In 2009, tobacco use was implicated in 438,000 deaths in the U.S. and over 80% of lung cancers were attributed to smoking. Lung cancer is the primary cause of cancer death for Latino men and the second leading cause for Latina women. Several pharmacological treatments for smoking cessation have been shown to be effective at improving tobacco abstinence rates, including nicotine replacement therapy (NRT). Despite the availability of these efficacious treatments, adherence to treatment is a significant barrier for Latinos. Developing novel, effective and culturally targeted interventions that increase NRT adherence among Latinos can ultimately inform clinical practice and improve the cessation rates of Latino smokers seeking to quit. The current study seeks to develop and test a culturally tailored medication adherence intervention that will include text messaging and behavioral components that target the unique needs of Latino smokers. These novel and targeted components will address misperceptions and barriers related to NRT treatment and offer real-time reminders and informational prompts to enhance adherence. In the initial development phase of the research, qualitative methods will be used to develop the Latino-targeted components of the intervention. During the clinical trial phase of the study, 98 Latino smokers interested in quitting will be randomized to one of two groups - Culturally Tailored Adherence (CTA), or 2) Standard Medication Management (SMM). All participants will receive 12 weeks of NRT and will receive ongoing assessments of NRT adherence, tobacco abstinence, and will be assessed on the constructs of our theoretical model (e.g. motivation or behavioral skills). The proposed study will be conducted in the context of a five-year career development program that will provide advanced training in Latino smoking cessation and health, qualitative methods, adherence interventions, tobacco addiction and cessation, and the use of technology in healthcare. The proposed training and research plans aim to promote the applicant's long-term career goal of establishing an independently-funded program of tobacco research with a focus on Latino populations. A comprehensive training plan is proposed, combining mentored research, structured mentorship activities guided by established researchers in the field, formal coursework and workshops, and participation in seminars at Brown University and Butler Hospital.
Considering the high rates of non-adherence among Latino smokers involved in smoking cessation treatment, the proposed study addresses several public health concerns related to smoking cessation, cancer, and health disparities among Latinos. We seek to develop and test a culturally tailored intervention that aims to increase adherence to nicotine replacement therapy among Latino smokers. The results of the proposed study can have a beneficial effect on improving cessation rates among this vulnerable subpopulation and ultimately decrease the risks of developing tobacco-related diseases and illnesses.
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