- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05694637
Botswana Smoking and Abstinence Reinforcement Trial (BSMART)
July 28, 2023 updated by: Man Charurat, University of Maryland, Baltimore
Many people living with HIV in southern Africa, specifically Botswana use tobacco products.
Using tobacco makes some of the effects of HIV worse and even causes excess deaths.
The investigators plan to use an intervention called Screening, Brief Intervention and Referral to Treatment (SBIRT) to help people to quit smoking and also a drug called varenicline.
Apart from helping people to stop smoking, the investigators will also test to see how task shifting can be used to help people stop smoking in a sustainable way.
Finally, the investigators will estimate the cost of the intervention.
Study Overview
Status
Enrolling by invitation
Conditions
Detailed Description
The investigators will utilize a stepped wedge cluster randomized trial to implement BSMART.
BSMART will be sequentially rolled out to 15 participating HIV treatment and care facilities assigned in three steps.
Each step will provide data for a 12- month control/pre-implementation, a 12-month implementation, and a 12-month maintenance period.
The investigators will stratify Botswana's HIV treatment and care facilities into three levels of facilities.
The investigative team will randomly assign each of the three levels of facilities to one of three study steps.
Each step will comprise (i.e. have representation) from 3 levels of facilities, giving each level of facilities the same probability of beginning the intervention at any step).
Study Type
Interventional
Enrollment (Estimated)
750
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Central
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Francistown, Central, Botswana
- Itekeng Clinic
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Francistown, Central, Botswana
- Masego Clinic
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Francistown, Central, Botswana
- Nyangabgwe Referral Hospital
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Sefhare, Central, Botswana
- Sefhare Primary Hospital
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Tutume, Central, Botswana
- Tutume Primary Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- HIV infected
- Self reported current daily smoker
- Age 18 and older
- Engaged in HIV care as defined by being on ART for at least 6 months
- Willing/able to provide informed consent in English or Setswana
Exclusion Criteria:
- Less than 18 years of age
- Pregnant
- Unable or cognitively impaired to provide consent
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: SBIRT
Trained LHWs will oversee the screening and brief intervention procedures (i.e., the 5As).
A culturally acceptable standardized form will be integrated into intake procedures within the HIV that will allow for the documentation and results of using the 5As.
The first "A" will be the screening question where the LHW will "Ask" study participants about smoking.
When a participant reports being a smoker, the LHW will proceed to the next 3 "A"s (Advise, Assess, Assist).
These 3As will constitute the brief intervention.
The LHW will utilize motivational enhancing discussion between the study participant with a focus on increasing insight and awareness regarding smoking and motivation toward behavioral change.
For those participants who are motivated for treatment, a referral will be made to a clinic nurse practitioner for evaluation for treatment with varenicline.
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Trained LHWs will oversee the screening and brief intervention procedures (i.e., the 5As).
A culturally acceptable standardized form will be integrated into intake procedures within the HIV that will allow for the documentation and results of using the 5As.
The first "A" will be the screening question where the LHW will "Ask" study participants about smoking.
When a participant reports being a smoker, the LHW will proceed to the next 3 "A"s (Advise, Assess, Assist).
These 3As will constitute the brief intervention.
The LHW will utilize motivational enhancing discussion between the study participant with a focus on increasing insight and awareness regarding smoking and motivation toward behavioral change.
For those participants who are motivated for treatment, a referral will be made to a clinic nurse practitioner for evaluation for treatment with varenicline.
Referral to treatment with varenicline will be provided to those identified as needing more than a brief intervention.
Participants will initiate medication treatment with varenicline for smoking cessation with a quit date scheduled for day 8 following first study dose of the medication.
Participants will meet with the study clinician at baseline who will provide medical clearance and sign off on prescription orders.
All medication will be provided to participants by the study team.
Participants will receive a weekly supply of medication for the first four weeks to ensure proper dosing and monitor for adverse events.
For the subsequent 8 weeks, participants will return every 4 weeks to receive the next month's supply of medication.
Dosage adjustments will be permitted in an effort to control adverse effects throughout the trial.
This will allow us to balance internal validity with good clinical practice.
Varenicline will be dosed in accordance with package labeling.
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No Intervention: Standard of Care
Trained LHWs will provide a brief motivation counseling and a brochure about smoking cessation.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Smoking Abstinence
Time Frame: Week 24
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Abstinence will be based on self-reported 7-day point prevalence abstinence confirmed by expired CO<6 ppm.
Abstinence criteria must be met in study month 6 or at an earlier study week and maintained through study month 6 to be considered a responder.
We will use CO Check+ (MD Spiro), a single-breath point-of-care tool designed specifically for use in smoking cessation programs and clinics
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Week 24
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adherence to medication
Time Frame: Weeks 0, 1, 2, 4, 8, and 12
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For those who agree to be treated with Varenicline, pill and counseling adherence were assessed at Weeks 0, 1, 2, 4, 8, and 12. Pill adherence will be tracked by the following question at each medication visit: How many days in the last week did you take at least one of your study pills 39.
Pill adherence will be defined by participant self-report of taking 6 or 7 pills at week 8 which coincided with their last receipt of Varenicline.
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Weeks 0, 1, 2, 4, 8, and 12
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Manhattan Charurat, PhD, University of Maryland, Baltimore
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
July 25, 2023
Primary Completion (Estimated)
February 1, 2027
Study Completion (Estimated)
August 31, 2027
Study Registration Dates
First Submitted
December 7, 2022
First Submitted That Met QC Criteria
January 11, 2023
First Posted (Actual)
January 23, 2023
Study Record Updates
Last Update Posted (Actual)
August 1, 2023
Last Update Submitted That Met QC Criteria
July 28, 2023
Last Verified
July 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HP-00102995
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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