多语种电话热线对亚洲吸烟者戒烟的影响:随机对照试验
2012/02/29
背景:虽然电话咨询服务(戒烟热线)已经成为美国很流行的戒烟行为干预措施,此项服务在英语不熟练的亚洲移民中很少进行。本试验中,我们研究戒烟电话咨询对说中文、韩语、越南语的吸烟者戒烟的影响。
方法:基于文化特征,用英语制定咨询方案,然后将其翻译成中文、韩语和越南语。以加利佛尼亚戒烟热线服务中心为基础,进行一项随机试验。入选2004年8月2日~2008年4月4日期间采用中文、韩语和越南语进行戒烟咨询的吸烟者。基于语种,对入选的2277名吸烟者进行分层,同时又随机分为咨询组(采用自助和最多6次的戒烟咨询;n=1124)和自助组(仅采用自助方式;n=1153)。共有729名华人(咨询组359名;自助组370名)、848名韩国人(咨询组422名;自助组426名)和700名越南人(咨询组343人,自助组357人)。主要转归为6个月时持续戒断。采用意向治疗分析估计所有受试者和和各语种受试者持续戒断率。统计分析采用双尾。
结果:意向治疗分析显示,与自助组相比,咨询能增加所有吸烟者6个月时的持续戒断率(分别为16.4% vs 8.0%,差异为8.4%,95%CI为5.7%~11.1%, P <0.001)。在各语种组,与自助组相比,咨询能增加6个月时持续戒断率(华人分别为14.8% vs 6.0%,差异为8.8%,95%CI为4.4%~13.2%, P <0.001;韩国人分别为14.9% vs 5.2%,差异为9.7%,95% CI为5.8%~13.8%, P <0.001;越南人分别为19.8% vs 13.5%,差异为6.3%,95% CI为0.9%~11.9%,P =0.023)。
结论:电话咨询能有效促进说韩语、韩语和越南语的吸烟者戒烟。该措施应该整合进入当前的戒烟热线,增设亚洲语种戒烟热线。
(陈欣 审校)
J Natl Cancer Inst. 2012 Jan 25. [Epub ahead of print]
The Effects of a Multilingual Telephone Quitline for Asian Smokers: A Randomized Controlled Trial.
Zhu SH, Cummins SE, Wong S, Gamst AC, Tedeschi GJ, Reyes-Nocon J.
Source
Affiliation of authors: Cancer Center, University of California, San Diego, CA (S-HZ, SEC, SW, ACG, GJT, JR-N).
Abstract
BACKGROUND:Although telephone counseling services (quitlines) have become a popular behavioral intervention for smoking cessation in the United States, such services are scarce for Asian immigrants with limited English proficiency. In this study, we tested the effects of telephone counseling for smoking cessation in Chinese-, Korean-, and Vietnamese-speaking smokers.
METHODS:A culturally tailored counseling protocol was developed in English and translated into Chinese, Korean, and Vietnamese. We conducted a single randomized trial embedded in the California quitline service. Smokers who called the quitline’s Chinese, Korean, and Vietnamese telephone lines between August 2, 2004, and April 4, 2008, were recruited to the trial. Subjects (N = 2277) were stratified by language and randomly assigned to telephone counseling (self-help materials and up to six counseling sessions; n = 1124 subjects) or self-help (self-help materials only; n = 1153 subjects) groups: 729 Chinese subjects (counseling = 359, self-help = 370), 848 Korean subjects (counseling = 422, self-help = 426), and 700 Vietnamese subjects (counseling = 343, self-help = 357). The primary outcome was 6-month prolonged abstinence. Intention-to-treat analysis was used to estimate prolonged abstinence rates for all subjects and for each language group. All statistical tests were two-sided.
RESULTS:In the intention-to-treat analysis, counseling increased the 6-month prolonged abstinence rate among all smokers compared with self-help (counseling vs self-help, 16.4% vs 8.0%, difference = 8.4%, 95% confidence interval [CI] = 5.7% to 11.1%, P < .001). Counseling also increased the 6-month prolonged abstinence rate for each language group compared with self-help (counseling vs self-help, Chinese, 14.8% vs 6.0%, difference = 8.8%, 95% CI = 4.4% to 13.2%, P < .001; Korean, 14.9% vs 5.2%, difference = 9.7%, 95% CI = 5.8% to 13.8%, P < .001; Vietnamese, 19.8% vs 13.5%, difference = 6.3%, 95% CI = 0.9% to 11.9%, P = .023).
CONCLUSIONS: Telephone counseling was effective for Chinese-, Korean-, and Vietnamese-speaking smokers. This protocol should be incorporated into existing quitlines, with possible extension to other Asian languages.
J Natl Cancer Inst. 2012 Jan 25. [Epub ahead of print]
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