Tobacco Cessation Treatment for Alaska Native Youth

Tobacco use among adolescents is a major public health problem in the United States. The prevalence of tobacco use among adolescents is currently highest among American Indians and Alaska Natives. Among Alaska Natives residing in the Yukon-Kuskokwim (Y-K) Delta region of western Alaska, approximately 29% of 11-14 year olds, and 63% of 15-18 year olds, use tobacco. No prior work has evaluated tobacco cessation interventions for Alaska Native adolescents.

This proposal builds on the investigators successful partnership and 7 year track record of collaboration with the Y-K Delta Alaska Native community. The objective of this proposal is to develop and pilot test a novel, culturally-appropriate, behavioral treatment approach for tobacco cessation among Y-K Delta Alaska Native adolescents ages 12 to 17. The behavioral intervention will include an initial, 2 day, group-based program with follow-up support for 6 weeks. Social cognitive (learning) theory is the conceptual basis for the proposed intervention. The investigators expect that as a result of this stage I project, the investigators will have developed a replicable, feasible, and acceptable intervention, the efficacy of which can be tested in future large-scale randomized clinical trials.

This project will take place in two phases. In phase 1, the investigators will develop the intervention with feedback from a teen advisory group, and develop a counselor manual. Follow-up strategies will also be developed, pilot-tested, and refined. Twenty adolescents will complete the protocol, which will be refined in an iterative manner based on feedback from participants and counselors. Phase 2, consisting of a pilot clinical trial, will apply a group-randomized design with assessments at weeks 0 (baseline), 6, and 26. Eight villages will be randomized to receive either the behavioral intervention or control condition (written self-help materials + quitline referral). Ten adolescents will be enrolled from each village, for a total of 80 participants. The investigators will assess the feasibility and acceptability of the intervention, as determined by qualitative ratings of treatment acceptability, and recruitment and retention rates. The investigators will estimate the magnitude of the effect of the intervention compared to the control condition on the biochemically confirmed tobacco abstinence rate at weeks 6 and 26, and estimate the intra-class correlation coefficient (ICC). At week 6, the investigators will evaluate the effect of the intervention on changes from baseline on perceived social support, self-efficacy for stopping tobacco use, and other mechanisms of change consistent with the investigators theoretical framework. The overall health related objective is to develop effective treatment programs for Alaska Native youth that will ultimately reduce their risk of tobacco-related disease.

Study Overview

• Status: Completed
• Conditions: Tobacco Cessation
• Intervention / Treatment: Behavioral: Written self-help materials; Behavioral: Group behavioral counseling

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • Alaska
    • Bethel, Alaska, United States, 99559
      • Yukon Kuskokwim Health Corporation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 17 years (CHILD)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Alaska Native
2. is from one of the targeted villages
3. is between 12-17 years of age
4. provides written assent
5. provides written parental consent
6. self-reports daily use of Iqmik, commercial ST, and/or cigarette smoking during the past 7 days, with current tobacco use status verified with a NicAlert salivary cotinine test strip value of >0
7. is willing to make a quit attempt
8. is willing and able to participate in all aspects of the study
9. has access to Web/e-mail and a working telephone.

Exclusion Criteria:

1. the adolescent is not able to fully participate in the intervention or would potentially pose harm to self or other group participants, and/or disrupt the group process (e.g., if subject is intoxicated at screening)
2. depression score of >16 as assessed by the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977)
3. current (past 3 months) participation in any tobacco pharmacological or behavioral treatment
4. another adolescent from the same household has enrolled.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: Behavioral: written self-help materials	Behavioral: Written self-help materials; Written materials to help adolescents stop tobacco use; Other Names: Control condition
EXPERIMENTAL: Group behavioral counseling; Group behavioral counseling, weekend program	Behavioral: Group behavioral counseling; group behavioral counseling (2 day weekend program); Other Names: intervention condition

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Feasibility of recruitment	Assessed at the time of screening

Secondary Outcome Measures

Outcome Measure	Time Frame
Biochemically confirmed tobacco abstinence	Assessed at Week 6 (End of Treatment)
Study retention	Assessed at week 24

Collaborators and Investigators

• Sponsor: Mayo Clinic
• Collaborators: Yukon Kuskokwim Health Corporation

Study record dates

Study Major Dates

• Study Start: September 1, 2010
• Primary Completion (ACTUAL): July 1, 2012
• Study Completion (ACTUAL): July 1, 2012

Study Registration Dates

• First Submitted: April 2, 2010
• First Submitted That Met QC Criteria: April 6, 2010
• First Posted (ESTIMATE): April 7, 2010

Study Record Updates

• Last Update Posted (ESTIMATE): May 23, 2013
• Last Update Submitted That Met QC Criteria: May 21, 2013
• Last Verified: May 1, 2013

More Information

Terms related to this study

• Other Study ID Numbers: 09-003981; R01DA025156 (NIH)