Research

Methods & Approach
We approach our mission to reduce the burden of tobacco use on people experiencing homelessness through research, education, and capacity building. Among our multiple methods are RCTs and cluster RCTs, EHR data analysis of tobacco use and cessation, national surveillance data analysis, and public health case studies.

Currently, we're conducting three research projects:

 

Contingency Management Smoking Cessation Intervention

Smoke-Free Home Study

Cessation Assistance in Homeless Shelters

 

 

 

 

 

 

Randomized trial of a contingency management smoking cessation intervention for homeless adults.

The purpose of this study is to test a smoking cessation intervention that provides financial incentives, i.e., money in the form of gift card to a local retail store and/or cash, for smoking cessation. All participants are also current patients at the Tom Waddell Urban Health Clinic in San Francisco, CA.

  • Objective: increase long-term tobacco abstinence by providing financial incentives for cessation.
  • Funding: Tobacco Related Disease Research Program.
  • Study design: Pilot RCT
    • Intervention groups get escalating incentives for demonstrating abstinence.
    • Control group gets fixed incentives for abstinence.
  • Setting: 3 clinics in the San Francisco Health Network.
    • Tom Waddell
    • Ward 86
    • Richard Fine People’s Clinic
  • Participants: Currently homeless and current cigarette smokers.
    • 83 participants recruited
  • Outcomes: Tobacco abstinence

A community-based trial of a voluntary smoke-free home intervention in permanent supportive housing for formerly homeless adults.

The goal of the study is to test and evaluate a smoke-free home intervention among residents in permanent supportive housing in the San Francisco Bay Area, and also to improve the facility’s capacity to promote smoking cessation among residents. A smoke-free home is a home where no smoking is allowed inside. The intervention includes distribution of written and graphic materials about the harms of secondhand smoke exposure, smoke-free home pledges and signs, and strategies to adopt a smoke-free home and address roadblocks to adoption. We expect to enroll 400 residents and 100 staff participants in this study, from 24 to 30 permanent supportive housing sites.

  • Objective: To increase voluntary adoption of smoke-free homes and increase access to cessation services
  • Funding: National Cancer Institute
  • Study design: Cluster randomized controlled trial.
    • Intervention sites get counseling intervention for residents and staff.
    • Control sites get usual care and are offered the intervention 6 months later
  • Setting. 38 permanent supportive housing sites for formerly homeless adults
  • Participants. 290 out of 400 participants recruited.
  • Outcomes. Smoke-free home adoption

Providing access to medication assistance program for smoking cessation for homeless adults seeking shelter services in San Francisco.

This program seeks to provide on-site access to medications for tobacco cessation for people experiencing homelessness and who are staying in navigation centers in San Francisco, CA. Funded by the San Francisco Cancer Initiative, this is part of a larger effort to increase smoking cessation services in shelters in partnership with Alto pharmacy.

  • Objective: To eliminate barriers to access to smoking cessation treatment through a community pharmacist-linked smoking cessation program for adults experiencing homelessness.
  • Funding: San Francisco Cancer Initiative
  • Study design: Single arm implementation study.
    • Pharmacist provides consultation and free delivery of NRT for up to 3 months
  • Setting: Navigation Centers and shelters
  • Participants: 60 participants each cycle
  • Outcomes: Tobacco abstinence