Clinical trial NCT02307734: A Family-Focused Intervention for Asian American Male Smokers
Official title: A Family-Focused Intervention for Asian American Male Smokers
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Smoking Cessation
Family
Health Behavior
Keywords: Lay Health Workers
Chinese
Vietnamese
Tobacco Use
Intervention
Behavior Change
Social Networks
Asians
Lead sponsor: University of California, San Francisco
Sponsor class: OTHER
Collaborators: name: University of California, Davis
name: Chinese Community Health Resource Center
name: Immigrant Resettlement & Cultural Center
name: Vietnamese Voluntary Foundation, Inc.
name: Southeast Asian Community Center
name: National Institute on Drug Abuse (NIDA)
First posted: 2014-12-04
Enrollment: 680
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This project proposes two aims. The first aim is to evaluate the efficacy of a family-focused intervention in promoting smoking cessation in Chinese and Vietnamese male smokers using a 2-arm cluster randomized controlled trial with assessments at baseline, 6, and 12 months targeting 360 smoker-family dyads. Half of the participants will be assigned to the proposed intervention, and the remaining half will be assigned to an attention-control condition where they will receive education on healthy eating and physical activity. The second aim is to explore mediators to identify key psychosocial and behavioral processes that underlie how the intervention affects the processes of quitting and maintaining abstinence in Chinese and Vietnamese smokers.

Detailed description: Smoking prevalence remains high in subgroups of Asian American men, particularly among those with low English proficiency (LEP) and immigrants from cultures where smoking prevalence is high, including Chinese and Vietnamese. The 2011-12 California Health Interview Survey estimates that nearly half (46%) of all Asian male smokers in California are either Chinese or Vietnamese. The smoking prevalences among LEP Chinese and Vietnamese men were 32% and 43%, respectively, compared to 16% of the general California male population. The investigators developed a family-focused intervention utilizing lay health worker (LWH) outreach that integrates formative qualitative research and selected constructs from Social Network Theory, Social Cognitive Theory, and the Transtheoretical Model. The intervention involves 2 small group education sessions with dyads of smokers and family members, and 2 follow-up individual telephone calls delivered by LHWs over 2 months. Our single-group pilot trial with 96 dyads of Chinese and Vietnamese male daily smokers and their family members showed a high feasibility of recruiting unmotivated smokers (42% were at "precontemplation"), and a promising 7-day point prevalence abstinence rate of 30% at 3 months with independent corroboration from family members. The first aim of the study is to evaluate the efficacy of the family-focused intervention in promoting smoking cessation in Chinese and Vietnamese male smokers. The second aim is to explore mediators to identify key psychosocial and behavioral processes that underlie how the intervention affects the processes of quitting and maintaining abstinence. The investigators will conduct a 2-arm cluster randomized controlled trial (RCT) with assessments at baseline, 6 and 12 months following intervention initiation. The RCT involves 60 lay health workers (LHWs); each recruits and delivers interventions to 6 dyads of one male daily smoker and one family member from his household, for a total 360 smoker-family dyads. Half of the LHWs, stratified by Asian subgroup and smoking history, will be randomized to the family-focused intervention group and the other half will be assigned to an attention control condition receiving education on healthy eating. All participants will receive written information on smoking cessation resources. The investigators hypothesize that, at 6 and 12 month follow-up, the intervention smokers will be more likely to achieve biochemically verified smoking abstinence (7-day point prevalence), to report having made at least one 24-hour quit attempt, and to report using at least one evidence-based smoking cessation resource (telephone counseling or Quitline, medication, health professional advice) than smokers in the control condition. Using prospective quantitative data obtained from the RCT, and post-trial dyadic and individual interviews of 12 smokers and 12 family members selected based on abstinence experiences, the investigators will explore mediators at individual, family and social network levels that explain how the intervention affects quitting and maintaining abstinence. The long-term goal is to understand effective ways to utilize family-based and social outreach strategies to reduce tobacco use disparities in hard-to-reach populations.

Eligibility criteria: Inclusion Criteria (for smoker participants):

* Chinese or Vietnamese males
* Age \> 18
* Speak Cantonese or Mandarin (major Chinese dialects) or Vietnamese
* Have smoked at least 1 cigarette daily during the past 7 days, have a family member in the household with whom he will participate in the study, plan to stay in the area for the next 3 months (to complete all intervention activities) and can provide a valid phone number and a mailing address (for follow-up assessments and for sending saliva sample collection kits and payments).

Exclusion Criteria (for smoker participants):

* Those who are currently in a smoking cessation program or trying to quit smoking with assistance will be excluded.

Inclusion Criteria (for family participants):

* Family members (male or female) of an eligible smoker
* Age \> 18
* Speak Cantonese or Mandarin (major Chinese dialects) or Vietnamese
* Have never smoked or have formerly smoked but have not had any cigarette in the year prior to participation

Exclusion Criteria (for family participants):

* Only one smoker-family dyad from a household may participate.
* They must not live in the same household as their own LHW (or another LHW) or have participated in the study at any time (e.g., focus groups not directly related to the intervention implementation)

Primary outcomes:
measure: long-term 7-day point prevalence smoking abstinence (smoker participants)
timeFrame: 12 months
measure: number of 24-hour quit attempts (smoker participants)
timeFrame: 12 months
measure: use of smoking cessation resources since program initiation (smoker participants)
timeFrame: 12 months
measure: at least 50% reduction of the amount of cigarettes smoked per day from baseline
timeFrame: 12 months
Secondary outcomes:
Other outcomes:
Locations:
city: San Francisco
country: United States
facility: Southeast Asian Community Center (SEACC)
state: California
city: San Francisco
country: United States
facility: Chinese Community Health Resource Center
state: California
city: San Jose
country: United States
facility: Vietnamese Voluntary Foundation
state: California
Study officials:
affiliation: University of California, San Francisco
name: Janice Y Tsoh, PhD
role: PRINCIPAL_INVESTIGATOR
References: