Using Rural Community Paramedicine to Engage Lower-Motivated Smokers: Spreading an Effective mHealth-Assisted Intervention to Motivate Cessation
利用农村社区辅助医疗吸引动机较低的吸烟者:传播有效的移动医疗辅助干预措施以激励戒烟
基本信息
- 批准号:10552308
- 负责人:
- 金额:$ 74.86万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-05 至 2027-08-31
- 项目状态:未结题
- 来源:
- 关键词:AbstinenceAddressAdultAppalachian RegionAreaAttentionCarbon MonoxideChronic DiseaseClinicClinical ServicesCodeCommunitiesComplexCountyDataEmergency medical serviceEmployeeEquilibriumFundingFutureGeographyGoalsHuman ResourcesHybridsIndividualInstitutionInternal MedicineInterventionKnowledgeMonitorNorth CarolinaOdds RatioPalateParticipantPathway AnalysisPathway interactionsPatientsPersonnel StaffingPersonsPrevalencePreventive MedicineProcessProtocols documentationPublishingRandomizedRecording of previous eventsReportingResearchRoleRuralRural CommunityRural HealthSamplingScienceSelf EfficacyServicesSmokeSmokeless TobaccoSmokerSmokingSmoking BehaviorTechnologyTestingThinkingTimeTobacco useTrainingVariantVulnerable PopulationsWorkbudget impactcancer preventioncomparison groupcostdesigndigitaleffectiveness outcomeeffectiveness researcheffectiveness trialevidence baseexperiencehealth care deliveryhigh rewardhigh riskimplementation costimplementation evaluationimplementation fidelityimplementation outcomesimplementation researchimplementation strategyimplementation trialinnovationmHealthnicotine cessationnicotine replacementnovelpopulation healthprogramsroutine practicerural arearural countiesskillssmoking cessationsmoking prevalencesuccesstobacco controlvaping
项目摘要
7. Project Summary/Abstract
We will conduct a multi-level “hybrid type 2” study (i.e.: implementation and effectiveness outcomes) to test
1) a novel implementation program in rural counties and 2) a mHealth (mobile health)-assisted brief abstinence
experience (Take a Break, TAB) for rural adults who smoke and are not-yet-ready to quit. In our network of rural
counties, the implementation trial will use a novel, multi-strategy implementation program centered on county
employees engaged in ‘community paramedicine.’ Emergency Medical Services personnel (EMS) are evolving
into this more expansive role (e.g.: non-emergent healthcare delivery, monitoring of chronic disease, and
preventive medicine). To test the implementation, we will randomize rural counties with EMS serving
geographically complex and ethnically varied areas (the mountainous region of Appalachia and plains of eastern
North Carolina). These counties have some of the highest smoking rates in the U.S. We will compare a well-
tested (standard) implementation program versus a novel enhanced program. The standard program uses
evidence-based external facilitation – providing training and technical support to EMS services to support the
integration of enhanced tobacco control practices (including recommending and referring people who smoke and
not-yet-ready-to-quit to the mHealth-assisted population health intervention. The novel enhanced
implementation program will include the standard program an EMS Champion program. EMS who currently
smoke will be offered participation in TAB themselves. Those who participate, Champions, will then use their
TAB experience to support implementation as internal facilitators. They will encourage other EMS to experience
TAB, longitudinally encourage use of the tobacco control practices in routine workflow for all EMS, and will be
able to use their personal experience with TAB to engage in a richer dialog with patients who smoke. Using these
strategies, we seek to engage individuals living in harder-to-reach rural areas with less access to clinical services.
Engaging these individuals is possible with brief, low intensity, palatable interventions that target self-efficacy
and facilitate skills building to support future abstinence. The TAB intervention addresses the challenge of
engaging lower motivated individuals using a novel format, a brief abstinence game, supported using mHealth
and building upon 10 years of research. We recently published the first TAB effectiveness trial in JAMA Internal
Medicine. This preliminary data supports the current application and does not include a large number of
individuals living in rural areas. In this project, we will randomize to TAB versus an active comparison designed
to isolate the effect of TAB and balance the participant contact across the two groups. In addition to evaluating
implementation success and effectiveness outcomes, we will study pathways to cessation. To inform
sustainment and dissemination, we will collect data on implementation fidelity, county-level adaptations,
variations in referrals, and patient-level engagement across the counties, and at the EMS and patient-level. To
evaluate budget impact, we will track the cost of the implementation strategies and the intervention.
7. 项目总结/摘要
我们将进行多层次的“混合型 2”研究(即:实施和有效性结果)来测试
1) 在农村县实施一项新颖的计划,以及 2) 移动医疗(移动医疗)辅助的短暂戒断
在我们的农村网络中,为吸烟且尚未准备好戒烟的农村成年人提供体验(休息一下,TAB)。
试点将采用以县为中心的新颖的、多策略的实施方案
从事“社区辅助医疗”的员工。紧急医疗服务人员 (EMS) 正在不断发展
发挥更广泛的作用(例如:非紧急医疗保健服务、慢性病监测以及
为了测试实施情况,我们将随机分配提供 EMS 服务的农村县。
地理复杂、种族多样的地区(阿巴拉契亚山区和东部平原)
北卡罗来纳州)。这些县是美国吸烟率最高的县。我们将比较一下-
测试的实现(标准)程序与新颖的增强程序标准程序使用。
基于证据的外部促进——为 EMS 服务提供培训和技术支持,以支持
整合强化烟草控制措施(包括推荐和推荐吸烟者和吸烟者)
尚未准备好退出 mHealth 辅助的人群健康干预。
实施计划将包括标准计划和目前的 EMS 冠军计划。
那些参与的人,冠军,将被提供参与 TAB,然后将使用他们的。
TAB 经验作为实施内部促进者提供支持,他们将鼓励其他 EMS 体验。
TAB,纵向鼓励在所有 EMS 的常规工作流程中使用烟草控制实践,并将
能够利用他们使用 TAB 的个人经验与吸烟患者进行更丰富的对话。
在战略中,我们寻求让生活在偏远农村地区、获得临床服务机会较少的个人参与进来。
通过针对自我效能的简短、低强度、可口的干预措施可以让这些人参与进来
并促进技能建设以支持未来的禁欲。TAB 干预解决了以下挑战:
使用新颖的形式(一种简短的禁欲游戏,并在移动医疗的支持下)吸引积极性较低的个人
基于 10 年的研究,我们最近在《JAMA Internal》上发表了第一个 TAB 有效性试验。
这个初步数据支持当前的应用,并不包括大量的数据。
在这个项目中,我们将随机选择 TAB 与设计的主动比较。
除了评估之外,还可以隔离 TAB 的影响并平衡两组参与者的接触。
实施的成功和有效性结果,我们将研究戒烟途径并提供信息。
维持和传播,我们将收集有关实施保真度、县级调整的数据,
各县以及 EMS 和患者层面的转诊和患者参与度存在差异。
评估预算影响,我们将跟踪实施策略和干预措施的成本。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Thomas K Houston其他文献
Bridging the Digital Divide: Reaching Vulnerable Populations Vulnerable Populations
弥合数字鸿沟:惠及弱势群体 弱势群体
- DOI:
- 发表时间:
2013 - 期刊:
- 影响因子:0
- 作者:
Betty L Chang;Suzanne Bakken;S. Scott Brown;Thomas K Houston;Gary L. Kreps;R. Kukafka;Ma Drph;Charles Safran;P. Stavri;M. Cashen;Jonathan Crossette;Karen B Eden;Ben S Gerber;Denise Goldsmith;Kenneth W. Goodman;John Holmes;Deborah A Lewis;David R Little;L. Neuhauser;Daniel Z. Sands;Laura H. Schopp;Lisa A Sutherland - 通讯作者:
Lisa A Sutherland
Informatics as a Strategy for Reducing Health Disparities in Underserved Populations
信息学作为减少服务不足人群健康差距的策略
- DOI:
- 发表时间:
2004 - 期刊:
- 影响因子:0
- 作者:
Betty L Chang;Suzanne Bakken;S. Scott Brown;Thomas K Houston;Gary L. Kreps;R. Kukafka;Ma Drph;Charles Safran;P. Stavri;M. Cashen;Jonathan Crossette;Karen B Eden;Ben S Gerber;Denise Goldsmith;Kenneth W. Goodman;John Holmes;Deborah A Lewis;David R Little;L. Neuhauser;Daniel Z. Sands;Laura H. Schopp;Lisa A Sutherland - 通讯作者:
Lisa A Sutherland
Thomas K Houston的其他文献
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{{ truncateString('Thomas K Houston', 18)}}的其他基金
Using Rural Community Paramedicine to Engage Lower-Motivated Smokers: Spreading an Effective mHealth-Assisted Intervention to Motivate Cessation
利用农村社区辅助医疗吸引动机较低的吸烟者:传播有效的移动医疗辅助干预措施以激励戒烟
- 批准号:
10697314 - 财政年份:2022
- 资助金额:
$ 74.86万 - 项目类别:
iDAPT: Implementation and Informatics - Developing Adaptable Processes and Technologies for Cancer Control
iDAPT:实施和信息学 - 开发癌症控制的适应性流程和技术
- 批准号:
10477068 - 财政年份:2019
- 资助金额:
$ 74.86万 - 项目类别:
iDAPT: Implementation and Informatics - Developing Adaptable Processes and Technologies for Cancer Control
iDAPT:实施和信息学 - 开发癌症控制的适应性流程和技术
- 批准号:
10020357 - 财政年份:2019
- 资助金额:
$ 74.86万 - 项目类别:
iDAPT: Implementation and Informatics - Developing Adaptable Processes and Technologies for Cancer Control
iDAPT:实施和信息学 - 开发癌症控制的适应性流程和技术
- 批准号:
10477064 - 财政年份:2019
- 资助金额:
$ 74.86万 - 项目类别:
iDAPT: Implementation and Informatics - Developing Adaptable Processes and Technologies for Cancer Control
iDAPT:实施和信息学 - 开发癌症控制的适应性流程和技术
- 批准号:
10247727 - 财政年份:2019
- 资助金额:
$ 74.86万 - 项目类别:
K12 Cardiopulmonary Implementation Science Scholars Program
K12心肺实施科学学者计划
- 批准号:
9372203 - 财政年份:2017
- 资助金额:
$ 74.86万 - 项目类别:
Take a Break: mHealth-assisted skills building challenge for unmotivated smokers
休息一下:移动健康辅助的针对无动力吸烟者的技能培养挑战
- 批准号:
8979296 - 财政年份:2015
- 资助金额:
$ 74.86万 - 项目类别:
Implementation Research Training Program in Cancer Prevention and Control
实施癌症预防和控制研究培训计划
- 批准号:
9070416 - 财政年份:2014
- 资助金额:
$ 74.86万 - 项目类别:
Implementation Research Training Program in Cancer Prevention and Control
实施癌症预防和控制研究培训计划
- 批准号:
8608335 - 财政年份:2014
- 资助金额:
$ 74.86万 - 项目类别:
Implementation Research Training Program in Cancer Prevention and Control
实施癌症预防和控制研究培训计划
- 批准号:
9278124 - 财政年份:2014
- 资助金额:
$ 74.86万 - 项目类别:
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