Use of smoking cessation clinical practices among persons living with HIV in Argentina

El consumo de tabaco en las personas que viven con VIH (PVV) en Argentina está entre un 40 y un 60%. El consumo de tabaco se relaciona con la aparición de cáncer en la población general y con una disminución de la respuesta al tratamiento antirretroviral en las PVV. Los médicos que atienden a las PVV pueden tener un papel fundamental en ayudar a sus pacientes a dejar de fumar. Este estudio examinó los factores relacionados con la utilización de las prácticas clínicas de cesación tabáquica en una muestra de médicos infectólogos que atienden a PVV en Argentina. MÉTODOS: Se administró una encuesta en línea a miembros de la Sociedad Argentina de Infectología, quienes referían atender a PVV. Se realizaron análisis descriptivos y modelos lineales generalizados. RESULTADOS: Participaron 138 profesionales (20,4% de los convocados). La implementación de métodos para la cesación tabáquica por los infectólogos fue significativamente mayor en aquellos profesionales que habían recibido educación al respecto (RPa: 1,22; IC 95%: 1,10-1,35), y disminuía significativamente en quienes no habían recibido entrenamiento formal (RPa: 0,64; IC 95%: 0,44-0,94). DISCUSIÓN: Hay necesidad de incorporar el entrenamiento en cesación tabáquica en la capacitación profesional de médicos que atienden a PVV para aumentar sus destrezas en estas prácticas clínicas y disminuir el consumo de tabaco en esta población.INTRODUCTION: In Argentina, the prevalence of smoking among persons living with HIV (PLWH) range between 40 and 60%. Tobacco smoking is related to cancer in the general population and to a reduced antiretroviral treatment response in PLWH. HIV care providers can have an important role in helping patients to quit smoking. This study examined factors related with the use of tobacco cessation clinical practices in a sample of infectious disease (ID) specialists serving PLWH in Argentina. METHODS: An online survey was administered to members of the Argentine Society of Infectious Diseases who served PLWH. Descriptive analyses and generalized linear models were conducted. RESULTS: A total of 138 professionals participated (20.4% of those invited). The implementation of smoking cessation interventions was significantly higher in ID specialists who had received tobacco-related education (OR: 1.22; 95% CI: 1.10-1.35) than in those without formal training on smoking cessation (OR: 0.64; 95% CI: 0.44-0.94). DISCUSSION: There is a need to integrate smoking cessation training in the professional training of medical providers serving PLWH to strengthen their skills in these clinical practices and ultimately decrease tobacco consumption in this population.Fil: Correa Fernandez, Virmarie. University Of Houston; Estados UnidosFil: Mejia, Raul Mariano. Centro de Estudios de Estado y Sociedad; Argentina. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pérez, Adriana. Centro de Estudios de Estado y Sociedad; Argentina. Universidad de Buenos Aires; ArgentinaFil: Llaneza, Danielle. University Of Houston; Estados UnidosFil: Cabrera, Noelia. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Fridman, Vanesa. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Tami Maury, Irene. University Of Texas Health Science Center At Houston.; Estados Unido

Addressing tobacco-related health disparities among Latinx adults: Community engagement and intervention research

This talk will focus on the process and preliminary outcomes in the implementation of a feasibility study (N=38) testing a wellness program for English-preferring Latinx adults who smoke cigarettes and experience anxiety and/or depression symptoms. The program involves the provision of nicotine patches and a video/phone-based counseling intervention grounded in Acceptance and Commitment Therapy (ACT). ACT's objective is to assist individuals in developing psychological flexibility by identifying their core values, strengthening their ability to experience uncomfortable thoughts and feelings, and engaging in values-consistent behaviors. The intervention entails an 8-session protocol that is culturally relevant for Latinx adults. This presentation will include: the process and outputs of the intervention development, challenges and lessons learned during recruitment, community engagement efforts, and treatment delivery (including transitioning to a virtual study during the COVID-19 pandemic), and preliminary results of the study. This work is significant because it addresses tobacco-related disparities experienced by Latinx groups

Adaptation of a counseling intervention to address multiple cancer risk factors among overweight/obese Latino smokers

More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social cognitive theory and principles of motivational interviewing originally developed for smoking cessation to also address physical activity and fruit/vegetable consumption among Latinos exhibiting multiple health risk behaviors. Literature reviews, focus groups, expert consultation, pretesting, and pilot testing were used to inform adaptation decisions. We identified common mechanisms underlying change in smoking, physical activity, and diet used as treatment targets; identified practical models of patient-centered cross-cultural service provision; and identified that family preferences and support as particularly strong concerns among the priority population. Adaptations made to the original intervention are described. The current study is a practical example of how an intervention can be adapted to maximize relevance and acceptability and also maintain the core elements of the original evidence-based intervention. The intervention has significant potential to influence cancer prevention efforts among Latinos in the United States and is being evaluated in a sample of 400 Latino overweight/obese smokers

Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed

Tobacco use is exceedingly high among those who are homeless or at risk of homelessness but not commonly addressed by clinicians. Taking Texas Tobacco Free (TTTF) is a tobacco control program that addresses known clinician barriers to intervention (e.g., low training receipt, limited resources). Here, we examine the process and outcomes of TTTF’s adaptation within four agencies that provide housing or other services to individuals who are homeless or vulnerably housed. Pre- and post-implementation data were collected from clinicians (N = 68) to assess changes in training receipt, knowledge, and intervention behaviors, relative to program goals. Results indicated significant gains in clinicians’ receipt of training in 9 (of 9) target areas (p’s ≤ 0.0042) and a 53% knowledge gain (p < 0.0001). From pre- to post-implementation, there were mean increases in the use of the 5As (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with significant gains seen in assisting residents/clients to quit, arranging follow-ups, and providing or referring for non-nicotine medications (p’s ≤ 0.0491). All program goals, except gains related to advising smokers to quit and the use of specific interventions (behavioral counseling), were met. Overall, TTTF improved clinicians’ capacity to address tobacco use among homeless and vulnerably housed individuals and can serve as a model for tobacco control efforts in similar agencies