Implementing a culturally appropriate digital health intervention to reduce tobacco-related cancer disparities among Hispanic/Latinx Communities

ABSTRACT Smoking is responsible for 30% of all cancer deaths and 80% of lung cancer deaths in the United States. Hispanic/Latinx (“H/L”) communities experience profound tobacco-related inequities. Among U.S adults who smoke, H/L are less likely to receive advice to quit by health professionals and to use smoking cessation counseling and/or medication, compared to other racial/ethnic groups, despite their high interest in quitting. Moreover, high stress (related to acculturation, immigration, discrimination, and other factors) is a critical barrier to smoking cessation among H/L. There is an urgent need to increase access to and use of culturally appropriate smoking cessation interventions that address barriers to cessation for H/L communities. Digital health interventions are a cost-effective way to increase access to smoking cessation treatment among H/L. Mindfulness-based interventions also show promise for promoting psychosocial functioning and smoking cessation in diverse populations including H/L. However, cultural adaptations, as well as strategies for their successful implementation in healthcare and community settings, are needed to increase intervention impact and reach. This project will culturally and linguistically adapt an evidence-based digital health smoking cessation intervention, iQuit Mindfully, for H/L. Using implementation mapping, we will engage in a systematic process for gathering in-depth, iterative community feedback to adapt and optimize the intervention, and to guide implementation practices and maintenance of this intervention in real world settings. Specific aims are to: 1) Linguistically and culturally adapt iQuit Mindfully for H/L adults; 2) Refine and evaluate the feasibility, acceptability, and implementation processes of the adapted intervention through iterative testing; and 3) Finalize and test implementation protocols for deploying the intervention in healthcare and community settings. Aim 1 will leverage formative work with community partners and key stakeholders. Aim 2 will involve three usability/pilot trials to refine the intervention and implementation processes based on user-centered design and ongoing community feedback. In Aim 3, we will partner with three other Cancer Prevention and Control Research Network (CPCRN) collaborating centers to refine, test, and finalize the implementation protocol. A culturally adapted text messaging intervention could be a scalable, cost-effective way to implement smoking cessation treatment to reduce cancer health inequities in H/L. The GSU CPCRN Collaborating Center will engage in large-scale network efforts to increase the impact of this project and others on cancer health equity.