COVID-19 Impact on Community-Based Participatory Randomized Controlled Trials-Lessons From the Oral Health Disparities in Children Consortium.

The COVID-19 pandemic has had a major impact on nearly every sector of science and industry worldwide, including a significant disruption to clinical trials and dentistry. From the beginning of the pandemic, dental care was considered high risk for viral transmission due to frequent aerosol-generating procedures. This resulted in special challenges for dental providers, oral health care workers, patients, and oral health researchers. By describing the effect that the COVID-19 pandemic had on four community-based randomized clinical trials in the Oral Health Disparities in Children (OHDC) Consortium, we highlight major challenges so researchers can anticipate impacts from any future disruptions.

Perceived Pain and Smoking Interrelations and Expectancies Are Associated With Pain and Smoking Cessation in Individuals With Mobility Impairments.

INTRODUCTION: Smoking and pain are highly prevalent among individuals with mobility impairments (MIs; use assistive devices to ambulate). The role of pain-related smoking motives and expectancies in smoking cessation is unknown. We examined cross-sectional and prospective associations between a novel measure of pain-related smoking motives (how smokers with pain perceive their pain and smoking to be interrelated) and pain and smoking behavior in smokers with MI. METHODS: This is a secondary data analysis of a smoking cessation induction trial (N = 263; 55% female) in smokers with MI. Participants did not have to want to quit to enroll. Pain-related smoking motives and expectancies were assessed at baseline with the pain and smoking inventory (PSI) which measures perceived pain and smoking interrelations in three distinct but related domains (smoking to cope with pain, pain as a motivator of smoking and as a barrier to cessation). Other measures included pain occurrence and interference, nicotine dependence, motivation and self-efficacy to quit smoking, and number of cigarettes per day. Biochemically verified smoking abstinence was assessed at 6 months. RESULTS: PSI scores were significantly higher among smokers with chronic pain occurrence compared to occasional and to no occurrence (p < .002) and were associated with greater pain interference (ps < .01) and lower self-efficacy to quit smoking (ps < .01). In prospective analyses adjusted for age, treatment group, and chronic pain, only expectancies of smoking to help cope with pain predicted lower odds of abstinence. CONCLUSIONS: Targeting expectancies of smoking as a mechanism to cope with pain may be useful in increasing smoking cessation in pain populations. IMPLICATIONS: Individuals with MI have a high prevalence of smoking and pain, yet the extent to which this population perceives pain and smoking to be interrelated is unknown. This is the first article to examine prospective associations between a novel measure of perceived pain and smoking interrelations (PSI) and smoking outcomes. The PSI was associated with greater pain and lower self-efficacy for quitting. Prospectively, the PSI subscale tapping into expectancies that smoking help coping with pain predicted a lower probability of smoking abstinence. In smokers with MI, expectancies of smoking as pain-coping mechanism may be an important clinical target.

Delivery of a smoking cessation induction intervention via virtual reality headset during a dental cleaning.

Smokers who are not motivated to quit are less likely to seek help or utilize medication for cessation, so it is critical to proactively reach them to motivate cessation. This study aims to determine feasibility and satisfaction of a smoking cessation induction intervention via a virtual reality (VR) headset worn during dental cleaning. Participants (n = 23) were adult dental patients who were current smokers. During their teeth cleaning, participants wore a VR headset to watch two 5-min smoking cessation videos, one targeted to smokers who are not ready to quit and one for those who are ready to quit. Questionnaires were administered pre- and postappointment, and 1 month later. Interviews were conducted immediately after the appointment. Implementation did not interfere with care delivery, including instrument manipulation and patient-provider communication. On a 1-7 scale, participants indicated satisfaction with the experience (M = 5.4, SD = 1.3), and a positive impact on their willingness to quit (15 of 22 rated ≥ 6) and their knowledge of the effects of smoking on their health (22 of 23 rated as ≥ 6). Participants were highly satisfied with the video content (M = 4.3; 1-5 scale). When prompted, 82.6% were able to recall three things from the video. One month later, four to five participants reported that they quit smoking (varied by measure) and 14 of 23 intentionally quit smoking ≥ 24 hr. Among nonquitters, motivation to quit increased from baseline to follow up. This study may help guide the integration of virtual reality headset use in the dental setting to promote smoking cessation regardless of motivation to quit.