Clinical trial NCT03064724: Practice-based Intervention for Vietnamese and Korean Patients
Official title: Practice-based Intervention for Vietnamese and Korean Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Smoking Cessation
Tobacco Use
Keywords: smoking
tobacco use
Asian
patients
provider advice
digital health intervention
Lead sponsor: Asian Health Services
Sponsor class: OTHER
Collaborators: name: University of California, San Francisco
First posted: 2017-02-27
Enrollment: 47
Sex: MALE
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief 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.

Eligibility criteria: Inclusion Criteria:

* current smokers identified on electronic health records (EHR)
* have a scheduled primary care visit during the recruitment period

Exclusion Criteria:

* already quit smoking or not smoking daily in the past 7 days
* had already quit smoking or not smoking daily in the past 7 days
* had canceled or rescheduled their primary care visit outside of the study period

Primary outcomes:
measure: Participation Rate
timeFrame: Baseline
measure: Acceptability
timeFrame: through study completion, an average of 1 year
Secondary outcomes:
measure: Patient-provider discussion
timeFrame: "through study completion, an average of 1 year
measure: Physician delivery of 5As
timeFrame: "through study completion, an average of 1 year
measure: Quit attempt
timeFrame: 3-month
measure: Abstinence
timeFrame: 3-month
Other outcomes:
Locations:
Study officials:
affiliation: Asian Health Services
name: Thu Quach, PhD, MPH
role: PRINCIPAL_INVESTIGATOR
affiliation: University of California, San Francisco
name: Janice Tsoh
role: PRINCIPAL_INVESTIGATOR
References: