Smoking Cessation Clinical Trial
Official title:
Smartphone-delivered Automated Video-assisted Smoking Treatment for People Living With HIV: Project AVAST - HIV
The proposed pilot study seeks to address the smoking treatment needs of people living with HIV/AIDS (PLWHA) by evaluating the feasibility and preliminary efficacy of a smartphone delivered automated video-assisted smoking treatment (AVAST). AVAST will enable smoking cessation treatment content to be presented with voice/audio, images, videos, and text in an interactive, structured format anytime and anywhere. This automated treatment approach is designed to enhance treatment engagement and facilitate abstinence from smoking among PLWHA. Participants will be recruited from the University of Oklahoma Health Sciences Center (OUHSC) clinics providing care to HIV+ individuals (e.g., the Infectious Diseases Institute).
Substantial evidence indicates that the prevalence of cigarette smoking among persons living
with HIV/AIDS (PLWHA) is far higher than the prevalence in the general US population.
Moreover, strong associations between smoking and numerous adverse AIDS- and non-AIDS-related
outcomes have been detailed. Thus, efficacious smoking cessation programs targeted to PLWHA
are needed. Despite the need, relatively few smoking cessation intervention trials for PLWHA
have been conducted, and the published results from these trials have not been overly
positive. The currently available literature indicates that HIV+ smokers appear to be
motivated to quit, as evidenced by high enrollment rates. Also, it appears that more
intensive interventions result in significantly higher quit rates (vs. minimal interventions)
at short term and intermediate follow-ups. However, smoking relapse rates are very high, and
treatment effects are not well sustained. This study seeks to address this treatment need by
evaluating the feasibility and preliminary efficacy of a smartphone-delivered automated
video-assisted smoking treatment (AVAST).
Participants (n=20) will be randomized to one of two treatment conditions: 1) Standard
Treatment (ST; n=10) or Automated Treatment (AT; n=10). In the ST condition, research staff
will provide participants with in- person brief advice to quit and enroll them in a proactive
telephone counseling program for smoking cessation. This ST approach mirrors the Ask Advise
Connect (AAC) approach that our team has previously developed and implemented in numerous
clinic settings. ST will be evaluated against AT, the fully automated AVAST approach. In the
AT condition, smokers will be provided with in-person brief advice to quit and be enrolled in
a fully automated and interactive smartphone-based treatment program that comprises
interactive text messaging, images and audio/video clips. Participants in both treatment
conditions will be provided with nicotine replacement therapy (NRT) in the form of
transdermal patches. The goal of this pilot project is to establish the preliminary efficacy
and feasibility of AT. Data collected in the pilot will then be used to support the
submission of a NIH R01 application, and to determine if AT performs no worse than the more
resource intensive ST approach. If lack of inferiority is established in the larger project,
the AT approach will be readily scalable; easily implemented by community-based clinics and
organizations; and offer an efficient way to allocate limited public health resources to
tobacco control interventions.
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