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Using Multiphase Optimization Strategy (MOST) to Optimize a Cost-effective, Sustainable and Scalable Smoking Cessation Package for Smokers in HIV Clinical Care

Award Number: R01CA268932
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary The adverse health impact of cigarette smoking on persons living with HIV is profound and effective treatments for long-term abstinence remain elusive. There is an acute need for interventions that address patient barriers to quitting and clinical barriers to effectively treating a broad heterogeneous population of smokers living with HIV (SLWH). This study’s long-term goal is to improve clinical outcomes among SLWH by providing optimized smoking cessation interventions in HIV clinical care. This proposal will use the Multiphase Optimization STrategy (MOST) to test four intervention components aimed at barriers to quitting among SLWH, with the objective of selecting the set that constitutes a cost-effective, sustainable, scalable smoking cessation package for HIV clinical care. Components include: Motivational Interviewing (Off/On); Peer Mentoring (Off/On); Text-messaging (Off/On); Varenicline or Combination Nicotine Replacement Therapy (Off/On). These components have shown promise in research but are under-utilized to help SLWH quit and have not been tested in an optimization trial. The proposed MOST factorial optimization trial is a highly efficient method for estimating the main effect contribution of each intervention component and all interactions between components. This approach addresses weaknesses in prior studies, which are not able to assess the contribution of individual components of multicomponent interventions. The proposal will also include a rigorous evaluation of the implementation process and theory-driven assessment of barriers to and facilitators of intervention implementation, sustainability and scalability in HIV clinical care. Aims include: (1) Assess the effectiveness of four smoking cessation intervention components on long-term abstinence among SLWH by conducting a highly efficient factorial optimization trial (i.e., MOST) with 500 SLWH in HIV clinical care. (2) Assess costs and the implementation process, including factors that affect the potential for sustainability and scalability of cessation treatment in HIV care settings serving SLWH. Guided by Proctor’s Implementation Outcomes Framework and the Consolidated Framework for Implementation Research, we will collect mixed methods data on reach, fidelity, acceptability and appropriateness among SLWH, stakeholders and study interventionists. (3) Identify the optimized intervention by conducting an innovative multi-criteria decision analysis to select the subset of the four components that achieves the highest level of cost-effectiveness and is both scalable and sustainable in HIV clinical care. Working in collaboration with New York City Health and Hospitals (H+H), the largest municipal public healthcare system in the U.S., and a team with unparalleled expertise in intervention optimization, smoking cessation and HIV/AIDS, the proposed study responds directly to the National Cancer Institute’s (NCI) call for smoking research that “optimizes intervention effectiveness, implementation and sustainability.” The optimized intervention will have a significant public health impact and add to scientific knowledge by providing a clear basis for further improvement of cessation interventions for SLWH in future research.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $155,676 )
2024	2024	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Cancer Cause and Prevention Research	000	3	8/14/2024	NON-COMPETING CONTINUATION	$155,676
														Subtotal = $155,676

Issue Date FY: 2023 ( Subtotal = $650,490 )
2023	2023	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Cancer Cause and Prevention Research	001	2	8/24/2023	NON-COMPETING CONTINUATION	$13,010
2023	2023	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Cancer Cause and Prevention Research	000	2	8/3/2023	NON-COMPETING CONTINUATION	$637,480
														Subtotal = $650,490

Issue Date FY: 2022 ( Subtotal = $668,411 )
2022	2022	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Cancer Cause and Prevention Research	000	1	6/17/2022	NEW	$668,411
														Subtotal = $668,411

Grand Total All Awards = $1,474,577

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Using Multiphase Optimization Strategy (MOST) to Optimize a Cost-effective, Sustainable and Scalable Smoking Cessation Package for Smokers in HIV Clinical Care

Award Number: R01CA268932

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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