Heart & Lung: The Journal of Acute and Critical Care
Volume 39, Issue 1 , Pages 50-63, January 2010

Combining community participatory research with a randomized clinical trial: The protecting the hood against tobacco (PHAT) smoking cessation study

  • Erika Sivarajan Froelicher, RN, MA, MPH, PhD

      Affiliations

    • Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California
    • Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California
    • Corresponding Author InformationCorresponding author: Erika Froelicher, RN, MA, MPH, PhD, Department of Physiological Nursing, 2 Koret Way, Room N631, University of California San Francisco, San Francisco, CA 94143-0610.
  • ,
  • Daniel Doolan, RN, PhD

      Affiliations

    • Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California
    • San Francisco University, San Francisco, California
  • ,
  • Valerie B. Yerger, ND

      Affiliations

    • Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
  • ,
  • Carol O. McGruder, BA, DEF

      Affiliations

    • Polaris Research and Development and San Francisco African American Tobacco Free Project, San Francisco, California
  • ,
  • Ruth E. Malone, RN, PhD, FAAN

      Affiliations

    • Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
    • Institute for Health Policy Studies, School of Medicine, University of California, San Francisco, California

published online 23 July 2009.

Background

This article describes the process and results of a smoking cessation intervention randomized clinical trial (RCT) that was conducted as a community-based participatory research project. This RCT tested whether outcomes are improved by adding social justice and tobacco industry targeting messages to a smoking cessation program conducted among African American adults within a low-income community in San Francisco, California. This study provides lessons for future similar research projects that focus on urban low-income populations.

Methods

Participants were randomly allocated to receive a smoking-cessation program (control group [CG]) or CG care plus tobacco industry and media (IAM) messages. Primary interventions were behavioral. At intake, participants reporting severe withdrawal or smoking25 cigarettes daily were offered free nicotine replacement therapy. Baseline data were from an in-person interview. Outcome measures included self-reported smoking status; validation of quitting was by salivary cotinine assays.

Results

Of 87 participants providing baseline data, 31% (27) did not join the RCT. Proportions quitting in the CG and IAM group were 11.5% and 13.6% at 6 months and 5.3% and 15.8% at 12 months, respectively.

Conclusion

African Americans in underserved inner-city neighborhoods can be recruited into RCTs with community participatory approaches. Differences between the CG and IAM in proportions who quit were 2.1% and 10.5% at 6 and 12 months, respectively. More than 3 years with adequate funding, high staffing ratios, and intense outreach and follow-up schedules are needed to achieve recruitment and study goals.

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 This study was supported by funding from the California Tobacco-Related Disease Research Program (grants 11BT-1701 and 12AT-1700).

PII: S0147-9563(09)00149-6

doi:10.1016/j.hrtlng.2009.06.004

Heart & Lung: The Journal of Acute and Critical Care
Volume 39, Issue 1 , Pages 50-63, January 2010