PROJECT SUMMARY Nationally, the prevalence of tobacco use is highest among Alaska Native (AN) people and tobacco cessation interventions developed specifically for this disparity group are lacking. Geographic remoteness, climate, and travel costs are key barriers to treatment delivery. Social media has promise as a scalable intervention strategy to promote smoking treatment utilization and cessation for AN smokers. Building on our team's longstanding tobacco control research partnership with the AN community, we propose to develop and pilot-test a culturally relevant, Facebook-delivered intervention to promote smoking treatment uptake and cessation among AN smokers. The Facebook content will include a digital storytelling approach adapted from the effective CDC Tips? from Former Smokers campaign. The Facebook intervention will promote the use of evidence-based treatment, e.g., state quitline and tribal cessation programs. This R34 application is submitted in response to PA-16-073, fulfilling the objectives for Stage I of the NIDA behavioral integrative treatment development program. In Stage Ia, we will develop the Facebook intervention. This formative research will use the cultural variance and surface/deep structure frameworks to address the influence of culture in designing health messages, and adopt qualitative and quantitative pretesting methods to develop and beta-test the intervention prototype. In Stage Ib, we will conduct a randomized pilot trial enrolling 60 adult AN smokers to evaluate the feasibility, uptake, consumer response, and potential efficacy of the Facebook intervention, compared to a control condition (quitline/treatment referral). The primary outcomes will be feasibility (e.g., Facebook engagement) and the biochemically-verified smoking abstinence rate at 1, 3, and 6 months follow-up. Secondary outcomes will include self-reported smoking cessation treatment utilization and abstinence from all tobacco/nicotine products. We will also explore interdependence (relationship orientation and collaborative efforts in lifestyle change) as a culturally relevant mediator of intervention efficacy. A community advisory committee will guide all project activities. The project is innovative for developing a new behavioral intervention to reach AN people statewide to promote smoking treatment utilization and cessation using social media communication tools that are culturally relevant and have already been adopted. The study is significant because it will advance research on population-specific treatments for an underserved, AN, tobacco-use disparity group. If the pilot intervention is successful, we will have a blueprint to conduct a large, randomized, controlled, efficacy trial.
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