The Healing and Empowering Alaskan Lives Toward Healthy-Hearts (HEALTHH) Project: Study protocol for a randomized controlled trial of an intervention for tobacco use and other cardiovascular risk behaviors for Alaska Native People - PubMed (original) (raw)

The Healing and Empowering Alaskan Lives Toward Healthy-Hearts (HEALTHH) Project: Study protocol for a randomized controlled trial of an intervention for tobacco use and other cardiovascular risk behaviors for Alaska Native People

Judith J Prochaska et al. Contemp Clin Trials. 2018 Aug.

Abstract

Background: Tobacco use and tobacco-related diseases disproportionately affect Alaska Native (AN) people. Using telemedicine, this study aims to identify culturally-tailored, theoretically-driven, efficacious interventions for tobacco use and other cardiovascular disease (CVD) risk behaviors among AN people in remote areas.

Design: Randomized clinical trial with two intervention arms: 1) tobacco and physical activity; 2) medication adherence and a heart-healthy AN diet.

Participants: Participants are N = 300 AN men and women current smokers with high blood pressure or high cholesterol.

Interventions: All participants receive motivational, stage-tailored, telemedicine-delivered counseling sessions at baseline and 3, 6, and 12 months follow-up; an individualized behavior change plan that is updated at each contact; and a behavior change manual. In Group 1, the focus is on tobacco and physical activity; a pedometer is provided and nicotine replacement therapy is offered. In Group 2, the focus is on medication adherence for treating hypertension and/or hypercholesterolemia; a medication bag and traditional food guide are provided.

Measurements: With assessments at baseline, 3, 6, 12, and 18 months, the primary outcome is smoking status, assessed as 7-day point prevalence abstinence, biochemically verified with urine anabasine. Secondary outcomes include physical activity, blood pressure and cholesterol, medication compliance, diet, multiple risk behavior change indices, and cost-effectiveness.

Comments: The current study has the potential to identify novel, feasible, acceptable, and efficacious interventions for treating the co-occurrence of CVD risk factors in AN people. Findings may inform personalized treatment and the development of effective and cost-effective intervention strategies for use in remote indigenous communities more broadly. Clinical Trial Registration # NCT02137902.

Keywords: Alaska Native; Cardiovascular risk factors; Intervention; Motivational; Randomized controlled trial; Smoking cessation; Telemedicine.

Copyright © 2018 Elsevier Inc. All rights reserved.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest declaration

Dr. Prochaska and Dr. Benowitz have served as expert witnesses against the tobacco companies in lawsuits for which they have received fees for the work and have provided consultation to pharmaceutical and technology companies that make medications and other treatments for quitting smoking. No other authors have any disclosures to report related to this work.

Figures

Figure 1.

Figure 1.

Norton Sound Region: HEALTHH Study Recruitment Communities

Similar articles

Cited by

References

    1. US Department of Health and Human Services. The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2014.
    1. Galloway JM. Cardiovascular health among American Indians and Alaska Natives: successes, challenges, and potentials. Am J Prev Med. 2005;29(5):11–17. - PubMed
    1. Jamal A, Phillips E, Gentzke AS, et al. Current Cigarette Smoking Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67:53–59. doi: 10.15585/mmwr.mm6702a1 - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation (STATE) System. Current Cigarette Use Among Adults (Behavior Risk Factor Surveillance System). 2015.
    1. Alaska Native Tribal Health Consortium. Statewide data: Adult current smoking. Alaska Native Epidemiology Center. 2017.

Publication types

MeSH terms

Substances

LinkOut - more resources