Exploring a Cessation Intervention for Low Income Smokers in an Emergency Setting

探索紧急情况下低收入吸烟者的戒烟干预措施

基本信息

批准号：
8337391
负责人：
E. Melinda Mahabee-Gittens
金额：
$ 19.25万
依托单位：
CINCINNATI CHILDRENS HOSP MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-22 至 2014-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8337391
关键词：
Abstinence Accident and Emergency department Acute Address Adult Affect Cancer Control Carbon Monoxide Child Child health care Childhood Clinical Practice Guideline Counseling Data Development Development Plans Effectiveness Electronic Health Record Electronic Mail Emergency Situation Environmental Tobacco Smoke Focus Groups Future Goals Grant Growth Health Hospital Administrators Household Intervention Interview K-Series Research Career Programs Low income Malignant Neoplasms Methods Modeling Morbidity - disease rate Motivation Nurses Outcome Parents Patient Self-Report Phase Physicians Preparation Prevalence Randomized Controlled Trials Recruitment Activity Research Research Personnel Resources Scientist Smoke Smoker Smoking Cessation Intervention Telephone Testing Text Tobacco Tobacco Dependence Tobacco Use Cessation Tobacco use Training Translating Translations Visit Work base brief intervention career career development effective intervention efficacy testing financial incentive follow-up health belief health disparity improved innovation interest intervention effect nicotine replacement preference prevent primary outcome prospective public health relevance quitline randomized trial screening and brief intervention screening, brief intervention, referral, and treatment secondary outcome smoking cessation success tobacco screening trend

项目摘要

Exploring a Cessation Intervention for Low Income Smokers in an Emergency Setting An estimated 6.6 million parents who smoke visit pediatric emergency departments (PED) annually. Up to 50% of these parental smokers are from low-income, racially/ethnically diverse households in which a variety of tobacco-related disparities exist for both the parents and their children. The PED is an ideal and innovative setting in which to address these disparities, which include differences in tobacco use, pediatric second hand smoke exposure (SHSe), quit rates, access to cessation resources, and morbidity such as cancer. The proposed Career Development Award application will facilitate the candidate's growth as an independent cancer control physician scientist conducting research in the PED setting. The long-term career goal of the candidate is to become an effective independent researcher able to conduct parental cessation interventions in the PED that are readily translated into practice. The candidate's immediate career goal is to develop and test a cessation intervention for low-income smokers in the PED. To achieve this goal, the candidate proposes a career development plan that includes professional development, grant preparation, and a research plan to collect pilot data. The proposed research plan extends the candidate's prior smoking cessation work in the PED setting which indicates that parental smokers who visit the PED are aware of the pediatric effects of SHSe, motivated to quit, and eager to receive cessation counseling in this setting. The proposed research will be conducted in two phases. During Phase I, we will explore the types of interventions acceptable to low- income parental smokers via focus groups. Focused interviews of PED nurses, physicians, and hospital administrators will be conducted to explore barriers to intervention sustainability that will assist in future intervention planning. This data will be used to develop a PED-based parental cessation intervention. During Phase II, we will conduct a pilot prospective trial to examine the effectiveness of our screening, brief intervention, and referral to treatment (SBIRT) intervention on parental smoking cessation. Equal numbers of parental smokers who bring their child to the PED for either a SHSe-related illness or non SHSe-related illness will be given a brief intervention using an adapted form of the Clinical Practice Guideline: Treating Tobacco Use and Dependence. Intervention components may include brief cessation counseling using an "Advise, Assess, and Assist" approach; information on SHSe in children; direct connection to the Quitline (QL) in the PED; and/or free administration of nicotine replacement therapy (NRT). The Health Belief Model will be used to explore whether factors unique to this setting (e.g., child's acute illness) moderate the effect of the intervention on cessation outcomes. Outcomes will be assessed following the intervention via phone, email, or text messaging. If effective, this intervention could reduce health disparities related to tobacco use, by improving treatment and preventing tobacco-related morbidities in low-income, racially/ethnically diverse smokers.

探索紧急情况下低收入吸烟者的戒烟干预措施据估计，每年有 660 万吸烟父母到儿科急诊室 (PED) 就诊。高达 50% 这些父母吸烟者来自低收入、种族/民族多样化的家庭，其中有各种父母及其子女都存在与烟草有关的差异。 PED 是一种理想且创新的解决这些差异的环境，包括烟草使用、儿科二手货的差异烟雾暴露 (SHSe)、戒烟率、获得戒烟资源的机会以及癌症等发病率。这拟议的职业发展奖申请将促进候选人作为独立人士的成长癌症控制医师科学家在 PED 环境中进行研究。的长期职业目标候选人将成为一名有效的独立研究人员，能够在以下方面进行父母戒烟干预： PED 很容易转化为实践。候选人的近期职业目标是开发和测试 PED 中针对低收入吸烟者的戒烟干预措施。为了实现这一目标，候选人提出职业发展计划，包括专业发展、资助准备和研究计划收集试点数据。拟议的研究计划将候选人之前的戒烟工作扩展到了 PED 设置表明访问 PED 的父母吸烟者了解吸烟对儿科的影响 SHSe，有戒烟动机，并渴望在这种情况下接受戒烟咨询。拟议的研究将分两个阶段进行。在第一阶段，我们将探索低收入人群可接受的干预措施类型通过焦点小组为父母吸烟者带来收入。对 PED 护士、医生和医院的重点访谈管理人员将探索干预可持续性的障碍，这将有助于未来干预计划。该数据将用于开发基于 PED 的父母戒烟干预措施。期间第二阶段，我们将进行一项试点前瞻性试验，以检查我们筛选的有效性，简要对父母戒烟的干预和转介治疗（SBIRT）干预。数量相等因 SHSe 相关疾病或非 SHSe 相关疾病将孩子带到 PED 的父母吸烟者将使用临床实践指南的改编形式进行简短的干预：治疗烟草使用和依赖。干预措施可能包括使用“建议、评估和协助”方法；有关儿童 SHSe 的信息；直接连接到戒烟热线 (QL) PED；和/或免费给予尼古丁替代疗法（NRT）。健康信念模型将用于探讨该环境特有的因素（例如儿童的急性疾病）是否会调节干预措施的效果关于戒烟结果。干预后将通过电话、电子邮件或短信评估结果消息传递。如果有效，这种干预措施可以通过改善吸烟率来减少与烟草使用相关的健康差异治疗和预防低收入、不同种族/民族吸烟者的烟草相关疾病。