Phone Enabled Implementation of Cessation Support (PHOENICS)

通过电话实施戒烟支持 (PHOENICS)

基本信息

批准号：
10701705
负责人：
Rima Nakkash
金额：
$ 52.47万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-09 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10701705
关键词：
Abstinence Address Administrator Adoption Adult American Behavioral Cancer Control Carbon Monoxide Cigarette Smoker Clinic Counseling Country Exploration, Preparation, Implementation, and Sustainment Female Focus Groups Fostering Goals Health Personnel Health system Hybrids Incidence Income Infrastructure Institution Intervention Interview Lebanon Malignant neoplasm of lung Measures Medical center Mediterranean Region Methods Modeling Morbidity - disease rate Patient Self-Report Patients Persons Pharmacotherapy Population Prevalence Primary Care Primary Health Care Protocols documentation Provider Public Health Recommendation Research Resource-limited setting Resources Services Smoke Smoker Smoking Cessation Intervention Surveys System Telephone Testing Tobacco Tobacco Dependence Tobacco use Universities World Health Organization arm brief advice cancer prevention comparative effectiveness contextual factors cost cost effective cost effectiveness design dissemination science effectiveness testing evidence base follow-up health training hookah implementation determinants implementation evaluation implementation process implementation science implementation/effectiveness interest low and middle-income countries male mortality multi-component intervention nicotine replacement primary care patient primary care setting primary health center programs public health relevance randomized trial reduce tobacco use safety net smoking cessation standard care success treatment program trial comparing

项目摘要

PROJECT SUMMARY The objective of this proposal is to evaluate the comparative effectiveness of promising multi-component interventions for implementing evidence-based tobacco treatment in Lebanon’s national system of safety net primary healthcare centers, which serves more than 50% of the population. This objective is directly responsive to NCI Notice of Special Interest (NOT-CA-20-025): Dissemination and Implementation Science for Cancer Prevention and Control in Low Resource Environments. The tobacco use burden in Lebanon is exceptionally high: 35% of adults are current cigarette smokers, 39% are waterpipe smokers, and 5% are dual smokers. The WHO endorses three interventions as the standard of practice for population-level tobacco dependence treatment: smoking cessation advice integrated into primary care settings; easily-accessible phone-based counseling; and low-cost nicotine replacement therapy (NRT). However, the evidence for these interventions comes primarily from high-income countries and they have rarely been evaluated in low- and middle-income countries (LMICs). Further, recommended interventions are not integrated as a routine part of primary care in Lebanon, as is the case in other low-resource settings. Addressing this evidence-to-practice gap requires research on multilevel interventions and contextual factors for implementing integrated, scalable, and sustainable cessation treatment within low-resource settings. We will conduct a group-randomized trial comparing three arms: 1) Ask about tobacco use, advise to quit, assist with brief counseling (AAA) as standard care; 2) Ask, advise, connect to phone-based counseling (AAC); and 3) AAC+NRT. Our central hypothesis is that connecting patients to phone-based counseling with NRT is the most effective alternative. Our hybrid design is informed by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework which emphasizes key steps and multilevel factors to optimize implementation success. We will pursue the following specific aims: 1) adapt and tailor an existing smoking cessation program to deliver phone-based counseling to smokers in Lebanon; 2) test the effectiveness and cost-effectiveness of a referral-based program that delivers smoking cessation services to primary care patients; and 3) identify the multilevel determinants of implementation and sustainability using mixed methods. The proposed project addresses the evidence-to- practice gap in the provision of tobacco dependence treatment within low-resource settings by developing and testing contextually-tailored multilevel interventions and optimizing implementation success and sustainability. This research is significant for its potential to guide the large-scale adoption of cost-effective strategies for implementing tobacco dependence treatment in low-resource settings thereby reducing tobacco-related morbidity and mortality.

项目摘要该提案的目的是评估承诺多组分的比较有效性在黎巴嫩国家安全网络中实施基于证据的烟草治疗的干预措施初级医疗保健中心为超过50％的人口提供服务。这个目标直接响应NCI特殊利益通知（Not-CA-20-025）：传播和实施科学在低资源环境中预防和控制癌症。黎巴嫩伯恩的烟草使用是异常高：35％的成年人是目前的吸烟者，39％是吸水者，而5％是双重吸烟者吸烟者。世卫组织认可三项干预措施，作为人群水平烟草的实践标准依赖治疗：纳入初级保健环境中的戒烟建议；易于访问基于电话的咨询；和低成本尼古丁替代疗法（NRT）。但是，这些证据干预措施来自高收入国家，在低收入和中等收入国家（LMIC）。此外，建议的干预措施未作为常规部分集成黎巴嫩的初级保健，就像其他低资源环境一样。解决这一证据对实践差距需要研究多层次干预措施和上下文因素，以实施集成，可扩展，以及在低资源环境中的可持续戒烟处理。我们将进行集体式试验比较三个武器：1）询问烟草使用，建议退出，协助简短咨询（AAA）作为标准关心; 2）询问，建议，连接到基于电话的咨询（AAC）； 3）AAC+NRT。我们的中心假设是将患者与NRT与电话咨询联系起来是最有效的替代方法。我们的混合动力设计由探索，准备，实施，维持框架（ESIP）框架告知强调关键步骤和多层次因素以优化实施成功。我们将追求以下具体目的：1）适应和量身定制现有的戒烟计划，以提供基于电话的咨询黎巴嫩吸烟者； 2）测试提供的基于推荐的程序的有效性和成本效益为初级保健患者提供戒烟服务； 3）确定使用混合方法实施和可持续性。拟议的项目解决了证据与通过开发和测试上下文规定的多层次干预措施，并优化实施成功和可持续性。这项研究很重要，因为它有可能指导大规模采用具有成本效益的策略在低资源环境中实施烟草依赖治疗，从而减少与烟草有关的发病率和死亡率。