Faith Based Pilot Intervention to Reduce Tobacco Use Among Somali Males
Condition: Tobacco Use; Faith-Based; Community-engaged; Text Messaging
Study type: Interventional

Summary: 
      1.1 In the last five years, representatives of WellShare International and the University of
      Minnesota have engaged a large community of Muslims of Somali descent in the Twin Cities of
      Minnesota in a community-academic research program to understand smoking and cessation
      behaviors. This followed research by WellShare International which discovered a smoking
      prevalence among Somali men of 44%, which is nearly three times that of the general
      population (14.4%) in Minnesota. More recently, pilot data from ecological momentary
      assessments (EMA) conducted by WellShare International and the University of Minnesota
      Program in Health Disparities Research before and during Ramadan, showed that the majority of
      smokers achieved spontaneous significant reductions in cigarettes smoked per day during
      Ramadan. Guided by the NIH Stage Based Intervention Development Model, this study aims to
      understand the processes underlying smoking reduction and cessation during Ramadan. The
      investigators plan to harness this knowledge and develop a culturally-tailored, faith-based
      smoking cessation intervention (Stage 1). The investigators also plan to assess the
      feasibility of the new culturally-tailored smoking cessation intervention by conducting a
      pilot study (Stage 2).

      The study aims are as follows:

      Aim 1: To develop a faith-based, community-informed innovative smoking cessation intervention
      for use with a Somali immigrant population in Minnesota:

      Aim 2: To assess the feasibility of a faith-based smoking cessation intervention delivered
      via a mobile phone during the Ramadan period:

      This pilot study will test a protocol for use of faith based text messages, as informed by
      the scholarly work of the Imams, Community Advisory Group (CAG) and focus groups conducted in
      Stage 1.
    

Detailed description: 
      Smoking Prevalence in the Muslim communities: Although significant declines in cigarette
      smoking prevalence have been realized in the United States (U.S.), this decline is not
      universal. Muslim communities continue to have disproportionately high smoking prevalence
      rates. For example, one of WellShare International's studies showed a smoking prevalence rate
      of 44.1% among Somali adult (predominantly Muslim) men in Minnesota, compared to the average
      smoking rate for adult men in Minnesota (14.4%) and in the United States of 17.8%. Despite
      ample evidence that pharmacotherapy and counselling are effective for smoking cessation in
      the general population, no one has identified effective ways to extend these benefits to the
      Muslim communities and the U.S.'s largest Somali population which resides in Minnesota. Even
      when readily available, such aids seem to be underutilized, reflecting the commonly held
      belief among Muslims that giving up smoking primarily requires only will power. Although
      approaches that draw on the need for will power around the Ramadan fast (during which smoking
      is prohibited during daylight hours) have been considered, no systematic attempt has been
      made to make effective evidence-based smoking cessation methods available leveraged on the
      Ramadan. Muslim smokers face yet another challenge during the holy month of Ramadan, where
      adherence to medications during this month has been documented as challenging. However,
      because cigarette smoking continues to be the leading cause of morbidity and mortality, it is
      critical to identify evidence-based methods for promoting adherence to known effective
      methods for reducing tobacco related health disparities in this underserved minority
      population in Minnesota.
    

Intervention name(s): Faith-Based messages
Intervention type(s): Behavioral
Intervention description(s): We will send out faith based text messages on a weekly basis for the one week prior to the start of Ramadan, then twice a day during the Ramadan period that will encourage smoking cessation and continue to encourage change of behavior. The faith-based messages will be incorporated with messages drawn from the Smokefree.gov Mobile Interventions QuitNowTXT Message Library. These messages will be geared towards reminding the smokers that as Ramadan is coming closer they need to consider the effects that smoking may have on their health and should consider taking steps towards quitting.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Faith-Based; Community-engaged; Text messaging; Tobacco