Carcinogen Exposure Part 2
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Transcript of Carcinogen Exposure Part 2
7/27/2019 Carcinogen Exposure Part 2
http://slidepdf.com/reader/full/carcinogen-exposure-part-2 1/23
QUEST Study: Results of Wave 3
Colleen Pierce RN, BSN, MSc, FNPc
Morgane Swift RN, BSN, MSc, FNPc
Georgetown University
School of Nursing & Health StudiesScholarly Project, December 8, 2006
7/27/2019 Carcinogen Exposure Part 2
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Overview of Total QUEST Study
Participants
May 1st, 2005 through May 19th, 2006 =
3 Waves of Participants in Quest Study
129 Met Criteria for Phone Screening
52 Eligible for Enrollment
47 Consented & Randomized
17 CommitLozenges
30 QuestCigarettes
300 Responded to Advertisement
After Georgetown University IRB Approval
7/27/2019 Carcinogen Exposure Part 2
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7/27/2019 Carcinogen Exposure Part 2
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Overview of Wave 3
Sample Size¾ N = 16
¾ Eight randomized toQuest cigarettes
¾ Eight randomized toCommit
Demographics: Gender:
Male = 12
Female = 4
Age: Mean = 47 yrs
Range = 35-58 yrs
Level of
Education: Graduate Level = 6 Undergraduate Level
= 6 with only 1 who
finished a four yeardegree
High School = 3
Ethnicity: African American = 9 Caucasian = 6 Hispanic = 1
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Selected Biological Baseline Data
0
20
40
60
80
100
120
140
160
180200
Hear t Rate SYSTOLIC DIASTOLIC WEIGHT CO
PRE
Visit 4
MEAN
83
77
MEAN
134 130
MEAN
80 75
MEAN
194 190
MEAN
21 19
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Pre and Week 4 Stress Levels
1 2 3 4
Question4
Question3
Question2
Question1
Each item addressed,Within the last week…
Upset with somethingunexpected…
Unable to control importantthings…
Felt nervous and stressed…
Dealt successfully with lifehassles…
Commit PRE
Quest PRE
Commit 4 WK
Quest 4 WK
7/27/2019 Carcinogen Exposure Part 2
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Pre and Week 4 Stress Levels
1 2 3 4
Question8
Question7
Question6
Question5
Each item addressed,Within the last week…
Effectively coping with lifechanges…
Ability to handle personalproblems…
Felt things were going yourway…
Felt you could not cope withlife’s irritations…
Commit PRE
Quest PRE
Commit 4 WK
Quest 4 WK
7/27/2019 Carcinogen Exposure Part 2
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Pre and Week 4 Stress Levels
1 2 3 4
Question12
Question11
Question10
Question9
Each item addressed,Within the last week…
Control irritations…
Felt on top of things…
Angered/could not controlthings
How often thinking aboutthings you need to
accomplish…
Commit PRE
Quest PRE
Commit 4 WK
Quest 4 WK
7/27/2019 Carcinogen Exposure Part 2
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Pre and Week 4 Stress Levels
1 2 3 4
Question14
Question13
Each item addressed,Within the last week…
Control the way you spendyour time…
Felt you could not overcomedifficulties…
Commit PRE
Quest PRE
Commit 4 WK
Quest 4 WK
7/27/2019 Carcinogen Exposure Part 2
http://slidepdf.com/reader/full/carcinogen-exposure-part-2 10/23
Snapshots on the FAB 4 Student
FNP Participants
The GOOD Our participants Our diverse research team
members Our overall learning experience
The BAD Challenges with study design Challenges of collecting bio-
markers
The UGLY Participant “life”challenges to
sustain retention
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Snapshots on the FAB 4 Student
FNP Participants
Jesus*: Quest
35 year old Hispanicmale
relapsed tx visit 6
not prepared to quit onquit date
Edgar*: Quest
45 year old Black male relapsed tx visit 1
continued to smokeown brand
*Name changed to protect participant identification
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Snapshots on the FAB 4 Student
FNP Participants
Otis*: Quest 56 year old Black male
dropped from study txvisit 4
couldn’t keep hisappointments dueto work obligations
Matthew*: Lozenge
46 year old White male quit study tx visit 3
CP x 2 episodes
PCP recommended
stopping study
*Name changed to protect participant identification
7/27/2019 Carcinogen Exposure Part 2
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Snapshots on the FAB 4 Student
FNP Participants
Adam*: Quest 53 year old Black
female
family/religion majorstressors
relapsed tx visit 10
Calvin*: Quest 56 year old White male,
HEAVY smoker relapsed tx visit 3
work stress
*Name changed to protect participant identification
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Snapshots on the FAB 4 Student
FNP Participants
Danny*: Quest
49 year old Black male
no show tx visit 1
concerned about
Marijuana use
Jack*: Quest
58 year old White male
dropped tx visit 1 TRIPLED his CO levels
(21 to 72)
*Name changed to protect participant identification
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Snapshots on the FAB 4 Student
FNP Participants Kim*: Lozenge
35 year old Blackfemale dropped tx visit 1 consumed 5 lozenges
at once!
Melvin*: Quest 55 year old Black male quit tx visit 1
thought the paperworkwas too tedious kept returning for the
money!
*Name changed to protect participant identification
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Snapshots on the FAB 4 Student
FNP Participants
Brad*: Lozenge 53 year old White male relapsed tx visit 1 death in family
Wally*: Lozenge 47 year old Black male relapsed tx visit 1 too excited his
daughter was coming
to visit
*Name changed to protect participant identification
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Snapshots on the FAB 4 Student
FNP Participants
Lisa*: Quest
41 year old Whitefemale
dropped from study
visit 6 was adherent to
protocol andappointments, then
disappeared without atrace
*Name changed to protect participant identification
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And Then There was One….
Andrew*: Quest
31 year old White male
after many obstacles(HTN, tachycardia,
wrecked motorcycle, job change) he made it!
Only participant tocomplete 14 wk study
and at the same timebecome SMOKE FREE
*Name changed to protect participant identification
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Limitations to Study
¾
Unfortunate “life”challenges forsample population
¾ Turn over rate of “part time”
laboratory staff ¾ Phlebotomy inconsistencies
¾ Topography inconsistencies
¾ Limited resources to support moreworker-friendly hours
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Implications for Advanced
Practice Nurses
¾
Value of APNs in clinical trials¾ Having “team”support for coverage for
RA/couselor with broken leg!
¾ Value of interdisciplinary research team toinclude undergraduate students
¾ Seek opportunities to partner with others
for increased sample size
¾ Sharing lessons learned
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Future Research Implications for
Advanced Practice Nurses
¾
Design similar RCT using a step-downapproach with Quest cigarettes (RE: .6 mgx 2 weeks, .3 mg x2 weeks, .05 mg x 2
weeks)¾ Design study to evaluate “what happens”
to participants who are dropped (do they
continue to try to quit using other methodsor skills they were taught during RCT)
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Thank you from theGeorgetownUniversity Schoolof Nursing &Health Studies
FAB 4 FNPs J ourneywith a TobaccoCessation Clinical
Trial
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Fab 4 Final Comments
Let’s help everyone
do it!
1-800-QUIT NOW