Search

Introduction: Smoking prevalence is high in Vietnam, yet tobacco dependence treatment (TDT) is not widely available.Methods: We conducted a quasiexperimental study that compared the effectiveness of health care provider advice and assistance (ARM 1) versus ARM 1 plus village health worker (VHW) counseling (ARM 2) on abstinence at 6-month follow-up. This study was embedded in a larger two-arm cluster randomized controlled trial conducted in 26 community health centers (CHCs) in Vietnam. Subjects (N = 1318) were adult patients who visited any participating CHC during the parent randomized controlled trial intervention period and were self-identified as current tobacco users (cigarettes and/or water pipe).Results: At 6-month follow-up, abstinences rates in ARM 2 were significantly higher than those in ARM 1 (25.7% vs. 10.5%; p < .001). In multivariate analyses, smokers in ARM 2 were almost three times more likely to quit compared with those in ARM 1 (adjusted odds ratio [AOR] = 2.96, 95% confidence interval [CI] = 1.78% to 4.92%). Compared to cigarette-only smokers, water pipe-only smokers (AOR = 0.4, 95% CI = 0.26% to 0.62%) and dual users (AOR = 0.62, 95% CI = 0.45% to 0.86%) were less likely to achieve abstinence; however, the addition of VHW counseling (ARM 2) was associated with higher quit rates compared with ARM 1 alone for all smoker types.Conclusion: A team approach in TDT programs that offer a referral system for health care providers to refer smokers to VHW-led cessation counseling is a promising and potentially scalable model for increasing access to evidence-based TDT and increasing quit rates in low middle-income countries (LMICs). TDT programs may need to adapt interventions to improve outcomes for water pipe users.Implications: The study fills literature gaps on effective models for TDT in LMICs. The addition of VHW-led cessation counseling, available through a referral from primary care providers in CHCs in Vietnam, to health care provider's brief cessation advice, increased 6-month biochemically validated abstinence rates compared to provider advice alone. The study also demonstrated the potential effectiveness of VHW counseling on reducing water pipe use. For LMICs, TDT programs in primary care settings with a referral system to VHW-led cessation counseling might be a promising and potentially scalable model for increasing access to evidence-based treatment. [ABSTRACT FROM AUTHOR]

Evaluates the effectiveness of communication and condom skills training for increasing condom-protected sex in a sample of high-risk women ages 17 to 61. Intervention methods and program content; Peer communication; Condom protected and unprotected sex outcomes; Quality of randomization and respondent characteristics.

Few studies have addressed recruitment and retention of participants in preventive interventions directed at human immunodeficiency virus (HIV), and these generally have not focused on women. In this study, part of the Women in Group Support (WINGS) project, we examine the experience of three sites in recruiting 444 high-risk women for a small group intervention to reduce risky sexual behavior. The intervention included six structured sessions, followed by a continuing series of client-focused, drop-in sessions. Incentives for participants included child care, food, and transportation tokens Attendees at each structured session also received a cash incentive of $10-$20. Forty-six percent of the women were recruited from community sources, 35% from clinics, and 19% from drug programs. Across all recruitment sources, almost a third of the women reported having had a sexually transmitted disease (STD) in the past year, 88%-94% reported a risky male partner (who, they believed, had sex with other partners or with sex workers, was an injecting drug user, or was inv positive), and 10%-36% reported trading sex for money or drugs. During 18 months of recruitment, each site averaged 34 screening interviews monthly to secure 8 eligible women a month who completed base- line interviews and reported for randomization. The average number of paid sessions attended by participants was five of six (83%). Average attendance at unpaid sessions was I of 12(8%). Key facilitators to recruitment and retention included linkages with community agencies and monetary incentives. Our findings suggest that researchers and community service providers need to explore alternative strategies to paying women for attending group sessions (e.g., in- corp orating group interventions into existing program requirements) and balance these against the costs and recruitment effectiveness. [ABSTRACT FROM AUTHOR]