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Description
PROJECT SUMMARY/ABSTRACT – Project 2
Tobacco use is a leading cause of cardiovascular disease and related chronic conditions (e.g., hypertension;
CVD & RCC). According to the 2014 Surgeon General’s Report on smoking and health, cigarette smoking
causes about 1 in 4 deaths from CVD. BIPOC communities experience higher prevalence of CVD & RCC
compared to White communities due, in part, to disparities in tobacco exposure. Smoking can be effectively
treated with guideline-recommended cessation counseling and medication, but such treatments are rarely used
and are particularly unlikely to be offered to or used by BIPOC patients. Project 2 of C2DREAM tests the effect
of adding an intervention to promote health equity among BIPOC patients: Longitudinal Proactive Outreach
(LPO; 4 culturally tailored outreach call cycles over one year by a counselor trained in motivational interviewing
to help connect patients to cessation counseling and medication) to the current standard of care, Ask-Advise-
Connect (AAC; primary care providers asking all patients if they smoke, advising smokers to quit, and
connecting smokers to the state quit line through an electronic referral). The proposed Project has 3 aims: A1:
Conduct a randomized controlled trial to examine the direct effect of AAC+LPO (a multilevel health system
intervention) vs. AAC on population-level smoking abstinence at 18 months and treatment utilization among
2000 BIPOC adults. A2: Examine the moderating effects of structural racism and daily interpersonal
discrimination on intervention effectiveness. A3: Use a mixed methods approach to evaluate implementation
outcomes of appropriateness, acceptability, and feasibility of AAC and LPO for BIPOC patients. To test these
aims, we will conduct a hybrid type 1 implementation-effectiveness trial where 2000 BIPOC patients who
smoke across two urban and rural healthcare systems in Minnesota will be randomly assigned to BIPOC
tailored LPO + AAC or AAC alone. Participants will be surveyed at 6, 12, and 18 months post-enrollment to
assess outcomes. The primary outcome is biochemically confirmed tobacco abstinence at 18 months.
Potential treatment mechanisms include increased treatment utilization, perceived behavioral control and
intention to quit. Potential moderators include structural racism in communities and personal experiences of
racism. LPO promotes health equity by addressing barriers caused by structural racism, including access to
care, care fragmentation, and provider racism, by systematically reaching out to all BIPOC patients who
smoke. LPO improves health equity by ensuring that those most at risk for CVD & RCC are offered preventive
care. LPO integrates individual-level treatment with public health approaches to increase treatment
engagement. Further, LPO will be culturally tailored in collaboration with BIPOC communities in Minnesota to
effectively reach and engage the target population.
Status | Finished |
---|---|
Effective start/end date | 9/1/21 → 6/30/23 |
Funding
- National Institute on Minority Health and Health Disparities: $616,846.00
- National Institute on Minority Health and Health Disparities: $602,431.00
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Projects
- 1 Active
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Techquity by FAITH!: A cluster randomized controlled trial to assess the efficacy of a community-informed, cardiovascular health promotion mobile hlth intervention with digital health advocate support
Allen, M. L., Patten, C. A., Everson-Rose, S., French, S. A., Fu, S. S., Pratt, R. J., Hardeman, R. R. & Wieland, M. L.
National Institute on Minority Health and Health Disparities
9/24/21 → 6/30/24
Project: Research project