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Grant Details

Grant Number: 5R01CA137375-05 Interpret this number
Primary Investigator: Muramoto, Myra
Organization: University Of Arizona
Project Title: Tobacco Cessation Training for Accupuncture, Massage, and Chiropractic Practition
Fiscal Year: 2013


DESCRIPTION (provided by applicant): Tobacco use remains the leading cause of morbidity and mortality in the United States. Effective tobacco cessation treatments are more widely available than ever before, yet remain underutilized. Tobacco cessation brief interventions (BIs) are low-cost and effective for increasing quit attempts and quit rates. However, BI training has focused primarily on conventional medical providers, largely overlooking other community-based health care and wellness practitioners who see tobacco users in their client and patient populations. Data from the 2004 National Health Interview Survey indicate that 36% of U.S. adults use some form of complementary and alternative medicine (CAM), and among those individuals, approximately 20% are tobacco users. Thus, CAM practitioners represent a large, untapped community resource for promoting tobacco cessation. Existing cessation intervention training is not suitable for the background and practice patterns of CAM practitioners, as it assumes a background in conventional biomedicine. Thus there is a pressing need to develop and test the effectiveness of cessation training that is grounded in guideline-based treatment and that is relevant and appropriate for CAM practitioners. The current proposal addresses this gap and builds on our prior research in community-based tobacco BI training and research with CAM practitioners. Primary aims are to: 1) conduct a multi-method study with three types of CAM practitioners (chiropractors, massage therapists, and acupuncture/Traditional Chinese Medicine practitioners) to document their knowledge, attitudes and experiences regarding tobacco dependence and cessation, and to elicit a range of practice patterns and scenarios in which to provide tobacco cessation interventions; 2) tailor a tobacco cessation BI training for CAM practitioners that is part of an office system intervention (called CAM Reach); 3) conduct a cluster-randomized lagged intervention Phase 2 study of CAM Reach in 60 CAM practices that will: a) test the feasibility and acceptability of implementing the CAM Reach intervention; and b) evaluate its effect on the primary outcomes of CAM practitioners' conduct of tobacco use screening and brief interventions and secondary outcomes of patients' readiness to quit, quit attempts, use of guideline-based tobacco cessation treatments and quit rates. A secondary aim is to explore CAM Reach's effect on patients who are do not use tobacco but want to help someone else quit, with respect to knowledge cessation aids and actions to help the user quit. Results of the Phase 2 trial will provide the necessary parameters, e.g. effect size and intraclass correlation, to design a Phase 3 multi-site trial. To this end, we also propose a qualitative study of a sample of trained CAM providers and their patients to examine factors associated with CAM providers' implementation and maintenance of cessation intervention behaviors, and changes in patients' tobacco use. We hypothesize that: 1) Trained CAM practitioners will have significantly higher rates of screening and delivery of tobacco cessation BIs compared to untrained CAM practitioners; and 2) Patients of trained CAM practitioners will have significantly higher rates of quit attempts and use of evidence-based tobacco cessation aids, than patients of untrained CAM practitioners.


Implementation of tobacco cessation brief intervention in complementary and alternative medicine practice: qualitative evaluation.
Authors: Eaves E.R. , Howerter A. , Nichter M. , Floden L. , Gordon J.S. , Ritenbaugh C. , Muramoto M.L. .
Source: BMC complementary and alternative medicine, 2017-06-23; 17(1), p. 331.
EPub date: 2017-06-23.
PMID: 28645292
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Printed Educational Materials' Impact on Tobacco Cessation Brief Interventions in CAM Practice: Patient and Practitioner Experiences.
Authors: Eaves E.R. , Nichter M. , Howerter A. , Floden L. , Ritenbaugh C. , Gordon J.S. , Muramoto M.L. .
Source: Health promotion practice, 2016 Nov; 17(6), p. 862-870.
EPub date: 2016-09-02.
PMID: 27591225
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Tobacco Cessation Training for Complementary and Alternative Medicine Practitioners: Results of a Practice-Based Trial.
Authors: Muramoto M.L. , Gordon J.S. , Bell M.L. , Nichter M. , Floden L. , Howerter A. , Ritenbaugh C.K. .
Source: American journal of preventive medicine, 2016 Aug; 51(2), p. e35-e44.
EPub date: 2016-04-06.
PMID: 27061892
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Integrative tobacco cessation: A survey assessing past quit strategies and future interest.
Authors: Howerter A. , Floden L. , Matthews E. , Muramoto M.L. .
Source: Advances in integrative medicine, 2016 Apr; 3(1), p. 22-25.
EPub date: 2015-12-12.
PMID: 27747150
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Is There a Role for Complementary and Alternative Medicine in Preventive and Promotive Health? An Anthropological Assessment in the Context of U.S. Health Reform.
Authors: Thompson J.J. , Nichter M. .
Source: Medical anthropology quarterly, 2016 Mar; 30(1), p. 80-99.
EPub date: 2015-03-25.
PMID: 25316618
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Considerations for practice-based research: a cross-sectional survey of chiropractic, acupuncture and massage practices.
Authors: Floden L. , Howerter A. , Matthews E. , Nichter M. , Cunningham J.K. , Ritenbaugh C. , Gordon J.S. , Muramoto M.L. .
Source: BMC complementary and alternative medicine, 2015-05-02; 15, p. 140.
EPub date: 2015-05-02.
PMID: 25933801
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Intervention development for integration of conventional tobacco cessation interventions into routine CAM practice.
Authors: Muramoto M.L. , Matthews E. , Ritenbaugh C.K. , Nichter M.A. .
Source: BMC complementary and alternative medicine, 2015-03-29; 15, p. 96.
EPub date: 2015-03-29.
PMID: 25887742
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Tobacco brief intervention training for chiropractic, acupuncture, and massage practitioners: protocol for the CAM reach study.
Authors: Muramoto M.L. , Howerter A. , Matthews E. , Floden L. , Gordon J. , Nichter M. , Cunningham J. , Ritenbaugh C. .
Source: BMC complementary and alternative medicine, 2014-12-18; 14, p. 510.
EPub date: 2014-12-18.
PMID: 25524595
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Use of provider-based complementary and alternative medicine by adult smokers in the United States: Comparison from the 2002 and 2007 NHIS survey.
Authors: Hamm E. , Muramoto M.L. , Howerter A. , Floden L. , Govindarajan L. .
Source: American journal of health promotion : AJHP, 2014 Nov-Dec; 29(2), p. 127-31.
EPub date: 2014-01-16.
PMID: 24359177
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