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.
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.
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.
Not yet available.
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.
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- 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.
- 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.
Substance Abuse and Addiction