Smoking Cessation Intervention for HIV-Infected Patients

Univ Of Massachusetts Med Sch Worcester, Worcester MA

Investigators

Abstract

DESCRIPTION (provided by applicant): The overall goal of this 4-year proposal is to provide Dr. Lai, the Principal Investigator (PI), opportunities to enhance her clinical research skills, training, and development as a clinical researcher in the medical setting. As part of the training, she will be a MPH degree candidate and participate in other seminars, workshops, and her mentor's research meetings. Dr. Lai's research goals are to: 1) Implement a provider-delivered smoking cessation office intervention for HIV/AIDS patients, 2) Conduct a smoking cessation intervention study to demonstrate the feasibility of recruitment approaches, 3) Evaluate study participants' experience, 4) Evaluate provider adherence to the delivery of smoking intervention and their attitudes towards incorporating smoking intervention in the context of HIV care, and 5) Assess the measurement approaches to evaluate the efficacy of the intervention in anticipation of a future RCT. Recent advances in anti-retroviral therapy have resulted in HIV/AIDS patients living longer and potentially leading more productive lives. Metabolic complications associated with HIV treatment such as lipid abnormalities, truncal obesity, and development of diabetes put patients at risk for cardiovascular disease. Development of a stronger care model for HIV-infected patients that includes smoking treatment services wilt be important. Such a model has not yet been developed. The intervention will be tested in a group of 80 HIV/AIDS patients who are current smokers. Their primary HIV care providers will initiate the intervention and patients will be provided with intensive mini-group and telephone counseling. Training of HIV/AIDS providers to deliver patient-centered smoking intervention will occur and provider adherence to the smoking intervention protocol will be assessed. At the conclusion of the study focus groups with study participants and providers will be conducted to assess their experiences. The current study is needed, as there have been no RCTs that have systematically examined whether the current evidence-based smoking treatments are suited for HIV patients and there are no clinical guidelines that outline smoking treatment strategies for HIV infected patients. Since HIV patients make more frequent visits each year to their physicians than most general patients in the primary care setting, access to smoking treatment services provided in the HIV clinic may be the most direct route for interventions.