Heather Wipfli, Jim Arinaitwe, Fastone Goma, Lynn Atuyambe, David Guwatudde, Masauso Moses Phiri, Elizeus Rutebemberwa, Fred Wabwire-Mangen, Richard Zulu, Cosmas Zyambo, Kyra Guy, Ronald Kusolo, Musawa Mukupa, Ezekiel Musasizi, Joan S Tucker
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引用次数: 0
Abstract
Background: Text messaging-based interventions (TMIs) have demonstrated effectiveness in reducing tobacco use in many populations. However, such interventions have not been tailored to meet the complex medical and psychosocial factors confronting people living with HIV (PLWH) in sub-Saharan Africa (SSA). We describe the process of adapting the SmokefreeTXT message library so that it is applicable to all forms of tobacco use, addresses issues specifically facing PLWH who use tobacco, and is culturally appropriate for use in Uganda and Zambia.
Methods/design: Participants were PLWH who currently used tobacco and health services workers recruited from HIV clinics in two regions of Uganda and two regions of Zambia. Eight focus groups (N = 48) were conducted with PLWH tobacco users and four focus groups (N = 28) were conducted with healthcare providers to adapt the TMI content for the cultural context and HIV status. A subsample of PLWH focus group participants (N = 14) provided feedback on the adapted TMI after using it for three weeks on their own phone. Focus group transcripts were analyzed for key themes based on the moderator guides using Dedoose software™. Means and percentages were calculated for survey data to assess the TMI's acceptability and feasibility.
Results: Focus group feedback on facilitators and barriers to quitting tobacco, as well as strengths and limitations of the TMI-based intervention approach, were used to finalize the adapted TMI's content and delivery for usability testing. PLWH identified multiple barriers to quitting tobacco including addiction, lack of support and education, and community perceptions. Health service workers highlighted the need for community-level interventions, improved provider knowledge on tobacco cessation, and tailored support strategies. Usability testing participants rated the TMI as helpful and relevant, emphasizing the interactive features as supportive and beneficial. Further, they reported few problems using it over three weeks, except for difficulty keeping their phone charged.
Conclusions: Results suggest that an adapted version of SmokefreeTXT is a feasible and acceptable option for PLWH in Uganda and Zambia who are interested in quitting tobacco use.
Trial registration: ClinicalTrials.gov Identifier NCT05487807. Registered August 4, 2022, https://clinicaltrials.gov/ct2/show/record/NCT05487807.
期刊介绍：
Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings.
Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use.
Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations.
Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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