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：
8117274
负责人：
Jonathan P Winickoff
金额：
$ 74.06万
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 2012-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8117274
关键词：
Abstinence Academy Address Adherence Adoption Adult American Attention Behavior Caring Child Childhood Cotinine Counseling Effectiveness Effectiveness of Interventions Enrollment Environmental Tobacco Smoke 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 Research Medication Management Methods Modeling National Cancer Institute National Cancer Program Outcome Pamphlets Parenting behavior Parents Patient Self-Report Pediatric Research Pediatrics Pharmaceutical Preparations Pharmacotherapy Physicians Population Pregnancy Outcome Primary Health Care Process Randomized Controlled Trials Research Research Institute Research Personnel Resources Services Site Smoking Smoking Behavior Spouses Strategic Planning Surveys System Techniques Testing Tobacco Tobacco Dependence Translations United States Visit Wood material Work Writing base cancer prevention chronic care model evidence base evidence based guidelines improved mortality practice-based research network preempt prevent primary outcome programs quitline smoking cessation therapy design tobacco control treatment as usual 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）：戒烟可平均延长父母的寿命七年，改善配偶的健康，消除儿童的大部分二手烟（SHS）暴露，减少与烟草相关的不良妊娠结局，消除房屋火灾死亡的最大原因，并改善了家庭的经济来源。已经开展了大量研究，开发技术来加强成人初级保健实践环境中循证烟草控制的提供，但父母可能没有初级保健临床医生，即使有初级保健临床医生，也经常比自己更频繁地去看孩子的医生。我们制定了一项干预措施来解决儿童医疗机构中家长吸烟问题，该干预措施结合采用基于证据的戒烟技术，包括 5 A（询问、建议、评估、协助、安排）、主动转介至地区和国家“戒烟热线”、 ”和烟草依赖的药物管理。我们将测试之前开发的、试点测试的、基于理论的干预措施，旨在提高临床医生层面对循证指南的遵守程度，促进家长行为层面的改变，并导致实践层面系统变革的实施。我们将把我们的干预措施与“注意力”控制进行比较，其中包括分发当前最佳烟草控制实践小册子。拟议的研究将是一项 60 个中心的有效性分组随机对照试验 (RCT)，以国家癌症研究所、空乘医学研究所和罗伯特·伍德·约翰逊基金会支持的焦点小组、可行性和有效性工作为基础。。它将在美国儿科学会 (AAP) 办公室环境儿科研究 (PROS) 基于实践的研究网络中进行，该网络是美国最大的儿科实践研究网络。研究结果将可通过 700 多个 PROS 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进行广泛复制和传播。这项研究将有助于 NCI 通过国家癌症计划战胜癌症，并且与 NCI 制定和应用循证干预措施预防癌症的战略计划完全一致。这项试验将帮助国家通过“加速癌症预防进展”来“抓住一切机会预防癌症”，并将重点放在构成美国无癌症人口未来的年轻人和儿童身上。