Latino smokers are less likely to receive advice to stop smoking from health care providers or use behavioral counseling or cessation medications to try to quit. This study will develop and test an innovativesmoking cessation intervention, delivered via touchscreen computer kiosk, that targets low-income Latinos attending safety net clinics. The objective of this applicationis to evaluate the feasibility,cultural appropriateness, acceptability and preliminaryoutcomes of the kiosk, Decidete. Consistent with the Chronic Disease Model, Decidete is designed to promote productive discussions regarding smoking cessation between health care providers and their Latino patients. Decidete has been developed and implemented in two safety net clinics. It was designed to help Latinos decide whether and how to quit smoking, facilitate access to pharmacotherapy, and link smokers to existing state-funded tobacco quitlines. The current proposal is based on this pilot work and consists of two studies. Study 1 assesses the acceptability and cultural appropriateness of Decidete from the perspectives of clinic staff and Latino smokers. Data from this evaluation will be used to revise Decidete in order to optimize its feasibility and efficacy. Study 2 assesses the impact of the revised version of Decidete on interactions with health care providers, use of smoking cessation resources, quit attempts and smoking cessation. Participants will include Latino health care providers throughout the metro area and Latino smokers attending safety net clinics. This project is within the scope of Redes en Accion, a Community Network Project to improve access to cancer interventions. Our project will integrate a smoking cessation program into community safety net clinics where many Latinos obtain their health care. The program is highly feasible because it tests a free-standing computer program that will not create new demands on cliniciansbut will rather supplement their efforts. Moreover, it was developed with input from local Latino smokers and health care providers, and reflects national guidelines for smoking cessation intervention. Initial input suggests the touchscreen format, simple layout, and audio/visual presentation enables even low-literacy smokers to use Decidete. However, its cultural appropriateness and efficacy have yet to be evaluated. Successful implementation of this project will ensure the program meets the needs of Latino smokers and health care providers and will lay the groundwork for future large-scale efficacy trials. Although the plan is ambitious for a 1-year project, it is feasible because it builds on an existing, ongoing project on which this experienced research team is already collaborating. We will be able to collect valuable data from an understudied and largely underserved population. The proposed research will address a topic identified as a priority by providers, patients and national health agencies.
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