title: The Process of Adapting the Evidence-Based Treatment for Tobacco Dependence for Smokers of Lower Socioeconomic Status.
abstract: BACKGROUND
  Tobacco use is the leading cause of preventable death and disease and contributes significantly to socioeconomic health disparities. The prevalence of smoking among individuals of lower socioeconomic status (SES) in the US, many of whom are African American (AA), is three to four times greater than the prevalence of smoking among individuals of higher SES. The disparity in tobacco dependence treatment outcomes between lower and higher SES smokers contributes to tobacco-related health disparities and calls for adapting evidence-based treatment to more fully meet the needs of lower SES smokers.
  
  
  OBJECTIVE
  We sought to adapt the evidence-based treatment for tobacco dependence using recommended frameworks for adapting evidence-based treatments.
  
  
  METHODS
  We systematically applied the recommended steps for adapting evidence-based treatments described by Barrera and Castro and Lau. The steps included information gathering, preliminary adaptation design, preliminary adaptation tests, and adaptation refinement. We also applied the PEN-3 Model for incorporating AA values and experiences into treatment approaches and a community-engaged approach.
  
  
  RESULTS
  Findings from each step in the process contributed to the results. The final results were incorporated into a revised treatment called the RITCh Study Tobacco Dependence Treatment Manual and Toolkit.
  
  
  CONCLUSIONS
  To our knowledge, this is the first adaptation of evidence-based treatment for tobacco dependence that has systematically applied these recommended frameworks. The efficacy of the treatment to reduce treatment outcome disparities is now being examined in a randomized controlled trial in which the revised treatment is being compared with a standard, individualized cognitive-behavioral approach.
authors.affiliation: HIV Centre for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA.
authors.forename: Shenell D
authors.initials: SD
authors.lastname: Evans
authors.affiliation: Sophie Davis School of Biomedical Education, City College of New York, New York, USA.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Sheffer
authors.affiliation: Center for Addiction Research, Virginia Tech Carilion Research Institute, Virginia, USA.
authors.forename: Warren K
authors.initials: WK
authors.lastname: Bickel
authors.affiliation: Walnut Street Works, Inc, Arkansas, USA.
authors.forename: Naomi
authors.initials: N
authors.lastname: Cottoms
authors.affiliation: Walnut Street Works, Inc, Arkansas, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Olson
authors.affiliation: Sophie Davis School of Biomedical Education, City College of New York, New York, USA.
authors.forename: Luana Panissidi
authors.initials: LP
authors.lastname: Pitì
authors.affiliation: Sophie Davis School of Biomedical Education, City College of New York, New York, USA.
authors.forename: Tekeshia
authors.initials: T
authors.lastname: Austin
authors.affiliation: Sophie Davis School of Biomedical Education, City College of New York, New York, USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Stayna
keywords: Cultural adaptation; Evidence-based treatments; Smoking cessation; Tobacco dependence