Culturally-tailored text-messaging intervention for smoking cessation in rural American Indian communities: Rationale, design, and methods.
Michael F Orr, Ekaterina Burduli, Katherine A Hirchak, Jo Ann Walsh Dotson, Sara L Young, Lonnie Nelson, Emma Lennstrom, Trevor Slaney, Terry Bush, Stephen R Gillaspy, John M Roll, Dedra Buchwald, Sterling M McPherson
Author Information
Michael F Orr: Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210-1495, USA.
Ekaterina Burduli: Program of Excellence in Addictions Research (PEAR), Washington State University, Spokane, WA, 99210-1495, USA.
Katherine A Hirchak: Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210-1495, USA.
Jo Ann Walsh Dotson: Program of Excellence in Addictions Research (PEAR), Washington State University, Spokane, WA, 99210-1495, USA.
Sara L Young: Montana State University, Bozeman, MT, 59717-2220, USA.
Lonnie Nelson: Initiative for Research and Education to Advance Community Health, Washington State University (IREACH), Spokane, WA, 99210-1495, USA.
Emma Lennstrom: Initiative for Research and Education to Advance Community Health, Washington State University (IREACH), Spokane, WA, 99210-1495, USA.
Trevor Slaney: Initiative for Research and Education to Advance Community Health, Washington State University (IREACH), Spokane, WA, 99210-1495, USA.
Terry Bush: Optum 11000 Optum Circle, Eden Prairie, MN, 55344, USA.
Stephen R Gillaspy: University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
John M Roll: Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210-1495, USA.
Dedra Buchwald: Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210-1495, USA.
Sterling M McPherson: Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210-1495, USA.
BACKGROUND: American Indian (AI) and Alaska Native (AN) communities experience disproportionately high rates of tobacco use when compared to the overall U.S. population, especially among rural populations. METHODS: We implemented a single-blind, randomized clinical trial of a text messaging-based smoking cessation intervention through the tobacco quitlines of five states (Alaska, Minnesota, New Mexico, Oklahoma, and Wisconsin) with high percentages of AI residents. We partnered with state quitlines and Optum, a multi-state entity that manages quitlines. Participants who called the quitlines and identified as AI/AN were given the option to enroll in this trial. Upon consent, they were randomly assigned to either the standard quitline program (control) or a program culturally tailored for AI/ANs (intervention), which used a text messaging intervention to encourage smoking cessation. We adapted the text messages based on key informant and focus group input. Baseline data was analyzed for differences across age, sex, and the Fagerstr��m Test for Nicotine Dependence. RESULTS: We recruited n���=���487 AIs into the trial. Participants had an average age of 41.9 years (SD���=���11.7) and 66% were female. The average Fagerstr��m Test for Nicotine Dependence score was 5.38 (SD���=���2.37). The intervention and control arms did not significantly differ across any of the baseline characteristics. CONCLUSION: Implementation of this trial illustrated important lessons in adapting, implementing, and evaluating trials in collaboration with AI communities and local and national organizations. This work will inform future efforts to implement culturally-tailored interventions with AI/ANs and advance our knowledge about adapting and implementing smoking cessation interventions.
