Development and Implementation of a Tobacco and ENDS Use Intervention for Adolescents and Young Adults in the Pediatric Hospital

针对儿科医院青少年和年轻人制定和实施烟草和电子尼古丁传送系统使用干预措施

• 批准号: 10621209
• 负责人: Abbey Masonbrink
• 金额: $ 18.95万
• 依托单位: CHILDREN'S MERCY HOSP (KANSAS CITY, MO)
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10621209
• 关键词: Abstinence; Academy; Acute; Address; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Alcohol consumption; Alcohols; American; Asthma; Behavior Therapy; Biochemical; Caring; Cigarette; Clinical; Complex; Consolidated Framework for Implementation Research; Counseling; Data; Decision Support Systems; Development; Devices; Diabetes Mellitus; Disease; Disease Outbreaks; Effectiveness; Electronic Nicotine Delivery Systems; Electronic cigarette; Electronics; Evaluation; Feedback; Future; Goals; Guidelines; Health; Health Educators; Healthcare Systems; High School Student; Hospitalization; Hospitalized Adolescent; Hospitals; Hybrids; Intervention; Intervention Trial; Link; Medical; Mental disorders; Middle School Student; Nicotine Withdrawal; Outcome; Parents; Patient Self-Report; Patients; Pediatric Hospitals; Pediatrics; Pharmacotherapy; Pilot Projects; Populations at Risk; Prevalence; Primary Care; Process; Provider; Randomized; Recommendation; Reporting; Research; Research Activity; Risk; Substance Use Disorder; Techniques; Testing; Tobacco; Tobacco use; United States; United States Preventative Services Task Force; Visit; Work; Youth; care coordination; cigarette smoking; combustible cigarette; comorbidity; computerized; contextual factors; critical developmental period; design; disability; efficacy evaluation; efficacy outcomes; evidence base; follow-up; hospital care; implementation barriers; implementation evaluation; implementation facilitators; implementation framework; implementation intervention; implementation measures; implementation outcomes; implementation trial; improved; intervention refinement; motivational enhancement therapy; novel; pilot test; pilot trial; poor health outcome; preventable death; primary care setting; primary care visit; primary outcome; randomized trial; respiratory; screening; secondary outcome; skills; substance use treatment; support tools; therapy design; tobacco control; tobacco products; tobacco user; vape pens; vaping; vaping associated lung injury; Abstinence; Academy; Acute; Address; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Alcohol consumption; Alcohols; American; Asthma; Behavior Therapy; Biochemical; Caring; Cigarette; Clinical; Complex; Consolidated Framework for Implementation Research; Counseling; Data; Decision Support Systems; Development; Devices; Diabetes Mellitus; Disease; Disease Outbreaks; Effectiveness; Electronic Nicotine Delivery Systems; Electronic cigarette; Electronics; Evaluation; Feedback; Future; Goals; Guidelines; Health; Health Educators; Healthcare Systems; High School Student; Hospitalization; Hospitalized Adolescent; Hospitals; Hybrids; Intervention; Intervention Trial; Link; Medical; Mental disorders; Middle School Student; Nicotine Withdrawal; Outcome; Parents; Patient Self-Report; Patients; Pediatric Hospitals; Pediatrics; Pharmacotherapy; Pilot Projects; Populations at Risk; Prevalence; Primary Care; Process; Provider; Randomized; Recommendation; Reporting; Research; Research Activity; Risk; Substance Use Disorder; Techniques; Testing; Tobacco; Tobacco use; United States; United States Preventative Services Task Force; Visit; Work; Youth; care coordination; cigarette smoking; combustible cigarette; comorbidity; computerized; contextual factors; critical developmental period; design; disability; efficacy evaluation; efficacy outcomes; evidence base; follow-up; hospital care; implementation barriers; implementation evaluation; implementation facilitators; implementation framework; implementation intervention; implementation measures; implementation outcomes; implementation trial; improved; intervention refinement; motivational enhancement therapy; novel; pilot test; pilot trial; poor health outcome; preventable death; primary care setting; primary care visit; primary outcome; randomized trial; respiratory; screening; secondary outcome; skills; substance use treatment; support tools; therapy design; tobacco control; tobacco products; tobacco user; vape pens; vaping; vaping associated lung injury

Project Summary Tobacco use is the single leading cause of preventable death, disability and disease in the United States. Adolescence is a critical developmental period to intervene as 90% of adult tobacco users initiate during this period. Use of electronic nicotine delivery system (ENDS), which are noncombustible tobacco products (e.g., e-cigarettes), has increased dramatically among youth and is associated with numerous adverse health outcomes as well as use of alcohol and other illicit substances. National guidelines recommend counseling to address tobacco use at every adolescent clinical visit; however, many at-risk adolescents do not routinely attend primary care. There are more than 1.5 million adolescent hospitalizations annually and many of these patients are at increased risk for tobacco use and tobacco-related poor health outcomes due to underlying comorbidities (e.g., mental health disorders, substance use disorders, asthma). Although evidence supports treatment of tobacco use during an adult hospitalization, no interventions have been developed or tested in the pediatric hospital setting. Based on promising theoretically-based evidence from the primary care and hospital settings, we propose to design, iteratively refine and assess implementation of a novel tobacco and ENDS use intervention for hospitalized adolescents and young adults (AYAs). We will develop the intervention to treat tobacco and ENDS use in hospitalized AYAs utilizing the 5A’s framework with motivational interviewing, pharmacotherapy and computerized decision support tools. We will iteratively refine the intervention based on key stakeholder feedback, including AYAs, parents/guardians and hospital providers. We will conduct a randomized controlled pilot study (n=144) with 3-month follow up to evaluate preliminary efficacy as well as implementation outcomes (i.e., acceptability, feasibility, fidelity). Through conduct of these formative research activities I will gain critical skills and expertise in the design and preliminary evaluation of behavioral interventions within the context of complex health care systems. We anticipate these findings will directly inform future plans for a hybrid implementation trial of the intervention to determine efficacy for short and long- term ENDS abstinence. This work is significant as it has the potential to increase screening and treatment of tobacco and ENDS use in AYAs leading to decreased rates of use and related poor health outcomes.

项目摘要 烟草使用是美国可预防死亡，残疾和疾病的单一主要原因。 青春期是干预的关键发展时期，因为在此期间有90％的成年烟草使用者发起 时期。使用电子尼古丁递送系统（末端），这些输送系统是不可抗性的烟草产品（例如， 电子烟），在青年中急剧增加，与许多不良健康有关 结果以及使用酒精和其他非法物质。国家准则建议咨询 在每次青春期临床访问中使用烟草使用；但是，许多处于危险的青少年并不常规 参加初级保健。每年有超过150万个青少年住院治疗 患者的使用风险增加了烟草使用和与烟草相关的不良健康结果的风险 合并症（例如，心理健康障碍，药物使用障碍，哮喘）。尽管证据支持 在成人住院期间治疗烟草使用的治疗，未在 小儿医院的环境。基于从初级保健和医院提供的理论证据 设置，我们建议设计，迭代地完善和评估新颖的烟草，并结束使用 干预住院的青少年和年轻人（AYAS）。我们将开发干预措施以治疗 烟草和结束在住院的AYA中使用5A的框架，并进行励志采访， 药物治疗和计算机决策支持工具。我们将根据基于 主要利益相关者的反馈，包括AYA，父母/监护人和医院提供者。我们将进行 随访的随机对照试验研究（n = 144），随访3个月，以评估初步效率以及 实施结果（即可接受性，可行性，保真度）。通过这些形成性研究 活动我将在行为的设计和初步评估中获得关键的技能和专业知识 在复杂的医疗保健系统的背景下进行干预。我们预计这些发现将直接 告知未来计划进行干预的混合实施试验，以确定短期和长期的效率 术语结束节制。这项工作很重要，因为它具有增加筛查和处理的潜力 烟草和末端在AYA中使用，导致使用率降低和相关的健康状况不佳。