Online Program

A participatory randomized intervention to promote and enhance nicotine dependence treatment in a low-income community using community peer-motivators

Tuesday, November 5, 2013

Payam Sheikhattari, MD, MPH, School of Community Health and Policy, Morgan State University School of Community Health and Policy, Baltimore, MD
Fernando A. Wagner, ScD, MPH, Prevention Sciences Research Center and the Center for Health Disparities Solutions, Morgan State University School of Community Health and Policy, Baltimore, MD
Background. Low-income urban residents have higher rates of tobacco smoking and they are less likely to utilize treatment services than the U.S. general population. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) initiative is a participatory randomized health promotion intervention to enhance smoking cessation services in an inner-city low-income setting. Methods. Peer-motivators, nurses, and physicians provided smoking cessation services at a community clinic as well as other community sites. Participants were randomized into group vs. individual counseling plus smoking cessation medication interventions in a clinic during the first phase. In the second phase participants were randomized into two group counseling plus nicotine replacement therapy with different incentive programs facilitated by community peer-motivators in local community sites (e, g., church, school, etc.). Data for this study were collected and triangulated from the following sources: a cross-sectional household survey (n=1,441); participants in smoking cessation interventions (n~650), street intercept surveys (n~4000); focus group discussions (n~100). Data were analyzed using qualitative and quantitative methodologies. Results. More than half (55%) of the total sample were current smokers. Between 36 to 50 percent of the current smokers had tried to quit smoking without seeking any kind of help in the past year. Peer-motivators facilitated interventions in community sites yielded better outcomes such as more abstinence (40% vs. 10%), higher retention (60% vs. 27%), and less cost (p<0.001). Conclusion. Community participatory approach to rigorous scientific methodology is a challenging and at the same time effective strategy to promote and enhance treatment services among underserved populations.

Learning Areas:

Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify important factors related to successful participatory health promotion trials Describe common challenges and their solutions related to the design and implementation of community based research initiatives

Keyword(s): Peer Counselors, Smoking Cessation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee the CEASE initiative funded by the NIH as a Co-PI and serve as an associate professor of Public Health at the Morgan State University
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.