Efficiency of Tailoring Treatment to Smoker Subgroup

针对吸烟者亚群量身定制治疗的效率

• 批准号: 6435239
• 负责人: CHARLES J NEIGHBORS
• 金额: $ 9.63万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6435239
• 关键词: absenteeism; adult human (21+); alcoholic beverage consumption; behavior therapy; body physical activity; cancer prevention; clinical research; clinical trials; combination therapy; comorbidity; cost effectiveness; depression; health care cost /financing; health care service utilization; high risk behavior /lifestyle; human data; human subject; human therapy evaluation; mental health epidemiology; nicotine replacement; patient care management; patient oriented research; postdoctoral investigator; smoking cessation; telemedicine

DESCRIPTION (provided by applicant): This K07 proposal in cancer prevention, control, and population sciences will enable the applicant to integrate two areas--business management and clinical psychology--into a research career on cost-efficient dissemination of primary and secondary cancer prevention interventions. The goals are to: a) gain experience in interventions for hard-to-treat smokers; b) build knowledge of statistical methods in economic research; c) apply methods from management science to research on cost- efficiency; and, d) develop a programmatic line and research on dissemination and cost-efficiency of interventions for cancer prevention and control. Cancer prevention through smoking cessation involves a paradox. Low cost/low intensity/low efficacy public health approaches have greater reach, while high cost/high intensity/low reach clinical interventions have greater efficacy. The difference in efficacy is greatest for hard-to-treat smokers who have greater levels of nicotine dependence, depression and problem alcohol use. Recently, some have called for integration of these contrasting intervention approaches through use of tailored stepped-care models that maximize cost- efficient allocation of healthcare resources. The research plan in this career development proposal calls for two studies that e amine costs and efficiencies of targeting subsets of smokers. Study 1 will use data from adult respondents to the 1997-1999 the National Health Interview Surveys (N = +/- 100,000) and the 1993 National Mortality Followback Survey (N = 22,957) to examine the medical utilization of subgroups of smokers who have high-risk alcohol consumption, sedentary lifestyle or depression. The costs of medical utilization will be estimated with data from the Medical Expenditure Panel Survey. Study 1 hypothesizes that smoking interacts with other health risk factors to predict greater costs for subgroups of smokers. Study 2 will examine the cost-effectiveness and operational efficiency of a telephone based tailored smoking intervention. Study 2 hypothesizes that tailored interventions will be more cost-effective than more standardized ones, particularly among smokers with other high-risk factors. Study 2 will also use tools from management science to evaluate clinical system factors affecting intervention efficiency. These studies will inform future dissemination research on cost-efficient and effective smoking cessation interventions that address the economic imperatives of healthcare delivery systems while maximizing the benefit to public health.

描述（由申请人提供）：该 K07 癌症预防提案， 控制和人口科学将使申请人能够整合两个 领域——商业管理和临床心理学——进入研究生涯 以具有成本效益的方式传播一级和二级癌症预防 干预措施。 目标是： a) 获得干预经验 难以治疗的吸烟者； b) 建立经济统计方法知识 研究; c) 将管理科学的方法应用于成本研究 效率; d) 制定传播计划和研究 以及癌症预防和控制干预措施的成本效益。 通过戒烟预防癌症存在一个悖论。 低成本/低 强度/低效的公共卫生方法具有更大的影响力，而高效率 成本/高强度/低范围的临床干预具有更大的功效。 对于难以治疗的吸烟者来说，疗效差异最大 尼古丁依赖、抑郁和酗酒问题的程度更高。 最近，一些人呼吁整合这些对比鲜明的干预措施 通过使用定制的阶梯式护理模式来最大化成本的方法 医疗资源高效配置。 本次研究计划 职业发展提案要求进行两项研究，即胺成本和 针对吸烟者子集的效率。 研究 1 将使用来自 1997-1999 年全国健康访谈调查的成年受访者（N = +/- 100,000) 和 1993 年全国死亡率追踪调查 (N = 22,957) 检查高危吸烟者亚组的医疗利用情况 饮酒、久坐的生活方式或抑郁。 医疗费用 将根据医疗支出小组的数据来估计利用率 民意调查。 研究 1 假设吸烟与其他健康风险相互作用 预测吸烟者亚群更高成本的因素。 研究 2 将 检查基于电话的成本效益和运营效率 量身定制的吸烟干预。 研究 2 假设定制 干预措施将比更标准化的干预措施更具成本效益， 尤其是具有其他高危因素的吸烟者。 研究 2 还将 使用管理科学的工具来评估临床系统因素 影响干预效率。 这些研究将为未来提供信息 关于具有成本效益和有效戒烟的传播研究 解决医疗保健提供的经济需求的干预措施 系统，同时最大限度地提高公众健康的利益。