Interactive Mobile Doctor (iMD) for Asian Smokers

The Asian American population is the fast-growing racial group during 2000 and 2010. Smoking
prevalence among that Vietnamese (43%), Chinese (32%), and Korean (27%) men who spoke limited
English are disproportionately higher than that of men of all races combined (17%). Thus,
some Asian groups, including Chinese, Korean and Vietnamese, have an unequal burden of
tobacco-related diseases. Asian Health Services (AHS) is a federally-qualified health center
in Alameda County, California, providing services in English and 12 different Asian
languages. The vast majority of the patients are Chinese, Vietnamese, and Korean with low
income. Because of high smoking rates and associated health impacts on patients and their
families, promoting smoking cessation is a health priority for AHS. The Vietnamese Community
Health Promotion Project (VCHPP) at UCSF has conducted numerous intervention studies to
promote smoking cessation among Asian Americans. Given the shared research interest, AHS and
VCHPP have partnered to address smoking in Asian Americans. The partners received a TRDRP
pilot Community-Academic Research Award grant to develop an interactive "Mobile Doctor" (iMD)
intervention in Korean and Vietnamese languages that delivers video education tailored to
patient's responses on a computer tablet during the clinic visit to enhance patient-provider
discussion of tobacco use. The primary goal of the proposed study is to evaluate the iMD
intervention with an expansion to the Chinese language in its efficacy to promote
patient-provider discussion and quitting smoking in Chinese, Korean, and Vietnamese male
smokers. The study will enroll 150 AHS Chinese-, Korean- or Vietnamese-speaking patients who
smoke daily and have a scheduled clinic visit. Participants will then be assigned (by chance)
into either receiving 1) iMD on tobacco or 2) video education on nutrition and physical
activity recommendations. Participants will be assessed at: before the scheduled intervention
visit, immediately after or within one week of the intervention visit, and 6 months following
the intervention visit. Additional data will be obtained from EHR. The investigators
anticipate that, when compared to participants receiving usual care alone, those who receive
the iMD will be more likely to receive physician advice on their tobacco use both at their
intervention visit and at one visit following the intervention visit within 6 months as
documented in EHR; and at 6 months follow-up, those receiving the iMD will be more likely to
report having been able to quit smoking for at least one day during the study period, and to
have reported having quit smoking for at least 7 days with their abstinence status verified
using a saliva sample. The long-term goal is to understand effective ways to enhance
patient-provider communication in tobacco use and to leverage each clinic encounter in
promoting smoking cessation among patients in community health settings.

Inclusion Criteria:

- age 18 or older;

- male;

- English, Chinese- (Cantonese), Korean- or Vietnamese-speaking;

- self-identified as ethnic Chinese, Korean, Vietnamese or Asian

- current smoker as identified by EHR;

- have an already scheduled provider visit at Asian Health Services;

- smoke at least 1 cigarette daily in the last 7 days; and

- unwilling or unavailable to participate the in study procedures (e.g., to complete a
brief post-visit survey right after the visit or by phone) according to the group
assignment

Exclusion Criteria:

- Have vision and/or hearing difficulty that prevents the participant from viewing or
hearing the intervention video messages and/or completing the assessment in person or
by telephone