Improving Participants' Retention in a Smoking Cessation Intervention Using a Community-based Participatory Research Approach

Anthony Estreet, Jummai Apata, Farin Kamangar, Christine Schutzman, Jane Buccheri, Anne-Marie O'Keefe, Fernando Wagner, Payam Sheikhattari, Anthony Estreet, Jummai Apata, Farin Kamangar, Christine Schutzman, Jane Buccheri, Anne-Marie O'Keefe, Fernando Wagner, Payam Sheikhattari

Abstract

Background: This study compares participant' sretention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community-based settings.

Methods: Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profiles and high rates of smoking (n = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence.

Results: Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was significantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confidence intervals [CI] = 4.6, 9.8). In addition to the intervention in community venues, predictors of retention included age and unemployment. Higher retention was significantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8).

Conclusions: Conducting the intervention in community settings using trained peer motivators rather than health-care providers resulted in significantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specific populations and improving the quality of the intervention based on feedback from participants and community partners.

Keywords: Community-based participatory research; retention; smoking cessation; underserved populations.

Conflict of interest statement

There are no conflicts of interest.

References

    1. National Center for Chronic Disease Prevention and Health Promotion d. Smoking and Tobacco Use; Tobacco Control State Highlights. Maryland: 2010. [Last accessed on 2016 Feb 02]. Available from: .
    1. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Centers for Disease Control and Prevention. Tobacco Control Highlights 2012. 2013. [Last accessed on 2016 Feb 02]. Available from: .
    1. Barbeau EM, Krieger N, Soobader MJ. Working class matters: Socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000. Am J Public Health. 2004;94:269–78.
    1. Hiscock R, Bauld L, Amos A, Fidler JA, Munafò M. Socioeconomic status and smoking: A review. Ann N Y Acad Sci. 2012;1248:107–23.
    1. Margerison-Zilko C, Cubbin C. Socioeconomic disparities in tobacco-related health outcomes across racial/ethnic groups in the United States: National Health Interview Survey 2010. Nicotine Tob Res. 2013;15:1161–5.
    1. Bureau UC. American Community Survey (ACS) [Last accessed on 2017 Jun 12]. Available from: .
    1. Brorson HH, Ajo Arnevik E, Rand-Hendriksen K, Duckert F. Drop-out from addiction treatment: A systematic review of risk factors. Clin Psychol Rev. 2013;33:1010–24.
    1. Wagner FA, Sheikhattari P, Buccheri J, Gunning M, Bleich L, Schutzman C, et al. A community-based participatory research on smoking cessation intervention for urban communities. J Health Care Poor Underserved. 2016;27:35–50.
    1. Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs. US Department Health Human Services Center Disease Control Prevention National Center Chronic Disease Prevention Health Promotion Office Smoking Health. 2014
    1. Yancey AK, Ortega AN, Kumanyika SK. Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006;27:1–28.
    1. El-Khorazaty MN, Johnson AA, Kiely M, El-Mohandes AA, Subramanian S, Laryea HA, et al. Recruitment and retention of low-income minority women in a behavioral intervention to reduce smoking, depression, and intimate partner violence during pregnancy. BMC Public Health. 2007;7:233.
    1. Sheikhattari P, Zhu S, Clubb P, Wagner FA. New insights on tobacco smoking among underserved and poor. World Academy of Science, Engineering, and Technology. 2010:400–5.
    1. Freshstart Program by American Cancer Society Workplace olutions. [Last accessed on 2016 Feb 05]. Available from: .
    1. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38–48.
    1. Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992;47:1102–14.
    1. Fagerstrom KO, Heatherton TF, Kozlowski LT. Nicotine addiction and its assessment. Ear Nose Throat J. 1990;69:763–5.
    1. Ryter SW, Choi AM. Carbon monoxide in exhaled breath testing and therapeutics. J Breath Res. 2013;7:017111.
    1. EpiData Software. EpiData Software. Odense, Denmark: EpiData Association. [Last accessed on 2016 Feb 02]. Available from: .
    1. Stata Statistical Software. College Station, TX: StataCorp LP: StataCorp. 2011. [Last accessed on 2016 Feb 02]. .
    1. Sheikhattari P, Apata J, Kamangar F, Schutzman C, O’Keefe A, Buccheri J, et al. Examining smoking cessation in a community-based versus clinic-based intervention using community-based participatory research. J Community Health. 2016;41:1146–52.
    1. ATLAS.ti: The Qualitative Data Analysis & Research Software. Atlas.ti. [Last accessed on 2016 Oct 26]. Available from: .
    1. Spencer MS, Rosland AM, Kieffer EC, Sinco BR, Valerio M, Palmisano G, et al. Effectiveness of a community health worker intervention among African American and Latino adults with type 2 diabetes: A randomized controlled trial. Am J Public Health. 2011;101:2253–60.
    1. Hooper MW, Larry R, Okuyemi K, Resnicow K, Dietz NA, Robinson RG, et al. Culturally specific versus standard group cognitive behavioral therapy for smoking cessation among African Americans: An RCT protocol. BMC Psychol. 2013;1:15.
    1. Wallen J, Randolph S, Carter-Pokras O, Feldman R, Kanamori-Nishimura M. Engaging African Americans in smoking cessation programs. Am J Health Educ. 2014;45:151–7.
    1. Amendola MG, Nazario N, Sanchez V. Using CBPR to assess client needs at a social service agency. Public Health Nurs. 2016;33:167–75.
    1. Andrews JO, Tingen MS, Jarriel SC, Caleb M, Simmons A, Brunson J, et al. Application of a CBPR framework to inform a multi-level tobacco cessation intervention in public housing neighborhoods. Am J Community Psychol. 2012;50:129–40.
    1. Rhodes SD, Kelley C, Simán F, Cashman R, Alonzo J, McGuire J, et al. Using Community-Based Participatory Research (CBPR) to develop a community-level HIV prevention intervention for Latinas: A local response to a global challenge. Womens Health Issues. 2012;22:e293–301.
    1. Lee CS, Hayes RB, McQuaid EL, Borrelli B. Predictors of retention in smoking cessation treatment among Latino smokers in the Northeast United States. Health Educ Res. 2010;25:687–97.
    1. Ahluwalia JS, Harris KJ, Catley D, Okuyemi KS, Mayo MS. Sustained-release bupropion for smoking cessation in African Americans: A randomized controlled trial. JAMA. 2002;288:468–74.
    1. Curtin L, Brown RA, Sales SD. Determinants of attrition from cessation treatment in smokers with a history of major depressive disorder. Psychol Addict Behav. 2000;14:134–42.
    1. Nevid JS, Javier RA, Moulton JL., 3rd Factors predicting participant attrition in a community-based, culturally specific smoking-cessation program for Hispanic smokers. Health Psychol. 1996;15:226–9.

Source: PubMed

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