Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

CDA 17-005 – HSR&D Study

New | Current | Completed | DRA | DRE | Portfolios/Projects | Centers | Career Development Projects

CDA 17-005
A Personalized mHealth Approach to Smoking Cessation for Veterans Living with HIV
Sarah M. Wilson PhD
Durham VA Medical Center, Durham, NC
Durham, NC
Funding Period: April 2018 - March 2023

BACKGROUND/RATIONALE:
Cigarette smoking remains a leading preventable cause of death and poor health in the United States. Veterans living with HIV have particularly high smoking rates; and due to HIV infection, smoking disproportionately affects their health risk. Although HIV patients face unique barriers to treatment access and smoking abstinence, few smoking cessation interventions have been developed for people living with HIV. To date, there have been no randomized controlled trials (RCTs) of smoking cessation interventions for Veterans living with HIV.

OBJECTIVE(S):
The overall goal of this award is to develop a personalized, multi-component mHealth/telehealth smoking cessation intervention that targets the individualized needs of Veterans living with HIV.
Aim 1: To qualitatively explore smoking cessation treatment preferences among Veteran smokers living with HIV, and to quantitatively evaluate perspectives on relapse-prevention messages among Veterans and smokers living with HIV
Aim 2: To use a successive cohort design to develop and obtain patient feedback on the intervention.
Aim 3: To determine the feasibility and acceptability of the tailored smoking cessation intervention for Veterans living with HIV.
Aim 4: To quantitatively examine trends and determine health disparities in use of smoking cessation aids among VHA patients living with HIV.

METHODS:
The study has multiple components: (1) Qualitative feedback will be elicited from 20 Veteran smokers living with HIV to tailor the intervention, and subsequent quantitative feedback (N=400 rapid online surveys) will gauge satisfaction with a library of support and relapse-prevention messages. Aim 1 results will be mixed to inform the preliminary intervention design. (2) Three successive cohorts (each n = 5) of patients will complete the intervention and provide feedback. Qualitative data from each cohort will be used to refine treatment components including the user experience. (3) A feasibility trial will include N = 30 Veteran smokers with HIV, randomized to MESH or to a comparison condition (best practice telehealth). Outcomes include measures of feasibility and acceptability, as well as preliminary implementation feasibility data (i.e., intervention cost and key stakeholder perspectives). (4) Two large national VA cohorts (Veterans Aging Cohort Study, Women Veterans Cohort Study) will be leveraged to examine systemic trends and potential disparities in smoking cessation pharmacotherapy prescriptions. Utilization rates will be compared by demographic group as well as medical comorbidity.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
Findings are not yet available. The study is anticipated to yield a new and potentially efficacious tailored intervention for smoking cessation among people living with HIV. This would have tremendous value in terms of reducing health risk and healthcare cost among this population of VHA high-utilizers.

PUBLICATIONS:

Journal Articles

  1. Phillips RD, Wilson SM, Sun D, VA Mid-Atlantic MIRECC Workgroup, Morey R. Posttraumatic Stress Disorder Symptom Network Analysis in U.S. Military Veterans: Examining the Impact of Combat Exposure. Frontiers in psychiatry. 2018 Nov 20; 9:608.
  2. Coughlin LN, Wilson SM, Erwin MC, Beckham JC, VA Mid-Atlantic MIRECC Workgroup , Calhoun PS. Cigarette smoking rates among veterans: Association with rurality and psychiatric disorders. Addictive Behaviors. 2019 Mar 1; 90:119-123.
  3. Lynch SM, Wilson SM, DeRycke EC, Driscoll MA, Becker WC, Goulet JL, Kerns RD, Mattocks KM, Brandt CA, Bathulapalli H, Skanderson M, Haskell SG, Bastian LA. Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C. Pain medicine (Malden, Mass.). 2018 Sep 1; 19(suppl_1):S5-S11.
  4. Wilson SM, Newins AR, Medenblik AM, Kimbrel NA, Dedert EA, Hicks TA, Neal LC, Beckham JC, Calhoun PS. Contingency Management Versus Psychotherapy for Prenatal Smoking Cessation: A Meta-Analysis of Randomized Controlled Trials. Women's health issues : official publication of the Jacobs Institute of Women's Health. 2018 Nov 1; 28(6):514-523.
  5. Wilson SM, Thompson AC, Currence ED, Thomas SP, Dedert EA, Kirby AC, Elbogen EB, Moore SD, Calhoun PS, Beckham JC. Patient-Informed Treatment Development of Behavioral Smoking Cessation for People With Schizophrenia. Behavior Therapy. 2018 Jul 27; https://doi.org/10.1016/j.beth.2018.07.004.
  6. Wilson SM, Burroughs TK, Newins AR, Dedert EA, Medenblik AM, McDonald SD, Beckham JC, VA Mid-Atlantic MIRECC Workgroup, Calhoun PS. The Association Between Alcohol Consumption, Lifetime Alcohol Use Disorder, and Psychiatric Distress Among Male and Female Veterans. Journal of studies on alcohol and drugs. 2018 Jul 1; 79(4):591-600.
  7. Dillon KH, Cunningham KC, Neal JM, Wilson SM, Dedert EA, Elbogen EB, Calhoun PS, Beckham JC, VA Mid-Atlantic MIRECC Workgroup, Kimbrel NA. Examination of the indirect effects of combat exposure on suicidal behavior in veterans. Journal of affective disorders. 2018 Aug 1; 235:407-413.
  8. Newins AR, Wilson SM, Hopkins TA, Straits-Troster K, Kudler H, Calhoun PS. Barriers to the use of Veterans Affairs health care services among female veterans who served in Iraq and Afghanistan. Psychological Services. 2018 Feb 8.
  9. Hicks TA, Wilson SM, Thomas SP, Dennis PA, Neal JM, Calhoun PS. Low Income as a Multiplicative Risk Factor for Oral Pain and Dental Problems Among U.S. Veteran Smokers. International Journal of Behavioral Medicine. 2018 Feb 1; 25(1):67-73.
  10. Cunningham KC, Davis JL, Wilson SM, Resick PA. A relative weights comparison of trauma-related shame and guilt as predictors of DSM-5 posttraumatic stress disorder symptom severity among US veterans and military members. The British journal of clinical psychology. 2018 Jun 1; 57(2):163-176.
  11. Calhoun PS, Wilson SM, Dedert EA, Cunningham KC, Burroughs TK, Hicks TA, Beckham JC, Kudler HS, Straits-Troster K. The association of alcohol consumption patterns with self-rated physical health and psychiatric distress among Afghanistan- and Iraq-era U.S. veterans. Psychiatry Research. 2018 Jan 1; 259:142-147.
  12. Green KT, Wilson SM, Dennis PA, Runnals JJ, Williams RA, Bastian LA, Beckham JC, Dedert EA, Kudler HS, Straits-Tröster K, Gierisch JM, Calhoun PS. Cigarette Smoking and Musculoskeletal Pain Severity Among Male and Female Afghanistan/Iraq Era Veterans. Pain medicine (Malden, Mass.). 2017 Sep 1; 18(9):1795-1804.
  13. Calhoun PS, Wilson SM, Hertzberg JS, Kirby AC, McDonald SD, Dennis PA, Bastian LA, Dedert EA, VA Mid-Atlantic MIRECC Workgroup , Beckham JC. Validation of Veterans Affairs Electronic Medical Record Smoking Data Among Iraq- and Afghanistan-Era Veterans. Journal of general internal medicine. 2017 Nov 1; 32(11):1228-1234.
  14. Gilmore AK, Wilson SM, Skopp NA, Osenbach JE, Reger G. A systematic review of technology-based interventions for co-occurring substance use and trauma symptoms. Journal of telemedicine and telecare. 2017 Sep 1; 23(8):701-709.


DRA: Substance Abuse and Addiction
DRE: none
Keywords: none
MeSH Terms: none