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The investigators have developed a hybrid computer- and person-delivered intervention, called "C-Raven" for smoking cessation that is tailored to people with tobacco use in Baltimore City. The computer delivered component consists of two ~20 minute sessions on an iPad guided by Edna Poe, an interactive avatar. These sessions are followed by elective in vivo initiation of nicotine replacement therapy (NRT). Community health workers (CHWs) trained in smoking cessation and motivational interviewing provide 6 weeks of supportive follow up counseling. The investigators propose a pilot of the intervention package in the Tobacco Treatment and Lung Cancer Screening Clinic (TTLCSC) at Johns Hopkins Hospital, and the Johns Hopkins Broadway Center for Addiction, assessing feasibility and acceptability of using this tool in these clinical settings. In addition, the investigators will compare whether the use of a virtual counselor is associated with greater satisfaction and engagement with the program.
To this end, the investigators propose a two-arm randomized controlled trial, randomizing up to 90 individuals with tobacco use to the current CRAVEN program which includes a virtual counselor, to CRAVEN without a virtual counselor. Primary outcomes include intervention feasibility and acceptability. The investigators will secondarily examine uptake and maintenance of pharmacotherapy for tobacco cessation, readiness to quit smoking, and tobacco cessation (7 day abstinence) at 6 months, patient satisfaction by intervention arm and CHW engagement by intervention arm.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| C-Raven + Avatar | Experimental | Computer delivered intervention with Avatar as virtual counselor plus linkage to community health worker |
|
| C-Raven | Active Comparator | Computer-delivered intervention without virtual counselor, with linkage to community health worker |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| C-Raven with avatar | Behavioral | Computer delivered intervention with the investigators' avatar; with linkage to community health worker. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percent of persons agreeing to participate among those referred | Feasibility will be assessed with percent of persons agreeing to participate among those referred. | 3 months |
| Percent of contacts made with community health worker | Implementation will be assessed with percent of contacts made with community health worker. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Readiness to quit smoking as assessed by a visual analog scale | A visual analog scale of 0-100 with 0 indicating not ready to change and 100 indicating ready to change. | Immediately post intervention |
| Uptake of pharmacotherapy as assessed by a yes/no response |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Geetanjali Chander | Johns Hopkins University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins Tobacco Treatment Clinic at Johns Hopkins Bayview Medical Center | Baltimore | Maryland | 21224 | United States |
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| ID | Term |
|---|---|
| D000073869 | Tobacco Smoking |
| ID | Term |
|---|---|
| D012907 | Smoking |
| D001519 | Behavior |
| D064424 | Tobacco Use |
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Care providers, investigators and outcome assessors will be blind to avatar versus no avatar conditions
| C-Raven without avatar | Behavioral | Computer delivered intervention without the investigators' avatar; with linkage to community health worker. |
|
Any uptake of nicotine replacement therapy or varenicline or wellbutrin. Dichotomous yes/no response will be collected. |
| 3 months |
| Smoking cessation as assessed by 7-day no tobacco use self report | 7 day point prevalence abstinence. No tobacco use for 7 days by self report - yes/no. | 3 months |