Improving Pediatric Tobacco Control in Primary Care

改善初级保健中的儿科烟草控制

基本信息

批准号：
9189692
负责人：
Darren M Mays
金额：
$ 16.95万
依托单位：
GEORGETOWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-12-07 至 2018-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9189692
关键词：
Address Adult Advisory Committees Affordable Care Act Age Antismoking Behavior Behavior Therapy Behavioral Cessation of life Childhood Clinic Clinical Clinical Practice Guideline Clinical Trials Cognition Computerized Medical Record Counseling Data Disease Documentation Environment Family Family Smoking Prevention and Tobacco Control Act Goals Habits Health Healthcare Systems Individual Internet Intervention Malignant Neoplasms Medical Metric System Modeling Morbidity - disease rate National Cancer Institute Nurses Outcome Outpatients Patient Education Patients Physicians Population Predisposition Prevention Preventive Intervention Preventive service Primary Health Care Provider Public Health Quality of Care Recording of previous events Reminder Systems Reporting Research Resources Risk Risk Assessment Self Efficacy Smoker Smoking Smoking History Smoking Prevention Source Structure System Technical Expertise Teenagers Tobacco Tobacco use Trust Visit Washington Youth adolescent patient base cancer prevention cancer risk care delivery care systems cigarette smoking clinical care compliance behavior design efficacy study evidence base follow-up health information technology improved individualized prevention mortality novel prevent primary care setting prospective public health priorities public health relevance routine care screening skills therapy design tobacco control tobacco prevention tool treatment as usual uptake

项目摘要

DESCRIPTION (provided by applicant): Preventing youth tobacco use is a public health priority and critical to achieving our nation's cancer prevention goals. The U.S. Preventive Services Task Force recently concluded that youth tobacco use prevention interventions in primary care settings are an important component of this effort, but highlighted a need for more research on smarter ways to integrate tobacco use prevention into our healthcare system. This study addresses this need by evaluating a novel, system-based intervention to improve youth tobacco control outcomes in pediatric primary care. We will determine if an Ask, Advise, Connect (AAC) intervention model that leverages health information technology and behaviorally-based tobacco control resources can improve population- and patient-level outcomes. The model relies on efficient tobacco use history-taking and intervention by pediatric primary care providers (e.g., medical assistants, nurses, physicians), paired with referral to freely accessible, evidence-based online tobacco prevention resources to deter and disrupt tobacco use uptake. By analyzing the pediatric outpatient workflow, we will evaluate how AAC intervention strategies can be seamlessly integrated, including electronic medical record prompts and brief behavioral counseling strategies to motivate patient adherence. We will assess the impact of the AAC intervention on population-level outcomes using system metrics to document provider assessment, patient education and guidance on tobacco use avoidance, and anti-smoking resource referral. We will also examine reach of the AAC intervention by capturing population-level metrics of resource use based on provider referral, and prospectively examine its effect on individual-level outcomes (e.g., susceptibility to tobacco use, tobacco use-related cognitions, skills to avoid tobacco use) among a subsample of patients. This AAC approach could be critical to promoting better and more sustainable youth tobacco control by strengthening the pediatric primary care system's technical expertise and workforce capacities to eradicate youth tobacco use. It is highly consistent with the Patient Protection and Affordable Care Act and the Family Smoking Prevention and Tobacco Control Act in that it seeks to reduce the public health and societal burden of morbidity and mortality caused by tobacco use, and is fully aligned with National Cancer Institute tobacco control objectives in precision prevention of cancer risk.

描述（由申请人提供）：预防青少年吸烟是一项公共卫生优先事项，对于实现我国癌症目标至关重要。美国预防服务工作组预防最近得出结论，初级保健机构中的青少年吸烟预防干预措施是其中的重要组成部分。努力，但强调需要对将烟草使用预防纳入我们的医疗保健系统的更智能方法进行更多研究，通过评估一种新颖的、基于系统的干预措施来改善儿科初级保健中的青少年烟草控制结果，从而满足这一需求。如果一个询问、建议、联系 (AAC) 干预模型利用健康信息技术和基于行为的烟草控制资源，可以改善人群和患者层面的结果，该模型依赖于儿科初级保健提供者的烟草使用史记录和有效干预。通过分析儿科门诊工作流程，我们将评估如何无缝整合 AAC 干预策略。，包括电子病历我们将使用系统指标来记录提供者的评估、患者教育和关于避免吸烟的指导以及反吸烟资源转介，以评估 AAC 干预对人群水平结果的影响。还将通过根据提供者推荐获取人口层面的资源使用指标来检验 AAC 干预的影响范围，并前瞻性地检验其对个人层面结果的影响（例如，对烟草使用的易感性、与烟草使用相关的认知、避免吸烟的技能）使用）之间这种 AAC 方法对于通过加强儿科初级保健系统的技术专长和劳动力能力来根除青少年烟草使用，对于促进更好、更可持续的青少年烟草控制至关重要。它与《患者保护和平价医疗法案》高度一致。《家庭吸烟预防和烟草控制法》旨在减少烟草使用造成的发病率和死亡率的公共卫生和社会负担，并与国家癌症研究所精确预防癌症风险的烟草控制目标完全一致。