FHIR-ed Up for Tobacco Cessation

FHIR-ed 致力于戒烟

基本信息

批准号：
10156252
负责人：
SARA S JOHNSON
金额：
$ 37.86万
依托单位：
PRO-CHANGE BEHAVIOR SYSTEMS, INC.
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2023-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10156252
关键词：
Address Adult American Appointment Back Behavior Behavioral Biometry Blood Pressure Cardiology Cause of Death Cellular Phone Centers for Disease Control and Prevention (U.S.)Cessation of life Chronic Cigarette Clinical Collaborations Communication Communities Consensus Data Data Store Development Documentation Electronic Health Record Electronic Nicotine Delivery Systems Enrollment Ensure Evidence based practice Expectancy Fast Healthcare Interoperability Resources Friends Goals Health Health behavior change Health system Healthcare Systems Healthy People 2020 Integrated Delivery Systems Medical Medical History Medicine Methods Modification Nature Occupations Participant Pathway interactions Patient Outcomes Assessments Patients Pharmacology Phase Pilot Projects Play Population Provider Readiness Recommendation Research Science Secure Smoke Smoker Smoking Substance Use Disorder Surveys Techniques Testing Time Tobacco Tobacco Use Cessation Tobacco use Translating acceptability and feasibility aged application programming interface base behavior change brief intervention clinical care college combustible cigarette commercialization cost cost effective data access data exchange design disability effectiveness trial electronic data evidence base experience health application health data indexing innovation insight interoperability mobile application patient health information premature programs prototype psychosocial recruit smartphone Application smoking cessation social media success tobacco cessation intervention tobacco products tobacco user transmission process treatment guidelines usability

项目摘要

Summary Tobacco use remains the leading preventable cause of death in the US, contributing to more than 480,000 premature deaths each year. The well-established Tobacco Treatment Guidelines and recently released American College of Cardiology Expert Consensus Decision Pathway for tobacco cessation treatment underscore the need to conceptualize tobacco use as a chronic substance use disorder and to offer any patients who use tobacco products brief interventions that include prescriptions for proven pharmacological smoking cessation aids and proactive connections to evidence-based behavioral support. The rapid expansion of smart phone capabilities enhances the potential for tobacco cessation apps to personalize behavior change guidance and to send contextually relevant tailored behavior change nudges based not just on readiness to quit, but also based on electronic heath record (EHR) data. Rich data from EHRs are now available to third-party apps from the Health app (iOS) via Fast Healthcare Interoperability Resources (FHIR) standard Application Programming Interface (API). The proposed research represents an innovative approach in that it will develop and examine the feasibility, acceptability, and preliminary effects of FHIR-ed Up- a theoretically-grounded, highly individualized tobacco cessation Health-Kit enabled app. Unlike existing tobacco cessation apps, FHIR- ed Up will: 1) implement a full range of best practices in tailored health behavior change communications; 2) individualize messaging based on Health app data and behavior change constructs; and 3) provide data and key insights back to electronic health records via HL7 transmissions from the server-portion of the FHIR-ed Up app. Developed in collaboration with interoperability and app development experts, FHIR-ed Up will achieve sustained use by hyper-personalizing the user experience for patients and integrating actionable insights seamlessly into the clinical workflow of their clinicians. Extensive end user and stakeholder input will ensure FHIR-ed Up is designed for rapid dissemination. Potential end users (n=8 tobacco users aged 18 and older) will be recruited via community and social media ads. Formative qualitative data will be combined with input from four experts and five clinician stakeholders to develop a prototype of FHIR-ed Up. Iterative usability testing (n=10) will allow the prototype to be refined before patients of an integrated delivery system with an upcoming appointment (n=100) are recruited to participate in a 30-day pilot test. Pilot participants will provide quantitative and qualitative data, and utilization and acceptability data will be examined. Pre-post comparisons of psychosocial expectancies for smoking will provide preliminary data on the effects of the program. Acceptability data from participating clinicians (n=5) who receive and deliver EHR prompts will also be gathered. The results will inform program modifications needed to proceed with the Phase II effectiveness trial. Phase II will provide the impetus for commercialization of a cost-effective, evidence-based, interoperable app that has the potential to address tobacco use on a population basis.

概括在美国，烟草使用仍然是可预防的死亡原因，贡献了超过480,000 每年过早死亡。建立了良好的烟草治疗指南，最近发布了美国心脏病学专家学院的共识决策途径强调需要将烟草用作慢性药物使用障碍的概念化并提供任何患者谁使用烟草产品的简短干预措施，包括用于经过验证的药理吸烟的处方停止辅助和积极的连接与基于证据的行为支持。智能的快速扩展电话功能增强了烟草戒烟应用程序个性化行为变更指导的潜力并发送与上下文相关的量身定制行为更改nudges，不仅是基于准备退出的准备，而且还基于电子荒地记录（EHR）数据。现在，来自EHR的丰富数据已可用于第三方应用程序通过快速医疗保健互操作性资源（FHIR）标准应用程序的健康应用程序（iOS）编程接口（API）。拟议的研究代表了一种创新的方法，因为它将发展并检查FHIR-ED上的可行性，可接受性和初步效果高度个性化的烟草戒烟启用了健康袋装应用程序。与现有的戒烟应用不同，fhir- ED UP将：1）在量身定制的健康行为变化通信中实施全范围的最佳实践； 2）基于健康应用程序数据和行为改变构建体的个性化消息传递； 3）提供数据和通过FHIR-ED的服务器部分的HL7传输回到电子健康记录的主要见解 UP应用程序。 FHIR-ED UP与互操作性和应用程序开发专家合作开发通过超级人体化患者的用户体验并整合可操作的用户体验来实现持续使用无缝地了解其临床医生的临床工作流程。广泛的最终用户和利益相关者的输入将确保FHIR-ED UP设计用于快速传播。潜在的最终用户（n = 8岁的烟草用户和较旧的）将通过社区和社交媒体广告招募。形成性的定性数据将与来自四个专家和五个临床医生利益相关者的投入来开发FHIR-ED UP的原型。迭代可用性测试（n = 10）将允许在综合递送系统的患者之前完善原型随着即将进行的任命（n = 100），将招募参加为期30天的试点测试。飞行员参与者将提供定量和定性数据，并将检查利用和可接受性数据。前柱对吸烟的心理心理期望的比较将提供有关影响的初步数据程序。接收和交付EHR提示的参与临床医生（n = 5）的可接受性数据也将被聚集。结果将为进行II期有效性所需的计划修改提供信息审判。第二阶段将为成本效益，基于循证的，可互操作的商业化提供动力有可能在人群基础上解决烟草使用的应用程序。