Practice-based Intervention for Vietnamese and Korean Patients
Condition: Smoking Cessation; Tobacco Use
Study type: Interventional

Summary: 
      This pilot project examined the feasibility of an multilingual interactive video education
      intervention "an interactive Mobile Doctor intervention (iMD)" to promote patient-provider
      discussion on tobacco use for Korean- and Vietnamese-speaking male patients at primary care
      settings.
    

Detailed description: 
      While California has made significant strides in tobacco control and is leading the nation in
      reducing smoking use, the decline is not observed in all groups. Select groups still have
      much higher smoking rates and thus bear an unequal burden of tobacco-related illnesses and
      deaths. Of important note, Asian American men as a combined group have a higher smoking rate
      than non-Hispanic Whites (22% vs. 18%, respectively); in particular, the highest smoking
      prevalence has been observed in Vietnamese (31%) and Korean (30%) men among major Asian
      subgroups. Research also shows that smoking rates are higher for Asian American men with low
      acculturation (e.g., immigrant status, low English proficiency) than for those who are more
      acculturated; yet the reverse trend is observed in Asian American women. These findings
      underscore the need for more targeted tobacco control efforts. The scientific literature
      suggests that provider advice to quit smoking can influence a smoker's decision to quit.
      However, research has shown that Asian Americans are less likely to receive such provider
      advice. Providers often have very limited face-time with patients during the short clinic
      visit, which presents a challenge as to whether they can incorporate smoking cessation
      messages during the visit. Overall, little research has focused on smoking cessation in the
      clinic setting, particularly research that focuses on Asian Americans. The purpose of the
      pilot study was to develop a more streamlined smoking cessation intervention that can be
      integrated into the clinic visit, especially to maximize the time when patients are waiting
      to see their providers. The research question was whether providing culturally appropriate
      video education that includes provider advice and was tailored to a patient's readiness for
      quitting smoking will increase whether a patient receives smoking cessation education
      according to the recommended Clinical Practice Guideline and whether this results in a
      decrease in tobacco use in low-income Vietnamese and Korean patients. Using a community-based
      participatory research approach, the investigators created the iMD that delivers tailored
      in-language video messages via a mobile tablet to Korean and Vietnamese male smokers right
      before their clinic visit with a provider. iMD delivers the "5 A's" and generates a bilingual
      tailored printout. Participants were Korean- and Vietnamese-speaking patients who
      self-identify as daily smokers and receive primary care at a federally-qualified health
      center. This study evaluated the feasibility and acceptability of iMD from the patients'
      perspectives. This study examined patient-provider discussion on tobacco use from patients'
      self-report and electronic health record (EHR), and self-reported quit attempts and smoking
      abstinence at 3 months post iMD visit.
    

Intervention name(s): Interactive Mobile Doctor ("iMD")
Intervention type(s): Behavioral
Intervention description(s): iMD delivers tailored interactive video education via a mobile tablet to smoking patients right before their clinic visit with a provider. iMD delivers the "5 A's" (ask, advise, assess, assist, and arrange) and generates a bilingual tailored printout, which aims to increase patient-provider discussion on tobacco use and to promote smoking cessation. This version of iMD delivers the intervention in Korean or Vietnamese languages as preferred by the patient.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: smoking; tobacco use; Asian; patients; provider advice; digital health intervention