A randomized controlled trial of a faith-placed, lay health advisor delivered smoking cessation intervention for rural residents

Nancy E. Schoenberg, Christina R. Studts, Brent J. Shelton, Meng Liu, Richard Clayton, Jordan Baeker Bispo, Nell Fields, Mark Dignan, Thomas Cooper

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Introduction: Rural US residents smoke at higher rates than urban or suburban residents. We report results from a community-based smoking cessation intervention in Appalachian Kentucky. Study design: Single-blind, group-randomized trial with outcome measurements at baseline, 17 weeks and 43 weeks. Setting/participants: This faith-placed CBPR project was located in six counties of rural Appalachian Kentucky. A total of 590 individual participants clustered in 28 churches were enrolled in the study. Intervention: Local lay health advisors delivered the 12-week Cooper/Clayton Method to Stop Smoking program, leveraging sociocultural factors to improve the cultural salience of the program for Appalachian smokers. Participants met with an interventionist for one 90 min group session once per week incorporating didactic information, group discussion, and nicotine replacement therapy. Main outcome measures: The primary outcome was self-reported smoking status. Secondary outcomes included Fagerström nicotine dependence, self-efficacy, and decisional balance. Results: With post-intervention data from 92% of participants, those in intervention group churches (N = 383) had 13.6 times higher odds of reporting quitting smoking one month post-intervention than participants in attention control group churches (N = 154, p < 0.0001). In addition, although only 3.2% of attention control group participants reported quitting during the control period, 15.4% of attention control participants reported quitting smoking after receiving the intervention. A significant dose effect of the 12-session Cooper/Clayton Method was detected: for each additional session completed, the odds of quitting smoking increased by 26%. Conclusions: The Cooper/Clayton Method, delivered in rural Appalachian churches by lay health advisors, has strong potential to reduce smoking rates and improve individuals' health.

Original languageEnglish
Pages (from-to)317-323
Number of pages7
JournalPreventive Medicine Reports
Volume3
DOIs
StatePublished - Jun 1 2016

Bibliographical note

Funding Information:
Support for this research was provided by the NIH /National Center on Minority Health and Health Disparities/National Cancer Institute through grant # 1R24MDOOZ75741 (PI: Schoenberg). We are grateful for the strong community support provided to this project, particularly from church partners, lay health advisors, and participants. This study is registered at Clinicaltrials.gov # NCT01373320 and additional protocol information may be accessed at https://www.clinicaltrials.gov/ct2/show/NCT01373320?term=smoking+cessation&state1=NA%3AUS%3AKY&rank=19 .

Publisher Copyright:
© 2016 The Authors.

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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