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Implementing Tobacco Use Guidelines in Community Health Centers in Vietnam

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01967654
Recruitment Status : Withdrawn
First Posted : October 23, 2013
Last Update Posted : August 4, 2015
Information provided by (Responsible Party):
NYU Langone Health

Brief Summary:
Vietnam has a smoking prevalence that is the second highest among South East Asian countries (SEACs). With a population of approximately 90 million, Vietnam also has the second largest total number of adult smokers (over 16 million) in SEA. According to the World Health Organization (WHO), most reductions in mortality from tobacco use in the near future will be achieved through helping current users quit. Tobacco use treatment, as defined by the U.S. Preventive Health Service Guideline (Guideline) on Treating Tobacco use and Dependence, is evidence-based and highly cost-effective. Yet, in the U.S. and globally, adoption of recommended care is suboptimal. The objective of this proposal is to fill the current research-to-practice gap by conducting a randomized controlled trial that compares the effectiveness and cost effectiveness of two practical and highly replicable strategies for implementing evidence-based guidelines for the treatment of tobacco use in public health clinics in Vietnam. The proposed implementation strategies draw on evidence-based approaches, and the WHO's recently released guidelines for implementing Article 14 of the Framework Convention on Tobacco Control (FCTC). The FCTC is an evidence-based treaty that was developed by the WHO in response to the globalization of the tobacco epidemic. Vietnam ratified the FCTC in 2004; however, they have not taken steps to implement Article 14 which specifies the need to integrate best practices for treating tobacco use and dependence into routine preventive care. The proposed implementation strategies also build on the growing literature that supports the effectiveness of integrating community health workers as members of the health care team to improve access to preventive services.

Condition or disease Intervention/treatment Phase
Tobacco Use Cessation Other: Technical Assistance, training and clinical reminders Other: Referral to Community Health Worker Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Study Start Date : January 2014
Estimated Primary Completion Date : August 2018
Estimated Study Completion Date : August 2018

Arm Intervention/treatment
Experimental: Technical assistance, training, plus clinical reminder system
To assess the contextual factors of the intervention settings (district level policies and organizational level characteristics) that may influence tobacco use treatment in CHCs and to inform additional modifications to the proposed implementation strategies.
Other: Technical Assistance, training and clinical reminders
Experimental: TTC + referral to community health workers
To compare the effectiveness and cost effectiveness of two multi component implementation strategies.
Other: Referral to Community Health Worker

Primary Outcome Measures :
  1. Adherence to tobacco use treatment guidelines [ Time Frame: 4-6 weeks ]
    To assess the primary outcome of provider adherence to tobacco treatment guidelines, the investigators will conduct patient exit interviews (PEI) (surveys conducted immediately after the patient visit) with 50 smokers pre and 50 postimplementation at each site (1300 in each study period).

Secondary Outcome Measures :
  1. Smoking abstinence [ Time Frame: 6 months ]
    Using accepted standards for measuring cessation outcomes, all patients who complete a PEI in the post intervention period will be followed prospectively to assess 3 and 6 month 7-day point prevalence abstinence, defined as any smoking (even a puff) in the past 7 days. Surveys will be conducted in person and smoking abstinence will be validated using carbon monoxide (CO) monitoring with abstinence defined as a CO<10ppm.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient eligibility:
  • Current patients at community health center for routine visit
  • 18 years or older
  • Current or regular smoker (>1 cigarette in past 7 days)
  • Willingness to complete survey
  • Provider eligibility:
  • Provider at community health center
  • 18 years or older
  • Willingness to complete survey or interview

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01967654

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Institute of Social and Medical Studies
Hanoi, Vietnam
Sponsors and Collaborators
NYU Langone Health
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Principal Investigator: Donna Shelley, MD, MPH NYU School of Medicine
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: NYU Langone Health Identifier: NCT01967654    
Other Study ID Numbers: 13-00413
First Posted: October 23, 2013    Key Record Dates
Last Update Posted: August 4, 2015
Last Verified: August 2015