# Implementing Sustainable mobile health Technology to Optimize smoking cessation Program for Lao people with HIV (I-STOP)

> **NIH NIH U01** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2024 · $653,951

## Abstract

PROJECT SUMMARY: Tobacco use remains the leading modifiable risk factor for preventing cancer globally,
particularly among people with HIV (PWH). In Lao People's Democratic Republic (Laos), 61%–80% of male
PWH and 3%–10% of female PWH smoke cigarettes. PWH who smoke in Laos currently have no theoretically
and empirically based smoking cessation support. Thus, implementing sustainable and evidence-based
smoking cessation interventions for PWH in Laos is critically needed. There is substantial evidence that mobile
health (mHealth)- based smoking cessation interventions are effective, cost-effective, and affordable. We
developed a scalable and affordable mHealth-based automated treatment program (MAP) to support Lao and
Cambodian smokers to quit smoking. The MAP involves interactive, tailored, personalized content (text
messages, photos, and videos) delivered via a smartphone app. Along with effective cessation treatments, it is
imperative to implement procedures to identify patients who smoke and to facilitate connections to treatment.
One such approach pioneered by our team is Ask-Advise-Connect (AAC, asking patients about smoking at
every visit, briefly advising those who smoke to quit, and connecting them to treatment), which showed great
impact in our US studies. The purpose of this application is to compare 2 smoking cessation implementation
strategies in 8 antiretroviral therapy (ART) clinics in the 5 most populous provinces/regions across Laos, using
a hybrid type-2 pragmatic effectiveness-implementation study and a parallel cluster randomized trial
design. Specifically, we will compare an AAC approach paired with our previously developed MAP (AA-MAP) to
an AAC approach paired with less resource intensive printed self-help material (AA-SH). To guide our
implementation work, we use the Practical, Robust Implementation and Sustainability Model (PRISM), which
expands the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to
include more key, multilevel contextual factors relevant to program implementation. Aim 1 is to evaluate the
reach and effectiveness of AA-MAP versus AA-SH. Reach is the proportion of PWH who smoke and are
willing to make a quit attempt that enroll in treatment. Effectiveness is the proportion of enrolled participants
(n=1,200) who achieve biochemically confirmed point prevalence abstinence 6 months after enrollment. We
hypothesize that compared with AA-SH, AA-MAP will have a lower reach but will be more effective. We will
also estimate the real-world impact (impact = reach × effectiveness) of each intervention. Aim 2 is to evaluate
other multi-level implementation outcomes (e.g., adoption, implementation fidelity, and sustainability) of AA-
MAP and AA-SH in the ART clinic setting using mixed methods. Aim 3 is to conduct a comprehensive
assessment of the resource use and costs of implementing AA-MAP and AA-SH and calculate the absolute
and relative cost effectiveness of the 2 intervention stra...

## Key facts

- **NIH application ID:** 11001800
- **Project number:** 1U01CA294811-01
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Thanh C. Bui
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $653,951
- **Award type:** 1
- **Project period:** 2024-08-12 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11001800

## Citation

> US National Institutes of Health, RePORTER application 11001800, Implementing Sustainable mobile health Technology to Optimize smoking cessation Program for Lao people with HIV (I-STOP) (1U01CA294811-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/11001800. Licensed CC0.

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