Electronic Pediatric Office Systems to Support Treatment for Parental Tobacco Use

电子儿科办公系统支持父母吸烟治疗

基本信息

批准号：
10322999
负责人：
Alexander Gabriel Fiks
金额：
$ 96.07万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-01-01 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10322999
关键词：
Accounting Address Adoption Adult Affect Cancer Burden Cancer Patient Carbon Monoxide Cessation of life Child Child health care Childhood Community Health Contracts Cotinine Counseling Data Developmental Delay Disorders Disease Documentation Early Diagnosis Effectiveness Electronic Health Record Electronic cigarette Enrollment Ensure Exposure to Family Fire - disasters Funding Future Goals Health Health Benefit Health Personnel Health Services Accessibility Health system Home Home visitation Household Insurance Coverage Intervention Interview Life Expectancy Link Malignant Neoplasms Medicaid Minority Morbidity - disease rate Outcome Parents Persons Population Pregnancy Outcome Prevention Quality of life Randomized Randomized Controlled Trials Research Resources Risk Schools Services Smoke Smoke-free home Smoker Smoking Smoking Cessation Intervention Surveys System Telephone Testing Time Tobacco Tobacco Dependence Tobacco Use Cessation Tobacco smoke Tobacco use United States Visit Work arm base compare effectiveness comparison intervention cost cost effective cost effectiveness design eVisit effectiveness testing evidence base follow-up free behavior health care delivery health care settings household tobacco use implementation framework implementation intervention improved innovation medically underserved member mortality nicotine replacement nicotine use quitline screening service delivery smoking cessation suburb success survivorship therapy duration thirdhand smoke three-arm study tobacco cessation intervention tobacco control tobacco smoke exposure tobacco user tobacco-free treatment arm treatment as usual

项目摘要

Project Summary/Abstract When parents quit smoking, their life expectancy is increased by an average of over 10 years, future tobacco- related poor pregnancy outcomes are eliminated, their children have much lower odds of becoming adult smokers, and their children may no longer be exposed to high levels of tobacco smoke, decreasing the odds of contracting diseases caused by tobacco smoke exposure and resulting in fewer missed school days. Helping parents and household members quit smoking also improves the financial resources of families, decreases the risk of developmental delays, and lowers the risk of house fires. Parents who smoke are often medically underserved, visiting their child's healthcare provider more often than they see their own clinician, if they even have one. Despite this extraordinary opportunity for intervention, child healthcare settings deliver effective tobacco dependence treatment to parents less than 2% of the time. Routinely delivered tobacco control to parents in child healthcare settings would benefit the overall health of the nation. The goal of the proposed study is to ensure that every parent who smokes tobacco or is a dual user of tobacco and e-cigarettes and visits their child's doctor receives evidence-based assistance to quit. We propose testing an innovative EHR systems platform (iEHR) in pediatric practices. The iEHR will facilitate universal screening for household tobacco use and routine offering and provision, if desired, of tobacco cessation services. We will compare this intervention to iEHR + navigator to test the effectiveness of additional support by a community health navigator. The navigator will work with pediatric offices to assist household tobacco users in cessation through telephone follow-up, ensuring access to services, and home visits, based on what they want to help them quit smoking. This trial will address critical unanswered questions of effectiveness, sustainability, and cost-effectiveness of a parental tobacco cessation intervention that supports delivery of tobacco cessation services using iEHR, with or without a navigator. This proposal is in exact alignment with NCI's objective to fund research to reduce the burden of cancer for patients and other affected persons through improvements in early detection, prevention, healthcare delivery, quality of life, and/or survivorship related to cancer. Aims are: A1. To compare parents' combusted tobacco quit rates, and adoption of tobacco free behaviors between the two intervention arms (1°: iEHR+Navigator vs. iEHR; 2°: each intervention vs. usual care control) A2. To establish the incremental cost per quit of the two intervention arms vs. usual care control A3. To assess the delivery and sustainability of the interventions Building on the success of past trials, this application will evaluate an innovative EHR-linked tobacco cessation intervention addressing household tobacco use with and without navigator support. The study is designed to yield fully-integrated, cost-effective, disseminable, and sustainable strategies to optimize parental cessation outcomes throughout child healthcare settings nationally.

项目概要/摘要当父母戒烟后，他们的预期寿命平均增加10岁以上，未来的烟草- 相关的不良妊娠结局被消除，他们的孩子成年的几率要低得多吸烟者及其孩子可能不再接触高浓度的烟草烟雾，从而降低了吸烟的几率感染因接触烟草烟雾而引起的疾病，并减少缺课时间。父母和家庭成员戒烟还可以改善家庭的经济来源，减少吸烟的风险。吸烟的父母通常会出现发育迟缓的风险，并降低房屋火灾的风险。服务不足，去看孩子的医疗保健提供者的次数比去看自己的临床医生的次数还要多，即使他们甚至尽管有这样一个绝佳的干预机会，但儿童保健机构仍能提供有效的帮助。对父母进行烟草依赖治疗的比例低于 2%。儿童保健机构中的父母将有利于国家的整体健康。研究旨在确保每位吸烟或同时使用烟草和电子烟的父母并拜访孩子的医生，接受基于证据的戒烟援助。儿科实践中的创新 EHR 系统平台 (iEHR) iEHR 将促进普遍筛查。家庭烟草使用以及日常提供和提供（如果需要）戒烟服务。将此干预措施与 iEHR + 导航器进行比较，以测试社区额外支持的有效性健康导航器将与儿科办公室合作，帮助家庭吸烟者戒烟。根据他们想要帮助的内容，通过电话跟进、获得服务和家访这项试验将解决有效性、可持续性和戒烟等关键的未解答问题。支持戒烟的父母戒烟干预措施的成本效益该提案与 NCI 的目标完全一致。研究基金旨在通过改进技术来减轻患者和其他受影响者的癌症负担与癌症相关的早期检测、预防、医疗保健、生活质量和/或生存目标是： A1. 比较父母的戒烟率以及无烟行为的采用情况两个干预组（1°：iEHR+Navigator 与 iEHR；2°：每次干预与常规护理控制） A2. 确定两个干预组与常规护理对照的每次戒烟增量成本 A3. 评估干预措施的实施和可持续性基于过去试验的成功，该应用程序将评估一种创新的电子病历相关烟草在有或没有导航器支持的情况下解决家庭烟草使用问题的戒烟干预措施。研究旨在产生完全整合的、具有成本效益的、可传播的和可持续的战略，优化全国儿童医疗保健机构中父母戒烟的结果。