Project 1: Break Free: Effectiveness of a multi-level smoking cessation program adapted for high-risk women in rural communities

项目 1：Break Free：针对农村社区高危女性的多层次戒烟计划的有效性

• 批准号: 9913495
• 负责人: Amy K Ferketich
• 金额: $ 27.87万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9913495
• 关键词: Abstinence; Adult; Age; Appalachian Region; Attitude; Cervical; Cervical Cancer Screening; Characteristics; Client; Clinic; Clinical; Clinical Practice Guideline; Communities; Counseling; Early Intervention; Effectiveness; Electronic Health Record; Evaluation; Fees; Female; Free Will; Geography; Goals; Health Personnel; Health Services Accessibility; Health system; Healthcare Systems; High Risk Woman; Human Papilloma Virus Vaccination; Income; Intervention; Knowledge; Malignant neoplasm of cervix uteri; Measurement; Outcome; Patient Education; Patients; Pharmacotherapy; Phase; Prevention program; Primary Health Care; Process; Protocols documentation; Provider; Readiness; Recovery; Reporting; Research; Resources; Risk; Risk Factors; Risk Reduction; Rural; Rural Appalachia; Rural Community; Rural Health; Rural Population; Services; Smoker; Smoking; Smoking Cessation Intervention; Standardization; System; Telephone; Testing; Tobacco; Tobacco use; Training; United States Public Health Service; Woman; Work; arm; base; cancer risk; cervical cancer prevention; clinical practice; cost; design; effectiveness implementation study; effectiveness testing; efficacy testing; evidence base; health care settings; high risk; implementation science; improved; innovation; insurance claims; intervention program; nicotine replacement; practice setting; prevention service; primary care setting; programs; rural patients; satisfaction; smoking cessation; smoking prevalence; stem; therapy design; uptake

PROJECT SUMMARY – PROJECT 1 The prevalence of smoking (25 – 35%) in many underserved Appalachia communities is nearly double the national rate and is a major contributor to the high-risk for cervical cancer in the region. Project 1 – `Break Free' (BF) will implement and test the effectiveness of a healthcare provider- and trained patient navigator-delivered smoking cessation intervention designed to reduce cervical cancer risk within an integrated cervical cancer prevention program. BF is the result of previous work of the team in adapting an evidence-based smoking cessation program to rural populations and will be tested, refined and implemented to achieve high impact and sustainability through billable cost-recovery. BF utilizes a standard format of clinical delivery of Ask, Advise and Connect (AAC) followed by 4 sessions of proactive telephone-based counseling with Nicotine Replacement Therapy support delivered to 600 adult female smokers in primary care practices of 10 non-overlapping health systems in the Appalachian region of four states (KY, OH, VA, WV). BF will be extended to all eligible smokers in the sustainability phase. Delayed versus early intervention health system groups will be compared. Project 1 is closely coordinated with the overall Program Project by providing a key component of an integrated cervical cancer risk reduction/prevention program and its overall outcome and will rely on its shared Cores for harmonization in its implementation, measurement, evaluation and dissemination processes. Project 1 aims are organized along three distinct levels of outcomes: 1) Service outcomes: Determine the effectiveness of a core component of an integrated cervical cancer prevention program designed to help female smokers quit by standardizing clinical practice supports and protocols; 2) Client outcomes: Determine satisfaction with the multi- level intervention; and 3) Implementation outcomes: Test the sustainability of the multi-level intervention via training of providers and staff on counseling and billing for evidence-based smoking cessation services. Successful implementation of BF in the diverse set of rural Appalachian clinics in participating health systems proposed, across 4 states, has the potential for a substantial and sustained impact by improving rural patients' access to high quality, culturally sensitive, and local evidence-based smoking cessation treatment. If successfully shown to be sustainable at the clinic level, BF could be disseminated widely within rural Appalachia, as well as to healthcare systems in other underserved geographic settings.

项目摘要 - 项目1 在许多服务不足的阿巴拉契亚社区中，吸烟的患病率（25 - 35％）几乎是一倍 全国性率，是该地区宫颈癌高风险的主要贡献者。项目1 - “休息免费” （BF）将实施和测试医疗保健提供者和受过训练的患者导航员的有效性 旨在降低综合宫颈癌中宫颈癌风险的戒烟干预措施 预防计划。 BF是团队以前工作改编基于证据的吸烟的结果 戒烟计划对粗略人口进行，并将进行测试，完善和实施，以实现高影响力和 可持续性通过可计费的成本恢复。 BF采用了临床交付，建议和的标准格式 连接（AAC），然后进行4次主动的基于电话的咨询，并替代尼古丁 在10个不重叠健康的初级保健实践中，提供给600名成年女性吸烟者的治疗支持 四个州的阿巴拉契亚地区的系统（KY，OH，VA，WV）。 BF将扩展到所有合格的吸烟者 在可持续性阶段。将比较延迟与早期干预卫生系统组。项目1 通过提供综合宫颈的关键组成部分，与整体计划项目密切协调 癌症风险降低/预防计划及其整体结果，并将依靠其共同核心 在其实施，测量，评估和传播过程中进行协调。项目1的目标是 沿三个不同级别的结果组织：1）服务结果：确定核心的有效性 综合宫颈癌预防计划的组成部分，旨在帮助女性吸烟者退出 标准化临床实践支持和方案； 2）客户结果：确定对多种多样的满意 水平干预； 3）实施结果：通过 培训提供者和员工咨询和计费以证据的戒烟服务。 在参与卫生系统中成功实施BF在农村阿巴拉契亚诊所的潜水 提议在4个州中提出的有可能通过改善粗糙的患者的重大影响而产生重大和持续的影响。 获得高质量，文化敏感和局部循证戒烟治疗的机会。如果成功 在诊所一级证明是可持续的，BF可以在艰难的阿巴拉契亚广泛传播，以及 在其他服务不足的地理环境中进行医疗保健系统。