nicotine replacement therapy (NRT). Primary outcomes will include intervention evaluations (content and format), acceptability, coping strategies, engagement, and NRT adherence. Secondary variables will include 24-hour quit attempts and biochemically verified tobacco use abstinence at the 1-month follow-up. Exploratory mediational analyses will examine the roles of urban hassles, acculturation, neighborhood environment, ethnic discrimination, and psychological distress in intervention effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Path2Quit | Experimental | Culturally specific text message intervention |
|
| SmokeFreeText | Active Comparator | The National Cancer Institute's publicly available, standard text messaging program for tobacco cessation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SmokeFreeText | Behavioral | SmokefreeTXT is a 6-8 week fully automated text-based cessation intervention. The program is free to U.S. subscribers who have a mobile phone, and is available on smokefree.gov or by texting "QUIT" to short code 47848. Participants are encouraged to set a quit date within the next 14 days, followed by count-down messages leading to the quit date. Starting on the quit date, participants receive 6 weeks of intervention text messages, and assessment questions (mood, cravings, smoking status). The message library contains 166 messages and 41 behavior change techniques,40 which are delivered at the greatest frequency during the first 2 weeks and taper over time. When in need of assistance, participants can text one of 3 keywords (MOOD, CRAVE, or SLIP) to receive a relevant message from the system. Participants can opt-out by texting STOP at any time. With informed consent, we will be able to access the SmokefreeTXT data for these participants. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of participants who abstain from smoking | Abstinence will be coded as a binary variable. Analysis will be conducted with an intent to treat approach | At 1-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Number of missed nicotine replacement therapy doses | Measure of NRT adherence. Number of missed doses will be recorded for each participant | Up to 1-month follow-up |
| 24-Hour quit attempts | Number of times a participant quits smoking for at least 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Average scores of Urban hassles | This is a 63 item scale scored 0-5 (total score 0-315) where higher scores indicate more severe hassle | Changes from baseline to 1 month follow-up |
| Average Neighborhood Environment scale score |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Monica Webb Hooper, PhD | Case Comprehensive Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Case Western Reserve University, Case Comprehensive Cancer Center | Cleveland | Ohio | 44106 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34647777 | Derived | Webb Hooper M, Miller DB, Saldivar E, Mitchell C, Johnson L, Burns M, Huang MC. Randomized controlled trial testing a video-text tobacco cessation intervention among economically disadvantaged African American adults. Psychol Addict Behav. 2021 Nov;35(7):769-777. doi: 10.1037/adb0000691. Epub 2021 Oct 14. |
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| ID | Term |
|---|---|
| D016540 | Smoking Cessation |
| D000073869 | Tobacco Smoking |
| ID | Term |
|---|---|
| D015438 | Health Behavior |
| D001519 | Behavior |
| D012907 | Smoking |
| D064424 | Tobacco Use |
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We will conduct a 2-arm semi-pragmatic randomized design among current tobacco users (N=100). CMHA residents will be randomly assigned to receive (1) the newly translated Path2Quit or (2) SmokeFreeText (NCI's publicly available, standard text messaging program) combined with brief behavioral counseling session plus 2 weeks of nicotine replacement therapy (NRT).
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| Path2Quit | Behavioral | Path2Quit will deliver 20-60 second video clips by multimedia messaging service. The message library will include 75-170 messages. Written text messages will be limited to brief phrases to indicate the topic of the video. Messages will be pushed to participants in the morning, in the afternoon, and 2 hours before the reported usual bedtime. The cultural adaptations will be infused throughout the video segments. Topics include deep structure: race and smoking in general, African American smoking statistics; norms for smoking; concerns about nicotine replacement/medication; family/collectivism; unique stressors; racism/discrimination, depression; co-morbid addiction; neighborhood/environmental influences; menthol cigarettes; race-specific weight issues and concerns; and working as a community against the tobacco industry. |
|
| At 1-month follow-up |
| Changes in carbon monoxide breath levels from baseline to followup | Breath carbon monoxide tests will biochemically confirm self-reported cessation | At 1-month follow-up |
| Changes in Contemplation ladder score | self-reported score 0-10 where a higher score indicates more readiness to quit | From baseline to up to 1-month follow-up |
| Average score of Intervention Evaluation (IRQ) | The IRQ is a 22 item scale scored 0-7 (total score 0-154) where higher scores indicate more satisfaction | At 1-month follow-up |
| Average score of smoking urges | This brief, 10 item scale is scores 1-7 (total score 10-70) with higher scores indicating greater agreement | Up to 1-month follow-up |
The neighborhood environment scale is an 18 item True or False scale
| At Baseline |
| Average General Ethnic Discrimination Scale Score | This is a measure of ethnic discrimination. These 16 items are scored 1-6 (total score 16-96) with higher scores indicating greater levels of ethnic discrimination | At baseline |
| Average psychological distress score using the the perceived stress scale | A ten item scale with each item scored 0-4 (total score 0-40) where higher scores indicate more stress. Positive items are scored in reverse. | At baseline |
| Average depression score using Center for Epidemiological Studies Depression (CES-D) Scale | A twenty item scale ranging from 0-60 with each item scored 0-3. Higher scores indicate more depression | At baseline |
| Average Beliefs and Attitudes Survey Score | This is a 24 item scale (total range 24-168) with each item scored 1-7. Higher scores indicate greater levels of agreement | At baseline |
| Average Ethnic Identity Score | This is based on the Multigroup Ethnic Identity Measure scale. These five items are scored 1-4 for a total score of 5-20. Higher scores indicate stronger ethnic identity | At baseline |
| Average Culturally Specific Interventions Expectancy Questionnaire | The Culturally Specific Interventions Expectancy Questionnaire is a 2 item scale with each item ranging 1-5 (total score 2-10) where higher scores indicate greater agreement. | At baseline |