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Practice-based Intervention for Vietnamese and Korean Patients

Not Applicable
Completed
Conditions
Tobacco Use
Smoking Cessation
Interventions
Behavioral: Interactive Mobile Doctor ("iMD")
Registration Number
NCT03064724
Lead Sponsor
Asian Health Services
Brief Summary

This pilot project examined the feasibility of an multilingual interactive video education intervention "an interactive Mobile Doctor intervention (iMD)" to promote patient-provider discussion on tobacco use for Korean- and Vietnamese-speaking male patients at primary care settings.

Detailed Description

While California has made significant strides in tobacco control and is leading the nation in reducing smoking use, the decline is not observed in all groups. Select groups still have much higher smoking rates and thus bear an unequal burden of tobacco-related illnesses and deaths. Of important note, Asian American men as a combined group have a higher smoking rate than non-Hispanic Whites (22% vs. 18%, respectively); in particular, the highest smoking prevalence has been observed in Vietnamese (31%) and Korean (30%) men among major Asian subgroups. Research also shows that smoking rates are higher for Asian American men with low acculturation (e.g., immigrant status, low English proficiency) than for those who are more acculturated; yet the reverse trend is observed in Asian American women. These findings underscore the need for more targeted tobacco control efforts. The scientific literature suggests that provider advice to quit smoking can influence a smoker's decision to quit. However, research has shown that Asian Americans are less likely to receive such provider advice. Providers often have very limited face-time with patients during the short clinic visit, which presents a challenge as to whether they can incorporate smoking cessation messages during the visit. Overall, little research has focused on smoking cessation in the clinic setting, particularly research that focuses on Asian Americans. The purpose of the pilot study was to develop a more streamlined smoking cessation intervention that can be integrated into the clinic visit, especially to maximize the time when patients are waiting to see their providers. The research question was whether providing culturally appropriate video education that includes provider advice and was tailored to a patient's readiness for quitting smoking will increase whether a patient receives smoking cessation education according to the recommended Clinical Practice Guideline and whether this results in a decrease in tobacco use in low-income Vietnamese and Korean patients. Using a community-based participatory research approach, the investigators created the iMD that delivers tailored in-language video messages via a mobile tablet to Korean and Vietnamese male smokers right before their clinic visit with a provider. iMD delivers the "5 A's" and generates a bilingual tailored printout. Participants were Korean- and Vietnamese-speaking patients who self-identify as daily smokers and receive primary care at a federally-qualified health center. This study evaluated the feasibility and acceptability of iMD from the patients' perspectives. This study examined patient-provider discussion on tobacco use from patients' self-report and electronic health record (EHR), and self-reported quit attempts and smoking abstinence at 3 months post iMD visit.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
47
Inclusion Criteria
  • current smokers identified on electronic health records (EHR)
  • have a scheduled primary care visit during the recruitment period
Exclusion Criteria
  • already quit smoking or not smoking daily in the past 7 days
  • had already quit smoking or not smoking daily in the past 7 days
  • had canceled or rescheduled their primary care visit outside of the study period

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Smoking Cessation GroupInteractive Mobile Doctor ("iMD")Patients received the interactive mobile doctor (iMD) intervention.
Primary Outcome Measures
NameTimeMethod
Participation RateBaseline

proportion of eligible participants consent to participate

Acceptabilitythrough study completion, an average of 1 year

proportion of participants who rated the intervention as moderately to extremely satisfied

Secondary Outcome Measures
NameTimeMethod
Physician delivery of 5As"through study completion, an average of 1 year

EHR-documented physician's delivery of assess, advice, assist, or arrange at the indexed clinical encounter

Abstinence3-month

self-reported 7-day point prevalent smoking abstinence

Patient-provider discussion"through study completion, an average of 1 year

self-reported by patient whether discussion on tobacco use took place at the indexed clinical encounter

Quit attempt3-month

self-reported at least one or more 24 hour quit attempts

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