Social-Ecological Framework to Improve Youth Smoking Outcomes

改善青少年吸烟结果的社会生态框架

• 批准号: 9063190
• 负责人: Steven A. Branstetter
• 金额: $ 6.54万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9063190
• 关键词: Address; Adoption; Adult; Air; American Lung Association; Case Study; Centers for Disease Control and Prevention (U.S.); Cessation of life; Cigarette; Complex; County; Data; Data Analyses; Data Set; Demographic Factors; Development; Disease; Economic Factors; Economics; Effectiveness; Enrollment; Environment; Epidemic; Equation; Goals; Habits; Health; Health Promotion; Health Services Accessibility; Individual; Intervention; Knowledge; Left; Linear Models; Maintenance; Measurable; Measures; Methodology; Methods; Modeling; Nature; Outcome; Pathway interactions; Policies; Political Factor; Price; Program Effectiveness; Public Health; Publications; Readiness; Reporting; Research; Sampling; Schools; Smoke; Smoker; Smoking; Smoking Behavior; Smoking Status; Social Network; Source; Students; System; Taxation; Taxes; Teenagers; Tobacco; Tobacco smoke; Tobacco use; Translating; Treatment Effectiveness; Withholding Treatment; Youth; base; cost effective; demographics; effectiveness trial; efficacy trial; improved; model building; programs; relational database; smoking cessation; smoking intervention; smoking prevalence; social; theories; tobacco control; uptake

DESCRIPTION (provided by applicant): The proposed study is guided by a Social-Ecological Model, with the goal to rapidly uncover optimal conditions for effectiveness, reach, and adoption of the American Lung Association's Not On Tobacco teen smoking cessation program, the most widely used teen cessation program in the US. Our proposal capitalizes on existing data from multiple sources, forming a unique N-O-T Social Ecological Relational Database. Central to the relational database is our newly-formed N-O-T Master Dataset that aggregates 12 years (1998-2010) of N-O-T efficacy and effectiveness trials with a heterogeneous sample of N=11,000 teens from CO, FL, NC, NJ, WI, and WV. The overriding research question is: What factors favorably moderate the relationship between macro-level economic, political, and demographic conditions and N-O-T effectiveness, reach, and adoption outcomes as identified in the RE-AIM framework? As a theory-driven, cost effective program N-O-T has received multiple federal model designations for effectiveness and scalability. Yet, program reach is a significant problem, with hundreds of thousands of teen smokers left unserved. To illustrate, N-O-T reaches <1% of teen smokers in WV, where teen smoking rates are among the nation's highest. Addressing this gap requires research to identify policy and systems strategies that will enhance the reach, adoption, and effectiveness of cessation programs. Accordingly, we propose an intensive 3-year study intended to rapidly enhance widespread N-O-T use and thereby reduce US youth smoking prevalence. Our model builds on empirically-based factors associated with tobacco use. Applying Hierarchical Linear Modeling (HLM) and Structural Equation Modeling (SEM) and beginning with moderators having the most compelling scientific evidence (e.g., tobacco tax, CIA, access, norms, and readiness to quit), we propose to characterize the effects of moderators (e.g., tobacco tax, tobacco price, clean indoor air, and school environment) on the relation between political, economic, and demographic factors and N-O-T program effectiveness; to determine optimal conditions for N-O-T reach and adoption; and to translate findings into a set of practical action strategies that can be implemented immediately to substantially increase the number of US youths who receive N-O-T and achieve cessation.

描述（由申请人提供）：拟议的研究以社会生态模型为指导，目的是快速揭示最佳条件，以实现有效性，触及和采用美国肺部协会的“不进行烟草青少年戒烟计划”，这是美国最广泛使用的青少年戒烟计划。我们的提案将来自多个来源的现有数据大写，形成了独特的N-O-T社会生态关系数据库。关系数据库的核心是我们新成型的N-O-T主数据集，该数据集汇总了N-O-T效力和有效性试验的12年（1998-2010），其n = 11,000名来自CO，FL，NC，NC，NJ，WI和WV的N = 11,000青少年的异质样本。最重要的研究问题是：哪些因素可以缓解宏观级别的经济，政治和人口条件与n-O-T有效性，覆盖范围和采用结果之间的关系，以及RE-AIM框架中确定的结果？作为一个理论驱动的，具有成本效益的计划，N-O-T已获得多个联邦模型指定，以实现有效性和可扩展性。然而，计划范围是一个重大问题，成千上万的青少年吸烟者没有被遗忘。为了说明，N-O-T达到了WV中青少年吸烟者的1％，那里的青少年吸烟率是全美最高的。解决这一差距需要研究以确定将增强戒烟计划的影响，采用和有效性的政策和系统策略。因此，我们提出了一项密集的3年研究，旨在迅速增强广泛的N-O-T使用，从而降低美国青年吸烟率。我们的模型基于与烟草使用相关的基于经验的因素。 Applying Hierarchical Linear Modeling (HLM) and Structural Equation Modeling (SEM) and beginning with moderators having the most compelling scientific evidence (e.g., tobacco tax, CIA, access, norms, and readiness to quit), we propose to characterize the effects of moderators (e.g., tobacco tax, tobacco price, clean indoor air, and school environment) on the relation between political, economic, and demographic factors和N-O-T计划有效性；确定N-O-T范围和采用的最佳条件；并将发现转化为一系列可以立即实施的实际行动策略，以实质上增加接受N-O-T并实现停止的美国青年人数。

项目成果

School-level disadvantage and failed cessation treatment among adolescent smokers.

青少年吸烟者的学校水平劣势和戒烟治疗失败。

• DOI: 10.18332/tpc/87074
• 发表时间: 2018
• 期刊: Tobacco prevention & cessation
• 影响因子: 1.8
• 作者: Horn,Kimberly;Ali,Maliha;Gray,Tiffany;Anesetti-Rothermel,Andrew;Branstetter,Steve
• 通讯作者: Branstetter,Steve