A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance.
A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance.
复制标题
为父母提供激励信息和戒烟治疗的临床决策支持系统：使用和接受度的试点评估。
DOI：
10.1055/a-2062-9627
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发表时间：
2023
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;Kelleher,Shannon;Karavite,DeanJ;Nekrasova,Ekaterina;Thayer,JerittG;Ratwani,Raj;Shea,JudyA;Nabi-Burza,Emara;Drehmer,JeremyE;Winickoff,JonathanP;Grundmeier,RobertW;Schnoll,RobertA;Fiks,AlexanderG
背景需要进行研究，以确定临床决策支持(CDS)系统如何支持吸烟父母在儿科环境中进行烟草使用治疗的沟通和参与。我们开发了一个CDS系统，它可以识别吸烟的父母，传递激励信息开始治疗，将父母与治疗联系起来，并支持儿科医生与父母的讨论。目的本研究的目的是评估该系统在临床实践中的表现，包括激励信息的接收和烟草使用治疗的接受率。我们收集了所有家长关于CDS系统表现的数据。此外，我们在临床接触后立即对使用该系统并报告吸烟的父母进行了调查。测量是：(1)父母记住了励志信息，(2)儿科医生强调了这一信息，(3)治疗接受率。治疗包括尼古丁替代疗法、戒烟热线转介(电话咨询)和/或戒烟TXT转介(短信咨询)。结果在整个研究期间，8,488名家长完成了CDS的使用：9.3%(n= 786)报告吸烟，48.2%(n= 379)接受至少一种治疗。访问了102名使用该系统的吸烟家长，调查了100名家长(回应率为98%)。大多数父母自我认同为女性(84%)，年龄在25至34岁之间(56%)，黑人/非裔美国人(94%)，并有孩子参加医疗补助保险(95%)。在接受调查的父母中，54%的人接受了至少一种治疗方案。大多数家长回忆起激励信息(79%；95%CI：71-87%)，31%(95%CI：19-44%)报告儿科医生加强了激励信息。结论在儿科初级保健中支持父母烟草使用治疗的CDS系统增强了关于戒烟和循证治疗启动的激励信息。
BackgroundResearch is needed to identify how clinical decision support (CDS) systems can support communication about and engagement with tobacco use treatment in pediatric settings for parents who smoke. We developed a CDS system that identifies parents who smoke, delivers motivational messages to start treatment, connects parents to treatment, and supports pediatrician–parent discussion.ObjectiveThe objective of this study is to assess the performance of this system in clinical practice, including receipt of motivational messages and tobacco use treatment acceptance rates.MethodsThe system was evaluated at one large pediatric practice through a single-arm pilot study from June to November 2021. We collected data on the performance of the CDS system for all parents. Additionally, we surveyed a sample of parents immediately after the clinical encounter who used the system and reported smoking. Measures were: (1) the parent remembered the motivational message, (2) the pediatrician reinforced the message, and (3) treatment acceptance rates. Treatments included nicotine replacement therapy, quitline referral (phone counseling), and/or SmokefreeTXT referral (text message counseling). We described survey response rates overall and with 95% confidence intervals (CIs).ResultsDuring the entire study period, 8,488 parents completed use of the CDS: 9.3% (n= 786) reported smoking and 48.2% (n= 379) accepted at least one treatment. A total of 102 parents who smoke who used the system were approached to survey 100 parents (98% response rate). Most parents self-identified as female (84%), aged 25 to 34 years (56%), and Black/African American (94%), and had children with Medicaid insurance (95%). Of parents surveyed, 54% accepted at least one treatment option. Most parents recalled the motivational message (79%; 95% CI: 71–87%), and 31% (95% CI: 19–44%) reported that the pediatrician reinforced the motivational message.ConclusionA CDS system to support parental tobacco use treatment in pediatric primary care enhanced motivational messaging about smoking cessation and evidence-based treatment initiation.