RCT for Smoking Cessation in 10 Medical Schools

10 所医学院的戒烟随机对照试验

基本信息

批准号：
8244668
负责人：
JUDITH K OCKENE
金额：
$ 13.8万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-06 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8244668
关键词：
Academic Detailing Accounting Address Adult Attention Behavior Cessation of life Clinical Clinical Practice Guideline Collaborations Control Groups Cost of Illness Counseling Crowding Data E-learning Education Educational Curriculum Educational process of instructing Effectiveness Elements Enrollment Epidemic Evaluation Evidence based intervention Feedback Geographic Locations Goals Hour Impact evaluation Individual Instruction Intervention Knowledge Learning Measures Mediating Medical Medical Education Medical Students Methods Modality Modeling Online Systems Outcome Patient Self-Report Patients Performance Physicians Play Policies Process Randomized Reporting Research Research Design Research Methodology Research Personnel Role Schedule Schools Self Efficacy Site Smoke Smoker Smoking Societies Structure Students Surveys System Teaching Method Testing Tobacco Tobacco Dependence Tobacco Use Cessation Tobacco use Training United States Public Health Service Update Withholding Treatment Work abstracting base cohort combat compare effectiveness control trial design evidence base experience follow-up improved innovation interest killings medical schools next generation premature primary outcome programs randomized trial secondary outcome skill acquisition skills skills training smoking cessation smoking prevalence theories tobacco control

项目摘要

6. Abstract Each year smoking kills 430,000 U.S citizens, exacerbates a myriad of diseases, and costs society approximately $100 billion. Despite the proliferation of information and restrictive smoking policies, adult smoking prevalence has remained relatively stable during the past five years, currently at 21%. Brief physician- delivered tobacco treatment, commonly known as "the 5As", is an evidence-based intervention demonstrated to double a smoker's likelihood of quitting. Given that 70% of smokers see a physician each year, it is imperative that all clinicians have the appropriate knowledge and skill level to counsel smokers. However, few physicians and physicians-in-training receive adequate training to develop these skills. Using a pair-matched, randomized group-controlled (RGC) design (implemented in 10 medical schools), we will compare two methods of teaching the 5As to medical students: 1) traditional medical education (TE), and 2) multi-modal education (MME) that adds two components to TE: a web-based instructional program for students and preceptor training. The primary outcome is observed tobacco treatment counseling skill as measured by the Objective Structured Clinical Examination (OSCE), the standard method for evaluating medical student skill level at all U.S. medical schools. A secondary outcome is self-reported tobacco treatment counseling skill level. In a nested cohort design, during the second year of the study a cohort of medical students will be followed from early in their first year of medical school (MS1) through the end of their third year (MS3) which occurs in the 4th year of the study. The Primary Aim of this RGC trial is to compare the effectiveness of MME for teaching the 5As counseling skills in medical school against TE. Hypothesis 1: MME will outperform TE on observed 5As counseling skills (OSCE). Hypothesis 2: MME will outperform TE on self-reported 5As counseling skills. Strengths of this study include: 1) the innovative study design that tests common and integrative teaching methods and 2) the potential to disseminate throughout US medical schools effective educational methods that can build physicians' skills to assist the millions of patients who continue to smoke. This is a unique window of opportunity to build on our team's prior research in medical education and tobacco dependence treatment. This study involves close collaboration among researchers, practitioners, educators, and stakeholders at 10 U.S. medical schools. This unique team is comprised of investigators with extensive experience developing and teaching an evidence-based, physician-delivered 5A tobacco treatment model; developing and evaluating a web-based tobacco dependence treatment course; implementation of academic detailing with physician preceptors; and experience in building a large medical school consortium for tobacco curriculum reform.

6。摘要每年吸烟会杀死430,000名美国公民，加剧无数疾病，使社会造约1000亿美元。尽管信息扩散和限制性吸烟政策，但成人在过去的五年中，吸烟流行率一直保持相对稳定，目前为21％。简短的医生 - 提供的烟草处理，通常称为“ 5AS”，是一种基于证据的干预措施使吸烟者戒烟的可能性加倍。鉴于每年有70％的吸烟者看医生，这是当务之急，所有临床医生都有适当的知识和技能水平来为吸烟者提供咨询。但是，很少培训中的医生和医生接受了足够的培训以发展这些技能。使用成对匹配，随机组控制（RGC）设计（在10所医学院实施），我们将比较两个向医学生教5A的方法：1）传统医学教育（TE）和2）多模式教育（MME）将两个组成部分添加到TE：一个基于网络的学生的教学计划，适合学生和主持人培训。观察到的主要结果是烟草治疗咨询技能客观结构化临床检查（OSCE），评估医学学生技能的标准方法在所有美国医学院的水平。次要结果是自我报告的烟草治疗咨询技能水平。在嵌套的队列设计中，在研究的第二年将遵循一系列医学生从医学院的第一年（MS1）到第三年结束（MS3）研究的第四年。该RGC试验的主要目的是比较MME的有效性教授医学院的5A咨询技能反对TE。假设1：MME在观察到的5A咨询技能（OSCE）上的表现将胜过。假设2：MME在自我报告的5AS咨询技能上的表现将胜过。这项研究的优势包括：1）测试常见和综合教学的创新研究设计方法和2）在整个美国医学院中传播有效的教育方法的潜力可以建立医生的技能，以帮助数百万继续吸烟的患者。这是建立我们团队先前在医学教育方面的研究和烟草依赖治疗。这项研究涉及研究人员，从业者，教育工作者和美国10个医学院的利益相关者。这个独特的团队由调查人员组成丰富的经验开发和教授基于证据的医师提供的5A烟草治疗模型;开发和评估基于网络的烟草依赖治疗课程；实施与医师受体的学术细节；以及建立大型医学院财团的经验烟草课程改革。