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: 10627795
• 负责人: Amy K Ferketich
• 金额: $ 16.34万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-11 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10627795
• 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; Eligibility Determination; 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; Process; Protocols documentation; Provider; Readiness; Recommendation; 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 Dependence; Tobacco use; Training; United States Public Health Service; Woman; Work; arm; cancer risk; cervical cancer prevention; clinical practice; cost; design; effectiveness evaluation; effectiveness testing; effectiveness/implementation study; efficacy testing; evidence base; health care settings; high risk; implementation framework; implementation outcomes; implementation science; improved; innovation; insurance claims; intervention program; nicotine replacement; patient navigator; practice setting; prevention service; primary care practice; primary care setting; programs; rural patients; rural setting; satisfaction; smoking cessation; smoking prevalence; stem; telephone based; 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％）既整齐又两倍 国家率是该地区癌症高风险的主要贡献者。 （BF）将暗示和测试医疗保健提供者的有效性和受过训练的患者导航员交付 旨在减少综合宫颈癌内宫颈癌风险的戒烟间隔 BF预防计划是团队的可靠工作的结果 戒烟人群并将进行测试 通过计费成本恢复的可持续性。 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）。 在可持续性阶段，将比较延迟与早期干预系统 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 癌症风险风险风险/计划，结果和结果，威利是共同的核心 在其实施，测量，评估和展示过程中的协调过程。 沿三个不同级别的结果组织：1）服务结果：确定核心的效应 综合宫颈癌计划的组成部分，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： 级别的间隔和3）隐含结果：通过 培训提供者和员工咨询和计费以证据的戒烟服务。 成功实施了BF 提议在四个州中提出的可能通过改善农村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的戒烟处理 在诊所一级证明是可持续的，BF可以在农村阿斯帕拉奇亚（Asppalachia）以及 在其他服务不足的地理环境中进行医疗保健系统。