Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients.
Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients.
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嵌入式电子健康记录、基于行为科学的儿童患者家长戒烟系统。
DOI：
10.1055/s-0042-1748148
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发表时间：
2022
影响因子：
2.9
通讯作者：
Fiks,AlexanderG
中科院分区：
文献类型：
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作者：
Jenssen,BrianP;Karavite,DeanJ;Kelleher,Shannon;Nekrasova,Ekaterina;Thayer,JerittG;Ratwani,Raj;Shea,Judy;Nabi-Burza,Emara;Drehmer,JeremyE;Winickoff,JonathanP;Grundmeier,RobertW;Schnoll,RobertA;Fiks,AlexanderG
帮助父母戒烟是公共卫生的优先事项。然而，父母很少，如果有的话，通过儿科环境提供烟草使用治疗。为儿科初级保健工作流程开发的临床决策支持（CDS）系统可以支持一致的筛查、治疗和转诊。目的本研究旨在通过使用以人为本的设计（HCD）开发CDS系统，以识别吸烟的父母，提供激励信息戒烟（由行为科学提供信息），并支持基于证据的烟草治疗的提供。MethodsOur多学科团队应用了严格的HCD过程，包括分析工作环境，用户参与形成性设计、迭代改进以及在以下三个群组的背景下对系统使用的评估：（1）吸烟的父母，（2）儿科临床医生，以及（3）诊所工作人员。来自每个队列的参与者提出了基于ECOMO的，高保真模型的系统组件，然后提供输入相关的角色，在使用CDS system.ResultsWe从事70个代表性的参与者，包括30名家长，30名临床医生，和10名诊所工作人员。所有群组设计审查会议的一个关键主题是需要使系统的功能自动化。家长们强调了一个以简单的方式呈现信息的系统，强调了戒烟的好处，并允许直接与治疗联系起来。儿科临床医生强调自动化烟草治疗。临床工作人员强调在患者就诊前通过几种方式筛查父母吸烟。一旦该系统的开发，大多数家长（80%）报告说，它很容易使用，和大多数儿科医生报告说，他们会使用该系统（97%），并满意它（97%.ConclusionA CDS系统，以支持父母戒烟儿科初级保健，通过HCD过程开发，证明易于使用和接受的父母，临床医生和办公室工作人员。这项初步工作证明了评估该系统对帮助父母戒烟的影响是合理的。
BackgroundHelping parents quit smoking is a public health priority. However, parents are rarely, if ever, offered tobacco use treatment through pediatric settings. Clinical decision support (CDS) systems developed for the workflows of pediatric primary care may support consistent screening, treatment, and referral.ObjectivesThis study aimed to develop a CDS system by using human-centered design (HCD) that identifies parents who smoke, provides motivational messages to quit smoking (informed by behavioral science), and supports delivery of evidence-based tobacco treatment.MethodsOur multidisciplinary team applied a rigorous HCD process involving analysis of the work environment, user involvement in formative design, iterative improvements, and evaluation of the system's use in context with the following three cohorts: (1) parents who smoke, (2) pediatric clinicians, and (3) clinic staff. Participants from each cohort were presented with scenario-based, high-fidelity mockups of system components and then provided input related to their role in using the CDS system.ResultsWe engaged 70 representative participants including 30 parents, 30 clinicians, and 10 clinic staff. A key theme of the design review sessions across all cohorts was the need to automate functions of the system. Parents emphasized a system that presented information in a simple way, highlighted benefits of quitting smoking, and allowed direct connection to treatment. Pediatric clinicians emphasized automating tobacco treatment. Clinical staff emphasized screening for parent smoking via several modalities prior to the patient's visit. Once the system was developed, most parents (80%) reported that it was easy to use, and the majority of pediatricians reported that they would use the system (97%) and were satisfied with it (97%).ConclusionA CDS system to support parental tobacco cessation in pediatric primary care, developed through an HCD process, proved easy to use and acceptable to parents, clinicians, and office staff. This preliminary work justifies evaluating the impact of the system on helping parents quit smoking.