African American patient perspectives on barriers and facilitators to tobacco-cessation treatment

• Published in: Psychological services 2024-08
• Main Authors: Dawson, Darius B, Johnson, Briana, Baig, Mirza U, Breland, Jessica Y, Chen, Patricia, Fletcher, Terri L
• Format: Article
• Language: English
• Subjects: Behavior Therapy; Black People; Female; Human; Male; Military Veterans; Smoking Cessation; Test Construction; Tobacco Smoking; Treatment Barriers; Treatment Withholding
• ISSN: 1541-1559; 1939-148X; 1939-148X
• DOI: 10.1037/ser0000897

African American veterans who use tobacco use evidence-based tobacco-cessation treatment less than other racial/ethnic groups, contributing to higher tobacco-related treatment burden for them. This study aimed to assess barriers and facilitators African American patients face before engaging in Veterans Health Administration behavioral tobacco-cessation treatment services, as an initial step to identify new implementation strategies. African American veterans (N = 30) who use tobacco at a large Veterans Affairs Medical Center completed interviews about perceived barriers and facilitators to behavioral treatment, views on telehealth, and suggested care improvements. We used a combination of deductive and inductive analytic approaches and identified four themes: (1) Patients described how low motivation to quit and intense withdrawal symptoms impede treatment engagement, despite known health risks; (2) : Patients described how histories of mistrust and stigma toward treatment impact engagement with the health care system, resulting in lack of awareness of treatment options and preference for self-reliance in quitting; (3) Patients described how persistent providers, access to telehealth modalities, personal health complications exacerbated by tobacco use, and benefits of positive lifestyle change increase motivation for treatment; and (4) : Patients expressed a desire for more African American group-specific outreach, including targeted advertisement and culturally aware providers to combat mistrust of the health care system. Findings indicate that generating patient-driven implementation strategies such as tailored education and proactive outreach are necessary to increase engagement of African American patients in tobacco-cessation treatment programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).