- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05429892
FRESH Delivers: An Innovative Approach to Reducing Tobacco Use Among Rural/Black African American Smokers
Study Overview
Status
Conditions
Detailed Description
The central hypothesis is that smokers who receive real-time video-based motivational counseling and home-based food deliveries will have greater cotinine-verified 7-day point prevalence abstinence than those who receive real-time video-based motivational counseling alone or home food delivery alone. The rationale for this approach is that studies show increased odds of smoking cessation with increasing food security. Prior studies have largely ignored intervening on social conditions that perpetuate disparities, resulting in repeated failures to reach African Americans in low-resource counties with effective interventions that help them quit smoking. A limited number of interventions that aimed to increase food security also resulted in increased fruit and vegetable consumption and decreased body mass index. But, none have examined the effects of providing food security as a means to help smokers quit. The aims are:
Aim 1. Test the efficacy of a social change intervention (home food delivery) on smoking abstinence using a 3-arm randomized controlled design. H1.1: Smokers who receive real-time video-based motivational counseling and home-based food delivery will have greater cotinine-verified 7-day point prevalence abstinence than smokers who receive real-time video-based motivational counseling alone or home food delivery alone.
Aim 2. Examine changes in measures of cigarette abuse liability across treatment groups. H2.1: Smokers in the real-time video-based motivational counseling and home-based food delivery intervention will have: 1) fewer signs of nicotine dependence, cravings, and withdrawal and lower levels of biomarkers of tobacco exposure (carbon monoxide, cotinine, trans-3'-hydroxycotinine) and tobacco harm (acrolein, acetaldehyde, benzaldehyde, and formaldehyde) than smokers who receive real-time video-based motivational counseling alone or home food delivery alone. H2.2: Smokers with higher social stressors (every day discrimination, major experiences of discrimination, discriminatory health care experiences) will show greater signs of nicotine dependence, cravings, and withdrawal and higher levels of biomarkers of tobacco exposure and harm.
Aim 3. Examine the extent to which a home food delivery intervention improves recruitment and retention of Black/African American smokers in the treatment condition. H3.1: Smokers in the real-time video-based motivational counseling and home-based food delivery intervention will have greater reach, dose, and successful referrals compared to smokers who receive motivational counseling alone or home food delivery alone.
Impact. The novel home-based food delivery with real-time video-based motivational counseling intervention could increase access to cessation interventions in rural counties where interventions are lacking, create equity in the reach of interventions to groups who face persistent structural racism and discrimination, and encourage a diverse clientele of Blacks/African Americans to participate in interventions that meet a basic need, food security, thus improving social conditions, increasing smoking cessation, and potentially eliminating the risk for cancer health disparities.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Pebbles Fagan, PhD, MPH
- Phone Number: 5015262294
- Email: pfagan@uams.edu
Study Contact Backup
- Name: Sandilyn Bullock, MPH
- Phone Number: 501-526-6039
- Email: SBBullock@uams.edu
Study Locations
-
-
Arkansas
-
Little Rock, Arkansas, United States, 72205
- Recruiting
- University of Arkansas for Medical Sciences
-
Contact:
- Sandilyn Bullock, MPH
- Phone Number: 501-526-6039
- Email: SBBullock@uams.edu
-
Contact:
- Pebbles Fagan, PhD, MPH
- Phone Number: 501-526-2294
- Email: pfagan@uams.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Currently smoke regularly for at least 1 year with a verified carbon monoxide level of 5 ppm or greater
- Live in Desha, Phillips, Chicot, or Lee Counties
- Aged 21 to 75
- Speak English
- Interest in quitting
- Provide written/online informed consent
- Working phone, home address, and email
- Willingness to use a study provided tablet/phone service
- Willingness to report COVID-19 symptoms as appropriate to assure everyone's safety during a personal visit.
Exclusion Criteria:
• Persons who do not meet the above criteria.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: TRTsocialmot1 arm
Smokers will receive real-time video-based motivational counseling and home-based food delivery. Participants will receive educational material. |
The community health workers will delivery five 30-minute sessions during intervention months 1 through 5 to provide interpersonal level support for smoking cessation. The community health workers will conduct real-time video motivational counseling to clients. The community health workers will implement the 5As (Ask, Advise, Assess, Assist, Arrange) and support smokers in quitting, if ready, and build confidence toward quitting if they are uncertain about change. Smokers enrolled in the TRTsocialmot1 arm will be provided with monthly delivery of food boxes in accordance with the number of persons in the household and caloric intake needed to support one week's worth of family meals. Healthy meal preparation instructions will be included and delivery by project staff will reduce transportation barriers to food access rural counties. Participants will receive educational materials.
Other Names:
|
Active Comparator: TRTmot3 arm
Smokers will receive real-time video-based motivational counseling only. Participants will receive educational material. |
The community health workers will delivery five 30-minute sessions during intervention months 1 through 5 to provide interpersonal level support for smoking cessation. The community health workers will conduct real-time video motivational counseling to clients. The community health workers will implement the 5As (Ask, Advise, Assess, Assist, Arrange) and support smokers in quitting, if ready, and build confidence toward quitting if they are uncertain about change. Participants will receive educational materials.
Other Names:
|
Active Comparator: TRTsocial2 arm
Smokers will receive home-based food delivery only. Participants will receive educational material. |
Smokers enrolled in the TRTsocial2 arm will be provided with monthly delivery of food boxes in accordance with the number of persons in the household and caloric intake needed to support one week's worth of family meals. Healthy meal preparation instructions will be included and delivery by project staff will reduce transportation barriers to food access rural counties. Participants will receive educational materials.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cotinine verified- 7 day point prevalence abstinence
Time Frame: Changes from baseline cigarette prevalence at 6 months
|
The study is powered to examine changes in our primary outcome, cotinine-verified 7-day point prevalence abstinence using survey data and collecting a saliva sample.
|
Changes from baseline cigarette prevalence at 6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Food security
Time Frame: Changes from baseline food security at 6 months
|
The secondary outcome will be food security measured using the US household food security 6-item survey.
Scores of 0-1= high to marginal food security; 2-4= low food security; 5-6= very low food security.
|
Changes from baseline food security at 6 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Abuse liability - nicotine dependence
Time Frame: Changes from baseline nicotine dependence at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured using a 6-item nicotine dependence (Fagerstrom Test for Nicotine Dependence) scale on surveys.
Scores of 8-10=very high dependence; 6-7= high ; 5= moderate; 3-4= low; 0-2= very low dependence.
|
Changes from baseline nicotine dependence at 6 months
|
Abuse liability - discrimination
Time Frame: Changes from baseline discrimination at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured using the 10-item everyday discrimination scale on surveys.
Scores range from 10 to 60 with higher scores (1=never to almost 6=everyday) being indicative of more frequent experiences.
|
Changes from baseline discrimination at 6 months
|
Abuse liability - carbon monoxide
Time Frame: Changes from baseline carbon monoxide at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured using carbon monoxide measured via the Smokerlyzer® monitors.
Higher carbon monoxide scores mean greater exposure to tobacco.
|
Changes from baseline carbon monoxide at 6 months
|
Abuse liability - cotinine
Time Frame: Changes from baseline cotinine at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured by collecting saliva that will allow us to assess cotinine levels.
Higher cotinine levels mean greater exposure tobacco.
|
Changes from baseline cotinine at 6 months
|
Abuse liability - trans-3'-hydroxycotinine
Time Frame: Changes from baseline trans-3'-hydroxycotinine at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured by collecting saliva that will allow us to assess - trans-3'-hydroxycotinine levels.
Higher levels mean greater exposure to tobacco.
|
Changes from baseline trans-3'-hydroxycotinine at 6 months
|
Abuse liability - cravings
Time Frame: Changes from baseline cravings at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured using the 10-item brief questionnaire of smoking urges.
Scores range from 1 (strongly disagree) to 7 (strongly agree) ad result in two factors related to specific items in the scale.
The higher the score, the stronger to urge.
|
Changes from baseline cravings at 6 months
|
Abuse liability - withdrawal
Time Frame: Changes from baseline withdrawal at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured using the 6-item Minnesota withdrawal scale (2021).
Scores range from 0=none to 4=severe.
The higher the score the more severe the withdrawal.
|
Changes from baseline withdrawal at 6 months
|
Abuse liability - acrolein
Time Frame: Changes from baseline acrolein at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured by collecting saliva that will allow us to assess -acrolein levels.
Higher levels mean greater exposure to this tobacco toxin.
|
Changes from baseline acrolein at 6 months
|
Abuse liability - benzaldehyde
Time Frame: Changes from baseline benzaldehyde at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured by collection saliva that will allow us to assess benzaldehyde levels.
Higher levels mean greater exposure to this tobacco toxin.
|
Changes from baseline benzaldehyde at 6 months
|
Abuse liability - formaldehyde
Time Frame: Changes from baseline formaldehyde at 6 months
|
Examine changes in measures of cigarette abuse liability across treatment groups.
Abuse liability will be measured by collection saliva that will allow us to assess formaldehyde levels.
Higher levels mean greater exposure to this tobacco toxin.
|
Changes from baseline formaldehyde at 6 months
|
Recruitment and retention- reach
Time Frame: Monthly until study completion, on average 1 year.
|
Examine reach to participants.
Reach will be assessed by calculating # participants enrolled in the study each month.
Staff will review completed consent forms and baseline surveys monthly.
|
Monthly until study completion, on average 1 year.
|
Recruitment and retention-dose delivered
Time Frame: Monthly until study completion, on average 1 year.
|
Examine dose of the intervention delivered to participants.
Dose delivered will be assessed by calculating the number of intervention activities delivered (motivational counseling, food delivery).
Staff will complete a process tracking form after the delivery of each intervention activity.
|
Monthly until study completion, on average 1 year.
|
Recruitment and retention-dose received
Time Frame: At 6 months.
|
Examine dose of the intervention received by participants.
Dose received will be assessed by calculating the participant report of number of interventions received (motivational counseling, food delivery).
Participants will be asked about the interventions received on the 6-month survey.
|
At 6 months.
|
Recruitment and retention- successful referral
Time Frame: Monthly until study completion, on average 1 year.
|
Examine successful referral of participants to the study.
Staff will document the number of persons who enrolled in the study who were referred by an enrolled study participant.
|
Monthly until study completion, on average 1 year.
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Pebbles Fagan, PhD, University of Arkansas
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 273441
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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