Behaviors and Mental Disorders

All Conditions

Behavior, Addictive

Compulsive Behavior

Impulsive Behavior

The program consists of five 50-minutes sessions conducted in person as scheduled during weekly class meetings. Educators will conduct workshops with PowerPoint presentations and worksheets dedicated to in-class activities.

educational intervention

Łukasz Moskal, MD

Konrad Reszka, MD

Urszula Staszek-Szewczyk, MD, PhD

Jagoda Łaba, MD

Krzysztof Szewczyk, MD, PhD

Smoking Prevention Program is a pilot exploratory study with a standardized curriculum based on the Tobacco Prevention Toolkit from Stanford University and translated into Polish by the members of Students Scientific Association of Oncology at Wroclaw Medical University. The program will assess the effectiveness of a school-based smoking prevention curricula keeping children as never smokers and test the feasibility of engaging medical students and teachers in implementing and evaluating a validated program on smoking prevention within the Polish School System. The research protocols, methods and data collection instruments of a standardized classroom based valid tobacco prevention program from Stanford University will be used for the study. The smoking prevention program is centred on drug resistance, personal self-management and increasing social skills. The program increases knowledge and uses coaching and practice to provide students with the skills to resist social pressures around cigarette use. The secondary outcome of this study is to determine the change in attitudes by Polish Medical Student regarding Cancer Prevention Research. During Smoking Prevention Program workshops, the 5-Session Curriculum for primary schools will be translated, applied and evaluated for polish students.

This community-based pilot will engage medical students, the local school district and the local health authority. The Educational program meets the requirements set by Centers for Disease Control and Prevention (CDC) in Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. Following parental consent, the program will be implemented with all 7th and 8th grade students (children age 12-15 years) from the Elementary School in Tyniec Mały. This project is supported by the Head of Lower Silesian Oncology Center, the Head of Department of Oncology of Wroclaw Medical University, the Health and Social Affairs Department of City of Wroclaw and under the patronage of the Lower Silesia Governor's Office, the Polish Society of Oncology, the Polish Society of Public Health, the Lower Silesian Department of Polish Society of Cardiology and the European Association for Cancer Education (EACE).

Smoking Prevention Program is funded by the READS Grant Program from the American Association for Cancer Education (AACE).

Smoking Prevention Program in Poland

Youth Smoking Prevention Program in Poland

Change in smoking intention among elementary school students after program completion (score based on survey results).

Change in knowledge about adverse effects of smoking after program completion (score based on survey results).

Stanford Reach Lab - Tobacco Prevention Toolkit

American Association for Cancer Education

Wroclaw Medical University

Principal Investigator

Students in the control group will receive the standard health education curriculum.

Students in the treatment group will receive the school-based classroom curriculum.

Participants will be randomized, at the school level, to receive either the e-cigarette/tobacco/areca nut use prevention curriculum or the standard of care (i.e., control). The curriculum will be implemented using 5 intensive in-class lessons over the span of 6 weeks. All sessions of the curriculum follow the same basic format: a) an introduction and/or review of the past lesson, b) a cultural wall activity, c) a video, d) 1-2 interactive activities, and e) a wrap-up activity. Lessons are designed such as to help improve knowledge about drugs and correct cognitive misperceptions and to train on skills to resist normative social influence. Participants will complete identical survey questionnaires for assessments at 3 time-points: pretest (baseline, before implementing the intervention), immediate posttest (following the end of the intervention), and six-month follow-up. The surveys will be administered in the classroom, during regular school hours.

School-based curriculum

Francis Dalisay, PhD

Pallav Pohkrel, PhD

The people of the U.S. Affiliated Pacific Islands (USAPI) face higher cancer incidence, especially lung/bronchia and head-and-neck cancer, and poorer cancer outcomes, compared with the U.S. nationally. This may partly be driven by the high rates of cigarette smoking and betel (areca) nut use in the USAPI. Previous data suggest that that adolescents on Guam, as young as middle school students report markedly higher e-cigarette and tobacco product use prevalence in the USAPI compared with the USAPI nationally. Guam youths are also at risk for the use of betel nuts. Yet, currently there are no tobacco product/areca nut use prevention programs that have been developed for and tested specifically USAPI adolescents. The proposed study will develop a school-based substance use prevention curriculum for e-cigarette, tobacco product, and areca nut use prevention among Guam youths. The curriculum will use lessons incorporating innovative videos and culturally grounded activities.

The study's specific aims are:

1. To develop a school-based curriculum for e-cigarette, tobacco product (i.e., cigarette, smokeless tobacco), and betel nut use prevention among middle school students in Guam.
2. Test the efficacy of the school-based curriculum in a randomized controlled trial.

BACKGROUND AND SIGNIFICANCE

The study focuses on e-cigarette, tobacco and areca nut prevention among adolescents in Guam. By developing and testing a school-based e-cigarette, tobacco and areca nut prevention program, the project will target psychosocial, lifestyle, and environmental/physical factors contributing to cancer disparities in the US Affiliated Pacific Islands (USAPI). Thus far, nationally, there has been limited effort in terms of developing a theoretical framework that would attempt to explain tobacco and areca nut use etiology among USAPI youth. Previous research indicates that social and environmental influences play key roles in shaping tobacco and areca nut use among USAPI youths. In addition, skills needed to resist social influence appear to be protective against tobacco and areca nut use. Particularly, past research has found peer influence and environmental risk factors such as parental permissiveness, ease of access to tobacco/areca nut at home and school and through adults and friends, to be strongly associated with current tobacco/areca nut use. On the other hand, competence in navigating through social situations conducive to tobacco/areca nut use and refusal self-efficacy (i.e., confidence in being able to say "no" at the face of peer pressure) have been found to be strongly associated with lower likelihood of current tobacco/areca nut use.

The curriculum to be developed and tested will focus on informing adolescents on the risks of tobacco product/areca nut use as well as training adolescents on social influence resistance skills in a culturally appropriate way, using innovative use of video vignettes. The intervention will seek to influence behavior (i.e., prevention and reduction of tobacco product/areca nut use) by countering the cognitive predispositions to tobacco product/areca nut use (e.g., by increasing risk perceptions, reducing positive expectancies) and by providing youths with skills to resist specific social influence to use tobacco products/areca nut on specific occasions.

RESEARCH DESIGN

This is an experimental study. Of the eight public middle schools in Guam, four schools will be randomly assigned to the "Treatment" and four to the "Control" condition. Students in the Treatment schools will receive the classroom-based curriculum whereas students in the Control schools will receive the standard health education curriculum (treatment-as-usual). Participants will be assessed at pre-test, immediate post-test, and six months after the post-test. Note that the decision to provide an intervention, albeit weaker, to the control group was guided by the ethics of good community practice. In preliminary discussions with schools, principals unanimously expected an intervention.

Participants

Participants will be 600 Guam middle school students. Based on a pilot study, the mean age of the participants is likely to be 12.7 years (SD = .89); 49% of the participants are likely to be girls; and 47% of the participants are likely to be Chamorus, 27% other Pacific Islanders, and 25% non-Pacific Islanders (i.e., Filipinos, Chinese, Japanese, white, and others). Treatment and Control conditions will represent roughly equal proportion of participants.

Recruitment

All eight public middle schools will be involved in the study. The Guam Department of Education (GDOE) has been very supportive of this study. At each school, seven classes will be randomly selected to participate in the study.

Intervention delivery

The classroom curriculum will begin in the Treatment schools within two weeks of the pre-test. The social media campaign will begin in all schools around the same time. Below we provide details on the delivery of each intervention component.

Classroom-based curriculum: Curriculum implementation. The curriculum will be delivered by teachers of the Treatment schools who normally teach physical health education classes. The curriculum will be implemented once a week for 45-60 minutes over a 10-week academic quarter in a required physical/health education course. All sessions of the curriculum will follow the same basic format of Ho'ouna Pono. Each lesson will be aligned with the Guam Content and Performance Standards for Health (6-8 grade) and/or the National Common Core Standards in public education. The teachers will be trained to implement the curriculum through a hybrid (i.e., in-person and virtual), credit-granting course sanctioned through the GDOE.

Data collection

Data will be collected at three timepoints from students in both Treatment and Control conditions: pre-test (baseline), immediate post-test (i.e., approximately a week after the last classroom-based curriculum session is delivered), and six months after the post-test. Data will be collected using self-report questionnaires, although self-report of cigarette use and areca nut use will also be validated using biochemical verification methods in random subsample of participants. At each timepoint the same questionnaire will be administered across Treatment and Control groups. The self-report questionnaire will include the following assessment measures.

Measures

Demographic measures. Age, gender, socio-economic status, and ethnicity will be assessed. Socio-economic status (SES) is measured based on participants' report on their parents' level of education. However, past research shows that a good proportion of adolescents do not know about parental education level. Hence, a measure of household crowdedness (i.e., the number of usual residents in a household divided by the number of rooms in the house) will also be included to assess SES. Ethnicity will be assessed with a single item previously used by us in Guam. A measure of acculturation will also be included.

Intrapersonal/Dispositional variables. These will include self-control, assessed in terms of behavioral and emotional self-control; sensation seeking; social competence in resisting social influence; general self-efficacy; refusal self-efficacy; and self-esteem. The items specific to substance use will be adapted for cigarette smoking, e-cigarette use, chewing tobacco use, and areca nut use.

Social/Interpersonal variables. These will include family and friend areca nut/tobacco product use, perceived norms, and social normative beliefs. Perceived norms and social normative beliefs will be adapted for cigarette smoking, e-cigarette use, chewing tobacco use, and areca nut use.

Cultural/Environmental variables. These will include availability of areca nut/tobacco at home and school, parental permissiveness, knowledge about areca nut/tobacco products, areca nut/tobacco product use expectancies, and areca nut/tobacco product use harm/risk perceptions.

Exposure to content relevant to tobacco products and areca nut on social media. Exposure will be assessed using 12 items previously validated by us for tobacco products and areca nut. The items assess exposure to user-generated content, traditional marketing, and prevention messages.

Areca nut and tobacco product use susceptibility. Areca nut use and tobacco product use susceptibility will be separately assessed for cigarette smoking, e-cigarette use, chewing tobacco use, and areca nut use with a measure of adolescent substance use intentions (13), adapted for each substance.

Areca nut and tobacco product use. The study will assess areca nut only use, combined areca nut and tobacco use, cigarette smoking, e-cigarette use, and chewing tobacco use separately. For each of these substance use outcomes, the study will assess lifetime (ever) use (e.g., "Have you ever used a areca nut in your lifetime?") and past-30-day use (e.g., "In the past 30 days, on how many days did you use areca nut?). Self-report measures of adolescent substance use have been extensively studied for their validity, by using multiple methods, and they have consistently been found to be valid.

Data Analysis

Data analysis will be performed with the help of the PIPCHE Biostatistics Core. The primary goal of the analysis is to examine the efficacy of this group randomized trial (16) for substance use prevention among middle schoolers. Aim 1 will compare the change in tobacco and areca nut beliefs, attitudes, initiation and use over time between the two randomization conditions, accounting for the clustering of classes within schools and the randomization unit of schools. In particular, the following mixed regression will be performed: where Z is a vector of covariates for each student at each time point, T is time, G is randomization group, TxG is the interaction of time and group, and η is a random effect for clustering of classes within schools and δ is a random effect for repeated measures within student. The link function ƒ is linear for continuous outcomes, such as a belief score, and logistic for dichotomous outcomes, such as initiation; outcomes will be transformed as needed to meet model assumptions. Potential covariates would include age, sex of student, grade, ethnicity, parent's education level, sensation seeking and teacher sex. Time T will be parameterized as indicator variables for baseline, post-intervention, and six month follow-up, or as continuous months if warranted by a monotonic change over time. The intervention effect will be assessed by the F-test in linear models and chi-square test in logistic models for the βTG parameter, with the degrees of freedom adjusted to account for the eight randomization units. Covariate-adjusted means and 95% confidence intervals will be estimated from the models for each level of randomization group and time point. The SAS procedure GLIMMIX will be used to fit these mixed models, which can accommodate data from students with missing data at some time points and allow for the results to be more generalizable to the student population. However, the study will assess the effect of missing data by comparing characteristics of students with complete and incomplete data and will perform multiple imputation if needed. As exploratory analyses, the study will test for differential intervention effects in subgroups, such as defined by student ethnicity, by adding interaction terms between subgroup and treatment/time variables and assessing the significance of the three way interaction. The study will also explore the effect of dose of the intervention, by studying change in outcomes by number of session attended among students in the intervention schools, and the effect of fidelity assessments of the intervention per classroom.

Statistical Power

The sample size of eight schools, with four randomized to each condition, each with seven classes of 20 students, is sufficient to ensure adequate statistical power to detect meaningful differences between intervention arms in all outcomes. For Aim 1, the effect size, Cohen's d was calculated based on a z-test comparing means and a chi-square test comparing proportions, with n=8 schools, with four schools per randomization condition, each with 20 students. The variance of the differences was adjusted for the Design Effect of the present study, accounting for the clustering in a group-randomized trial (GRT) by adjusting the test degrees of freedom to the number of communities. The intraclass correlation coefficient (ICC) of outcomes within schools and within class in schools was set to 0.01-0.02, based on past school-based studies, for an overall ICC varying between 0.02 to 0.04. The study assumed a critical level α of 0.05 (two-sided) or 0.005 (Bonferroni-corrected for 10 tests), a power of 80%, and up to a 20% attrition in sample size at post-intervention. The effect size for a test of means is medium at 0.29-0.38 for α=0.05 and at 0.37-0.50 for α=0.005. The following differences between conditions in changes in proportions will be detectable with α=0.05: 0% versus 4.0% and 3% versus 10.5%; and with α=0.005: 0% versus 6.5% and 3% versus 15.5%.

Testing a School-Based E-cigarette, Tobacco, and Betel (Areca) Nut Use Prevention Curriculum for Guam Youths

University of Guam/University of Hawaii Cancer Center Partnership for Cancer Health Equity, Full Project I: Developing and Testing a School-Based Curriculum for E-cigarette, Tobacco, and Betel (Areca) Nut Use Prevention for Guam Youths

Tobacco, e-cigarette, and areca nut use behavior will be assessed using a standardized self-report measure of recent use that is use in the national YRBS survey. The questionnaire item will ask: "In the past 30 days, on how many days did you smoke a cigarette?" This question will be adapted for e-cigarette and areca nut. Response options include: "0 days," "1-2 days," "3-5 days," "6-9 days," "10-19 days," "20-29 days," "all 30 days."

This is a standardized self-report measure containing 4 items originally designed to assess smoking susceptibility among adolescents. In addition to the original measure, the current study will also adapt the measure to assess e-cigarette and areca nut use susceptibility. The 4 items are: "Do you think you will smoke a cigarette soon?", "Do you think you will smoke a cigarette in the next year?", "Do you think in the future you might experiment with cigarettes?", "If one of you friends were to offer you a cigarette, would you smoke it?"

This is a standardized self-report scale containing 7 items designed to assess generalized self-control, including impulsivity and behavioral self-control.

This is a standardized self-report scale containing 27 items designed to assess social competence is resisting social influence related to tobacco and other substance use among adolescents.

This is a standardized self-report scale containing 6 items designed to assess confidence in performing a behavior. Sample items include "When I make plans, I am certain I can make them work", "If I can't do a job the first time, I keep trying until I can", and "When I have something unpleasant to do, I stick to it until I finish it".

This is a standardized self-report scale containing 6 items designed to assess confidence in refusing tobacco and other substance use offers.

National Cancer Institute (NCI)

University of Hawaii Cancer Research Center

University of Guam

Phase 2: Implementation processes for assessing vaping behaviors and referring patients to a vaping cessation intervention (This is Quitting-TIQ) developed in Phase 1 will be tested within oncology survivorship clinics. Participants who opt to enroll in TIQ will also be asked to answer acceptability and applicability questions about their experience with the program.

Implementation processes developed in Phase 1 to develop assessment of vaping behaviors and referral to an evidence-based program for vaping cessation (TIQ) will be tested in Phase 2.

TIQ program is a mHealth, text messaging based intervention. Users who enroll in this program will receive 1 to 2 messages per day with 3 messages sent on their quit date. Messages are tailored to users' age, enrollment date or quit date, and the vape product they use.

Those not ready to quit receive 4 weeks of messages focused on building skills and confidence. Users who set a quit date receive messages for up to 6 weeks preceding the date and up to 8 weeks after that include encouragement, support, skill- and efficacy- building exercises, coping strategies, etc. Keywords such as COPE, STRESS, SLIP, and MORE can be used to request on-demand support.

Behavioral: Quitting Program (TIQ)

Rachel Webster, PhD

The purpose of this study is to understand e-cigarette use and interest in quitting by exploring e vaping behaviors among a cohort of AYA survivors (N=500). The investigators will also examine demographic, medical, and psychosocial factors associated with vaping behaviors.

Primary Objectives:

Phase 1.

* Objective 1. Identify characteristics of adolescent and young adult childhood cancer survivors (AYA CCS) nicotine vaping behaviors (e.g., e-cigarette use, interest in quitting, and quit attempts) and associations with demographic (e.g., sex, race, socioeconomic status, LGBTQ+ identification), cancer-specific (e.g., diagnosis, treatment factors), and psychosocial and behavioral factors.
* Objective 2. Develop strategies to improve implementation of an evidence-based, mHealth vaping cessation program within an AYA oncology clinic.
* Objective 2a: Use qualitative interviews to explore patient preferences regarding program implementation (e.g., timing of assessment of vaping behavior, confidentiality, referral approach) and identify barriers to uptake.
* Objective 2b: Interview and/or ask healthcare providers (e.g., practitioners, advanced practice providers, social workers practicing in AYA oncology settings) to complete open- ended questionnaires related to current processes (e.g., workflow), needs, and barriers for assessing e-cigarette use and vaping cessation referral processes. Evaluate healthcare providers' information needs, preferences, and tools needed for integrating e- cigarette assessment and cessation program referrals into current practice.

Phase 2.

* Objective 3. Develop and test vaping assessment and referral implementation processes (developed from Objectives 1 \& 2)., and uptake of an established mHealth vaping cessation program
* Objective 3a: Using qualitative and quantitative measures, we will assess the reach (% of eligible AYA CCS that enrolled in mHealth program), adoption (% providers making referrals), strategy potential (provider/patient perceptions of referral process; appropriateness of program for patients), and maintenance (barriers/facilitators to implementation) of the program.

Phase 1.

To understand the needs and interest of the targeted population, this mixed-method project will first examine e-cigarette use and interest in quitting among a cohort of AYA survivors who range in age from 13-24 on the day of consent and are at least 3 months post treatment completion. Research participants will complete study assessments via REDCap, a HIPAA-compliant, password-protected, data collection and storage platform. AYA survivors who endorse current vaping and desire to quit (N=25) and healthcare providers engaged in AYA oncology care (N=15), will be asked to complete questionnaires related to attitudes, beliefs, and knowledge about e-cigarette use.

Phase 2.

Using data gathered from Phase 1, study investigators will develop implementation strategies by leveraging Expert Recommendations for Implementing Change1 to test implementation processes including systematically assessing vaping behaviors and referring patients to an evidenced based vaping cessation program. Qualitative and quantitative measures will be completed by patients who complete the vaping cessation program and healthcare providers who are engaged in assessment/referral process. These assessments will inform the reach, adoption, and implementation of the program.

Implementing an Adolescent and Young Adult (AYA) mHealth Vaping Cessation Program Into Oncology Clinics

Individual participant de-identified datasets containing the variables analyzed in the published article will be made available (related to the study primary or secondary objectives contained in the publication). Supporting documents such as the protocol, statistical analyses plan, and informed consent are available through the CTG website for the specific study. Data used to generate the published article will be made available at the time of article publication. Investigators who seek access to individual level de-identified data will contact the computing team in the Department of Biostatistics (ClinTrialDataRequest@stjude.org) who will respond to the data request.

Current e-cigarette use (yes/no). This question assesses whether or not a participant is currently using e-cigarettes.

E-cigarette frequency of use assesses how often a participant is using e-cigarettes (daily to less than monthly)

These questions assess how motivated someone is to quit e-cigarettes (not all motivated to very motivated)

This assessment explores if a participant has tried to quit vaping and how many quit attempts were made. (yes/no; if yes, how many quit attempts)

Semi-structured interviews will assess preferences for assessment of e-cigarette use within oncology clinic settings and referral for cessation programs.

The Feasibility of Intervention will be administered to healthcare providers to assess the potential utility and modifications needed for the developed implementation strategies. This brief 4-item questionnaire was designed to test implementation outcomes related to program feasibility. This questionnaire is considered a strong indicators of future implementation success and will be used to inform modifications for large scale testing of implementation processes in future research. Items on this assessment are routinely modified to match the specific implementation programming, and for this study were modified slightly to gauge healthcare provider perceptions of vaping assessment and referral processes to This is Quitting

Similar to the framework used by Harrell et al. positive (e.g., negative affect reduction, stimulation/state enhancement, stress reduction) and negative consequences (e.g., cost, addiction) associated with e-cigarette use will be evaluated using a 15-item questionnaire derived from the Smoking Consequences Questionnaire-Adult (SCQ-A). In addition items related to having had cancer were included in the questionnaire in line with prior research (e.g., "E-cigarettes help me reduce cancer-related stress."). Response options range on a 7-point Likert scale from "very strongly disagree" to "very strongly agree.

Motivation and contemplation to quit assess how motivated someone is to quit e-cigarettes (not all motivated to very motivated)

Prior history of e-cigarette quitting behaviors assesses how many times a participant has tried to quit (yes/no; if yes, how many quit attempts)

Questionnaires will assess current processes and barriers to vaping assessments and referral to cessation programs, as well as information needs, preferences, and required tools.

Interviews will assess provider experience, barriers, and facilitators of developed implementation strategies

The Feasibility of Intervention will be administered to healthcare providers to assess the potential utility and modifications needed for the developed implementation strategies. This brief 4-item questionnaire was designed to test implementation outcomes related to program feasibility. This questionnaire is considered a strong indicator of future implementation success and will be used to inform modifications for large scale testing of implementation processes in future research. Items on this assessment are routinely modified to match the specific implementation programming, and for this study were modified slightly to gauge healthcare provider perceptions of vaping assessment and referral processes to This is Quitting

Items were modified from previous research to assess patient-doctor communication surrounding e-cigarette use including interest, comfort, and importance of these discussions. Questions also assessed for discussions related to use, referral for quitting support, and attitudes/beliefs about e-cigarette risk.

The Acceptability of Intervention Measure and Intervention Appropriateness Measures will be administered to evaluate implementation potential of the vaping cessation program. These brief 4-item questionnaires were designed to test implementation outcomes related to program acceptability and appropriateness. They are considered strong indicators of future implementation success and will be used to inform modifications. Items on this assessment are routinely modified to match the specific implementation programming, and for this study were modified slightly to gauge participant perceptions of This is Quitting.

This survey will evaluate patient participant perspectives on satisfaction of TIQ programming including types of messages and frequency of messaging, and the degree the program was helpful in reducing vaping.

Cancer-related worry and fear of cancer recurrence will be assessed using the Cancer Worry Scale. The 6-item assessment measures participant fears of relapse, late-effects, and fertility concerns. Participants respond on a 4- point Likert scale with response options ranging from "strongly disagree" to "strongly agree." This measure has been successfully used with both adolescent and young adult populations and will inform the extent to which cancer-related worry is associated with e-cigarette use.

The Patient Reported Outcome Measurement Information System (PROMIS) Profile will be administered to assess self-reported physical functioning mobility, anxiety, depressive symptoms, fatigue, peer relationships, pain interference, and pain intensity over a 7-day period. Participants \<18 will complete the self-reported pediatric version (49 items), and participants ≥ 18 will complete the adult version (43 items). Items are summed and T-scored, have a mean of 50 and a standard deviation of 10. This assessment will help inform psychological components associated with vaping behaviors and interest in quitting that may support implementation processes

Social support is a known protective factor against substance use, and social media influence can promote substance use. We will implement assessments to explore the association of social influence on vaping behaviors using the Multidimensional Scale of Perceived Social Support (MSPSS). The MSPSS is a 12-item self-report questionnaire that assesses perceived support from friends, family, and a significant other. Questions are answered on 7-point Likert scale from "very strongly disagree" to "very strongly agree." Higher scores are indicative of more social support. Additional items will be administered to assess social media influence on vaping behaviors.

The Investigators will use several brief dietary assessment to explore associations within this study.

Rapid Easting Assessment for Participants is used to quickly assess nutrient intake/diet quality in a clinical and research settings. It is completed for the previous week's food intake and scored by summing responses from 'usually/ often' to 'rarely/never or does not apply to me'. Possible scores ranged from 13 to 39 with a higher score indicating a higher diet quality. There is an additional 3-question section at the end about cooking/shopping and willingness to change eating habits.

The Binge Eating Scale includes 16 multiple choice items assessing the presence of certain binge eating behaviors which may be indicative of an eating disorder. Scores are summed for a maxi

Research has highlighted links between smoking cessation and increased physical activity in the general AYA population, and physical activity may be an important determinant in supporting vaping cessation. Understanding physical activity behaviors may provide additional mechanisms to improve vaping behaviors. As such, we will administer the International Physical Activity Questionnaire (IPAQ) short form is a 7-item self-reported questionnaire that assesses perceived health-related physical activity. Questions are answered based on the amount of reported minutes and/or hours per days participants engage in physical activity. Physical activity level is scored and categorized within three levels of activity: vigorous, moderate, and walking intensity. Scores can be converted to metabolic equivalents.

General demographic data will be gathered about health care providers including provider type (e.g., physician, psychologist, nurse practitioner), gender identity, and years of independent practice.

CES is a 20-item self-report questionnaire that assesses the extent to which the most stressful or impactful traumatic event experienced in participants' lives serves as a pivotal point in the development of their identity or influences their attribution of meaning to other events in their lives. For this questionnaire, participants will specifically answer questions about their cancer experience. Of the 20 items, 8 items assess the extent to which an event has become a reference point for the participant, 6 items assess the extent to which the event is central to participants' identity, and 6 items assess the extent to which participants think the event was a turning point in their life story. Questions are answered on a 5-point Likert scale ranging from " Totally Disagree" to "Totally Agree." No items are reverse coded and higher scores indicate greater centrality of the traumatic event to the participant.

St. Jude Children's Research Hospital

Neoplasms

Substance Related Disorders

Carcinoma

Tobacco Use Disorder

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

All Drugs and Chemicals

Nicotine

Erin Mead-Morse, MD, MPH

Aim 1: To compare the overall toxicant exposure in pregnant women who use electronic cigarettes (e-cigs, vapor, e-liquid, e-juice, vape, vaping devices) compared to women who smoke conventional cigarettes.

Aim 2. To compare toxicant exposure and birth outcomes among infants born to pregnant women who use e-cigs compared to women who smoke conventional cigarettes.

Aim 3. To explore potential mechanisms by which e-cigs could influence birth weight.

In addition to examining characteristics of pregnant e-cig users as well as patterns of their product use, this study is innovative in several ways. First, it is the first known study to examine toxicant exposure to cigarettes and e-cigs in a sample of pregnant smokers who are using these products. Although studies have reported on toxic exposures with e-cigs, this is the first study to apply toxic exposure tests to pregnant women.

Second this is the first study to examine the impact of electronic cigarette use on birth outcomes in pregnant smokers. Although e-cigarettes are similar to tobacco cigarettes in that they deliver nicotine, they are distinguished from tobacco cigarettes in that they do not contain many toxic substances such as carbon monoxide and volatile organic compounds. Consequently, similar to nicotine replacement therapies they have the potential to improve birth outcomes. However, it possible that there may be unanticipated negative effects on birth outcomes, and this study could provide a signal for potential other adverse effects (i.e., miscarriages etc.). Third, this study is the first to examine whether e-cigs alter carcinogen exposure to the fetus, which has been implicated in causing low birth weight and in long-term cancer risk for infants born to smokers. Finally, this is the first study to explore formaldehyde in urine as a measurement of conventional smoking and electronic cigarette use.

Electronic Cigarette Use During Pregnancy

The overall toxicant exposure will be measured at each trimester and adjusted for potential confounding covariates. A multivariate analysis of variance (MANOVA) with repeated measures will be used to evaluate the pregnant women who use electronic cigarettes compared to women who smoke conventional cigarettes at each trimester.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Smoking Prevention Program in Poland	NCT05488743	Smoking Smoking Behavio... Smoking (Tobacc... E-cigarette Use Vaping	educational int...	12 Years - 15 Years	Wroclaw Medical University
Smoking Prevention Program in Poland	NCT05488743	Smoking Smoking Behavio... Smoking (Tobacc... E-cigarette Use Vaping	educational int...	12 Years - 15 Years	Wroclaw Medical University
Testing a School-Based E-cigarette, Tobacco, and Betel (Areca) Nut Use Prevention Curriculum for Guam Youths	NCT05037656	Tobacco Smoking Vaping Tobacco Chewing	School-based cu...	11 Years - 15 Years	University of Guam
Implementing an Adolescent and Young Adult (AYA) mHealth Vaping Cessation Program Into Oncology Clinics	NCT05967585	Vaping Vaping Cessatio...	Behavioral: Qui...	13 Years - 24 Years	St. Jude Children's Research Hospital
Electronic Cigarette Use During Pregnancy	NCT03480373	Cigarette Smoki...		16 Years - 45 Years	UConn Health

Spots Global Cancer Trial Database for vaping

Every month we try and update this database with for vaping cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for vaping

Every month we try and update this database with for vaping cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for vaping cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.