Addressing Parental Smoking by Changing Pediatric Office Systems

通过改变儿科办公系统来解决父母吸烟问题

基本信息

批准号：
7244897
负责人：
Jonathan P Winickoff
金额：
$ 79.59万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-30 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7244897
关键词：
Abstinence Academy Address Adherence Adoption Adult American Attention Behavior Caring Child Childhood Classification Cotinine Counseling Effectiveness Effectiveness of Interventions Enrollment Evidence based intervention Family Fire - disasters Focus Groups Foundations Future Hand Health Healthcare Home environment Hour Housing Institution Intervention Lead Life Maintenance Malignant Neoplasms Maps Measures Medical Medication Management Methods Modeling NCI Strategic Planning National Cancer Institute National Cancer Program Outcome Pamphlets Parenting behavior Parents Patient Self-Report Pediatric Research Pediatrics Pharmaceutical Preparations Pharmacotherapy Physicians Population Practice based research Pregnancy Outcome Primary Health Care Process Prohibit Randomized Controlled Trials Rate Research Research Institute Research Personnel Resources Score Services Site Smoke Smoking Smoking Behavior Spouses Surveys System Techniques Testing Tobacco Tobacco Dependence Translations United States Visit Week Wood material Work Writing base cancer prevention chronic care model day evidence based guidelines improved mortality preempt prevent programs quitline smoking cessation therapy design tobacco control young adult

项目摘要

DESCRIPTION (provided by applicant): Quitting smoking adds an average of seven years to a parent's life, improves the health of the spouse, eliminates the majority of secondhand smoke (SHS) exposure of the children, reduces tobacco-related poor pregnancy outcomes, eliminates the greatest cause of house fire mortality, and improves the financial resources of the family. Much research has been done developing techniques to enhance the provision of evidence-based tobacco control in the adult primary care practice setting, but parents may not have a primary care clinician and even when they do, often visit their child's doctor more frequently than their own. We developed an intervention to address parental smoking in the child healthcare setting that employs, in combination, evidence-based smoking cessation techniques including the 5 A's (Ask, Advise, Assess, Assist, Arrange), proactive referral to regional and national "quitlines," and pharmacologic management of tobacco dependence. We will be testing this previously developed, pilot tested, and theoretically-based intervention designed to improve adherence to evidence-based guidelines at the clinician level, facilitate change at the parent behavior level, and lead to implementation of systems changes at the practice level. We will compare our intervention to an "attention" control consisting of handing out a current best practice tobacco control pamphlet. The proposed study will be a 60-site, group randomized controlled trial (RCT) of effectiveness that builds on focus group, feasibility, and efficacy work supported by the National Cancer Institute, the Flight Attendant Medical Research Institute, and the Robert Wood Johnson Foundation. It will be conducted in the American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) practice-based research network, the largest research network of pediatric practices in the United States. Findings will be widely reproducible and transportable through the more than 700 PROS practices (which provide care to over 3 million of the nation's children) and to other practice networks and practices nationally. This research will contribute to the NCI's efforts to defeat cancer through the National Cancer Program and is in exact alignment with NCI's Strategic Plan to develop and apply evidence-based interventions for preventing cancer. This trial will help the nation to "preempt cancer at every opportunity" by "accelerating progress in cancer prevention" and to focus efforts on the young adults and children who form the future of a cancer-free U.S. population.

描述（由申请人提供）：戒烟平均为父母的生活增加了七年，改善了配偶的健康，消除了大多数二手烟（SHS）暴露儿童，减少与烟草相关的贫困妊娠结局，从而消除了家庭火灾死亡的最大原因，并改善了家族的金融资源。已经进行了许多研究，开发了在成人初级保健实践中增强基于证据的烟草控制的技术，但是父母可能没有初级保健临床医生，即使他们这样做，也经常比自己的医生更频繁地去拜访孩子的医生。我们开发了一项干预措施，以解决儿童医疗保健环境中的父母吸烟，该环境结合使用了基于证据的戒烟技术，包括5 A（询问，建议，评估，协助，安排），积极地转介到区域和国家“戒烟”和“ Quitlines”，以及对烟草依赖的药理管理。我们将测试这种先前开发的，试点测试和基于理论上的干预措施，旨在提高依从性地遵守临床医生一级的基于证据的准则，促进父母行为水平的变化，并导致实践级别实施系统变化。我们将将干预与“注意”控制进行比较，包括分发当前的最佳实践烟草控制小册子。拟议的研究将是一项有效性的60个站点，随机对照试验（RCT），该试验基于国家癌症研究所，飞行员医学研究所和罗伯特·伍德·约翰逊基金会（Robert Wood Johnson Foundation）支持的焦点小组，可行性和效力工作。它将在美国儿科学院（AAP）办公室环境（PRO）基于实践研究网络（美国最大的儿科实践研究网络）中进行。通过700多种专业实践（为全国超过300万儿童提供护理）以及全国其他实践网络和实践，发现将是可重现和运输的。这项研究将有助于NCI通过国家癌症计划击败癌症的努力，并与NCI的战略计划完全一致，以制定和应用基于证据的干预措施来预防癌症。该试验将通过“加速预防癌症的进步”，将精力集中在构成无癌症美国人群的未来的年轻人和儿童上，以帮助该国“在每一个机会上抢占癌症”。