Tobacco Cessation Training for accupuncture, massage, and chiropractic practition

针灸、按摩和脊椎按摩疗法的戒烟培训

• 批准号: 8076725
• 负责人: MYRA L. MURAMOTO
• 金额: $ 58.63万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8076725
• 关键词: Acupuncture procedure; Address; Adult; Advisory Committees; Attitude; Behavior; Chinese Traditional Medicine; Chiropractor; Client; Clinical; Clinical Practice Guideline; Communities; Complementary and alternative medicine; Data; Dental; Educational Intervention; Effectiveness; Environment; Environmental Tobacco Smoke; Guidelines; Health; Health Personnel; Healthcare; Individual; Intervention; Knowledge; Maintenance; Massage; Measures; Medical; Medicine; Methods; Modality; Morbidity - disease rate; National Health Interview Survey; Nurses; Patient Education; Patient Self-Report; Patients; Pattern; Phase; Phase II Clinical Trials; Phase III Clinical Trials; Play; Population; Preparation; Preventive; Primary Health Care; Provider; Randomized; Randomized Controlled Trials; Readiness; Reporting; Research; Research Training; Resources; Role; Sampling; Screening procedure; Self Efficacy; Services; Social Network; Source; System; Testing; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Training; United States; United States Public Health Service; Visit; Withholding Treatment; base; behavior change; brief intervention; chiropracty; conventional therapy; cost effective; design; evidence base; experience; mortality; multi-site trial; patient population; phase 2 study; primary outcome; screening and brief intervention; secondary outcome; success; tobacco screening; training project

DESCRIPTION (provided by applicant): Tobacco use remains the leading cause of morbidity and mortality in the United States. Effective tobacco cessation treatments are more widely available than ever before, yet remain underutilized. Tobacco cessation brief interventions (BIs) are low-cost and effective for increasing quit attempts and quit rates. However, BI training has focused primarily on conventional medical providers, largely overlooking other community-based health care and wellness practitioners who see tobacco users in their client and patient populations. Data from the 2004 National Health Interview Survey indicate that 36% of U.S. adults use some form of complementary and alternative medicine (CAM), and among those individuals, approximately 20% are tobacco users. Thus, CAM practitioners represent a large, untapped community resource for promoting tobacco cessation. Existing cessation intervention training is not suitable for the background and practice patterns of CAM practitioners, as it assumes a background in conventional biomedicine. Thus there is a pressing need to develop and test the effectiveness of cessation training that is grounded in guideline-based treatment and that is relevant and appropriate for CAM practitioners. The current proposal addresses this gap and builds on our prior research in community-based tobacco BI training and research with CAM practitioners. Primary aims are to: 1) conduct a multi-method study with three types of CAM practitioners (chiropractors, massage therapists, and acupuncture/Traditional Chinese Medicine practitioners) to document their knowledge, attitudes and experiences regarding tobacco dependence and cessation, and to elicit a range of practice patterns and scenarios in which to provide tobacco cessation interventions; 2) tailor a tobacco cessation BI training for CAM practitioners that is part of an office system intervention (called CAM Reach); 3) conduct a cluster-randomized lagged intervention Phase 2 study of CAM Reach in 60 CAM practices that will: a) test the feasibility and acceptability of implementing the CAM Reach intervention; and b) evaluate its effect on the primary outcomes of CAM practitioners' conduct of tobacco use screening and brief interventions and secondary outcomes of patients' readiness to quit, quit attempts, use of guideline-based tobacco cessation treatments and quit rates. A secondary aim is to explore CAM Reach's effect on patients who are do not use tobacco but want to help someone else quit, with respect to knowledge cessation aids and actions to help the user quit. Results of the Phase 2 trial will provide the necessary parameters, e.g. effect size and intraclass correlation, to design a Phase 3 multi-site trial. To this end, we also propose a qualitative study of a sample of trained CAM providers and their patients to examine factors associated with CAM providers' implementation and maintenance of cessation intervention behaviors, and changes in patients' tobacco use. We hypothesize that: 1) Trained CAM practitioners will have significantly higher rates of screening and delivery of tobacco cessation BIs compared to untrained CAM practitioners; and 2) Patients of trained CAM practitioners will have significantly higher rates of quit attempts and use of evidence-based tobacco cessation aids, than patients of untrained CAM practitioners. PUBLIC HEALTH RELEVANCE: Practitioners of Complementary and Alternative Medicine (CAM) are an important source of health care for the US population, including tobacco users. The proposed research will tailor and evaluate a tobacco cessation brief intervention training and office system intervention for 3 types of CAM practitioners: acupuncture/Traditional Chinese Medicine, massage, and chiropractic.

描述（由申请人提供）：烟草使用仍然是美国发病率和死亡率的主要原因。有效的戒烟治疗比以往任何时候都更广泛，但仍未得到充分利用。烟草戒烟简介干预措施（BIS）对于提高戒烟尝试和戒烟率是低成本且有效的。但是，BI培训主要集中在传统的医疗提供者上，在很大程度上忽略了其他基于社区的医疗保健和健康从业者，他们看到了客户和患者人群中的烟草使用者。 2004年国家健康访谈调查的数据表明，36％的美国成年人使用某种形式的互补和替代医学（CAM），在这些人中，大约20％是烟草使用者。因此，CAM从业者代表了一种较大的，尚未开发的社区资源，用于促进烟草戒烟。现有的停止干预培训不适合CAM从业者的背景和实践模式，因为它假定了常规生物医学的背景。因此，迫切需要开发和测试以基于指南的治疗为基础的戒烟训练的有效性，并且对CAM从业人员很重要且适合。当前的提案解决了这一差距，并建立在我们先前在基于社区的烟草BI培训和与CAM从业者研究的研究。主要目的是：1）对三种类型的CAM从业人员（脊医，按摩治疗师和针灸/传统中医从业人员）进行多方法研究，以记录其有关烟草依赖和戒烟的知识，态度和经验，并引起实践模式和场景，以提供二比式cassione tobacco cessions Interventions casseation in Interventions conseation consection in Interventions; 2）针对CAM从业人员量身定制烟草戒烟BI培训，这是办公室系统干预的一部分（称为CAM REACH）； 3）在60个CAM实践中进行群集滞后的滞后干预阶段2研究： b）评估其对CAM从业人员进行烟草使用筛查和简短干预措施的行为的主要结果的影响，以及患者准备戒烟，戒烟尝试，使用基于指南的戒烟治疗和戒烟率的次要结果。第二个目的是探索CAM覆盖范围对不使用烟草但想帮助别人戒烟的患者的影响，以帮助用户戒烟，以帮助用户退出。第二阶段试验的结果将提供必要的参数，例如效应大小和类内相关性，以设计3阶段的多站点试验。为此，我们还建议对训练有素的CAM提供者及其患者样本进行定性研究，以检查与CAM提供者实施和维持戒烟干预行为以及患者烟草使用的变化有关的因素。我们假设：1）与未经训练的CAM从业人员相比，经过训练的CAM从业人员将具有更高的筛查和交付烟草戒烟率； 2）训练有素的CAM从业人员的患者将比未经训练的CAM从业者的患者更高的戒烟尝试和使用基于证据的戒烟剂。公共卫生相关性：补充医学和替代医学（CAM）的从业者是包括烟草使用者在内的美国人口的重要来源。拟议的研究将针对三种类型的CAM从业人员量身定制和评估烟草戒烟简短的干预培训和办公室系统干预：针灸/中医，按摩和脊骨疗法。