title: Combining community participatory research with a randomized clinical trial: the Protecting the Hood Against Tobacco (PHAT) smoking cessation study.
abstract: BACKGROUND
  This article describes the process and results of a smoking cessation intervention randomized clinical trial (RCT) that was conducted as a community-based participatory research project. This RCT tested whether outcomes are improved by adding social justice and tobacco industry targeting messages to a smoking cessation program conducted among African American adults within a low-income community in San Francisco, California. This study provides lessons for future similar research projects that focus on urban low-income populations.
  
  
  METHODS
  Participants were randomly allocated to receive a smoking-cessation program (control group [CG]) or CG care plus tobacco industry and media (IAM) messages. Primary interventions were behavioral. At intake, participants reporting severe withdrawal or smoking > or = 25 cigarettes daily were offered free nicotine replacement therapy. Baseline data were from an in-person interview. Outcome measures included self-reported smoking status; validation of quitting was by salivary cotinine assays.
  
  
  RESULTS
  Of 87 participants providing baseline data, 31% (27) did not join the RCT. Proportions quitting in the CG and IAM group were 11.5% and 13.6% at 6 months and 5.3% and 15.8% at 12 months, respectively.
  
  
  CONCLUSIONS
  African Americans in underserved inner-city neighborhoods can be recruited into RCTs with community participatory approaches. Differences between the CG and IAM in proportions who quit were 2.1% and 10.5% at 6 and 12 months, respectively. More than 3 years with adequate funding, high staffing ratios, and intense outreach and follow-up schedules are needed to achieve recruitment and study goals.
authors.affiliation: Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California 94143-0610, USA.
authors.forename: Erika Sivarajan
authors.initials: ES
authors.lastname: Froelicher
authors.forename: Daniel
authors.initials: D
authors.lastname: Doolan
authors.forename: Valerie B
authors.initials: VB
authors.lastname: Yerger
authors.forename: Carol O
authors.initials: CO
authors.lastname: McGruder
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Malone
mesh_terms: D000328:Adult; D001741:Black or African American; D015400:Clinical Nursing Research; D055812:Community-Based Participatory Research; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D018579:Patient Selection; D011203:Poverty; D016540:Smoking Cessation / Q000208:ethnology*; D012935:Social Justice; D014505:Urban Population