Computer-Facilitated 5A's for Smoking Cessation in Primary Care

初级保健中计算机辅助戒烟 5A 标准

• 批准号: 8511420
• 负责人: JASON M SATTERFIELD
• 金额: $ 59.07万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-15 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8511420
• 关键词: Address; Adherence; Adoption; Advocacy; Alcohol consumption; Alcohol or Other Drugs use; Appointment; Attitude; Bupropion; Clinic; Communities; Computer Assisted; Computer software; Computers; Counseling; Drug usage; Educational workshop; Electronics; Ensure; Evidence based practice; Focus Groups; Frequencies; Goals; Handheld Computers; Happiness; Health; Health Services; Individual; Internet; Intervention; Interview; Journals; Knowledge; Lead; Measures; Meta-Analysis; Methods; Modeling; Outcome; Patients; Pharmaceutical Preparations; Pharmacotherapy; Primary Health Care; Provider; Public Health; Publications; Randomized; Readiness; Relative (related person); Research; Resources; Sampling; Schedule; Science; Self Efficacy; Services; Site; Smoker; Smoking; Societies; Surveys; System; Tablets; Technology; Telephone; Testing; Time; Visit; Work; base; behavioral health; computer design; computer studies; design; evidence base; follow-up; implementation science; improved; informant; nicotine replacement; primary care setting; programs; provider intervention; quitline; service intervention; skills; smoking cessation; social norm; success; symposium; tool; uptake; varenicline

DESCRIPTION (provided by applicant): This study tests the use of handheld computer tablets to promote the integration of 5A's for smoking cessation in academic and community primary care clinics. Although most patients receive the "ask" and "advise" steps, only slightly more than half are "assessed" for readiness to change, less than half receive "assistance" in changing, and only 9% have an "arranged" follow-up. While the large majority of primary care providers support the 5A's model, negative attitudes and the lack of time, knowledge, and cessation skills are common obstacles. Alternate service delivery systems that address these obstacles and evidence-based strategies to promote their implementation are needed to improve provider adherence and 5A's fidelity. This proposal develops and tests a computer-facilitated 5A's (CF-5A's) model that administers the 5A's intervention to patients then prompts providers for reinforcing next steps. CF-5A's could efficiently and effectively promote smoking cessation while educating providers about cessation resources and appropriate follow-up. Based on the Technology Acceptance Model, clinically tailored strategies to promote CF-5A's implementation will be developed and tested to ensure the appropriate use and uptake of this new service delivery model. Although focused on 5A's for smoking cessation, this study examines the underlying implementation science of computer-aided service delivery models with important implications for the integration of other substance use or behavioral health interventions in primary care. A careful, mixed methods exploration and testing of key implementation factors is used to help build evidence-based strategies to improve the integration of behavioral health services in primary care settings. The goals of this implementation study will be achieved in 4 specific aims: AIM 1: Develop a computer facilitated 5A's (CF-5A's) service delivery model and implementation plan to promote smoking cessation in primary care. AIM 2: Evaluate the CF-5A's service delivery model by comparing randomized intervention and control providers in academic and community primary care clinics. AIM 3: Identify and evaluate individual, clinic, and systems level implementation outcomes and predictors of implementation success using a mixed methods design. AIM 4: Disseminate the CF-5A's and implementation interventions to a national sample of academic and community clinics.

描述（由申请人提供）：这项研究测试了使用手持计算机平板电脑来促进5A在学术和社区初级保健诊所中戒烟的整合。尽管大多数患者都会收到“询问”和“建议”步骤，但“评估”只有一半以上，以准备改变，不到一半的变化中获得“援助”，只有9％的人进行了“安排”的后续行动。尽管绝大多数初级保健提供者都支持5A的模型，但负面态度以及缺乏时间，知识和戒烟技巧是常见的障碍。需要解决这些障碍和基于证据的策略以促进其实施的替代服务交付系统，以提高提供商的依从性和5A的忠诚。 该提案开发并测试了计算机相关的5A（CF-5A）模型，该模型将5A的干预措施用于患者，然后促使提供者加强下一步。 CF-5A可以有效地有效地促进戒烟，同时对提供者进行戒烟资源和适当的随访。基于技术接受模型，将开发和测试临床量身定制的促进CF-5A实施的策略，以确保适当使用和采用这种新的服务交付模型。 尽管专注于戒烟的5A，但本研究研究了计算机辅助服务交付模型的基本实施科学，对在初级保健中其他物质使用或行为健康干预措施的整合具有重要意义。仔细的，混合的方法探索和对关键实施因素的测试用于帮助建立基于证据的策略，以改善在初级保健环境中行为健康服务的整合。这项实施研究的目标将在4个具体目标中实现：目标1：开发促进5A（CF-5A）服务交付模型和实施计划，以促进初级保健中的戒烟。 AIM 2：通过比较学术和社区初级保健诊所中的随机干预和控制提供者来评估CF-5A的服务提供模型。 AIM 3：使用混合方法设计确定和评估个人，诊所和系统级别的实施成果和实施成功的预测指标。 AIM 4：将CF-5A和实施干预措施传播到国家学术和社区诊所样本中。