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Phone Enabled Implementation of Cessation Support (PHOENICS)

通过电话实施戒烟支持 (PHOENICS)

基本信息

批准号：
10436582
负责人：
Rima Nakkash
金额：
$ 56.75万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-09 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10436582
关键词：
Abstinence Address Administrator Adoption Adult American Behavioral Cancer Control Carbon Monoxide Cigarette Smoker Clinic Counseling Country Exploration Preparation Implementation and Sustainment Female Focus Groups Fostering Goals Health Personnel Health system Hybrids Incidence Income Infrastructure Intervention Interview Lebanon Malignant neoplasm of lung Measures Medical center Mediterranean Region Methods Modeling Morbidity - disease rate Patient Care Patient Self-Report Patients Persons Pharmacotherapy Population Prevalence Primary Health Care Protocols documentation Provider Public Health Research Resource-limited setting Resources Services Smoke Smoker Smoking Cessation Intervention Surveys System Telephone Testing Tobacco Tobacco Dependence Tobacco use Training Universities World Health Organization arm base brief advice cancer prevention comparative effectiveness contextual factors cost cost effective cost effectiveness design dissemination science effectiveness implementation design effectiveness testing evidence base follow-up hookah implementation determinants implementation evaluation implementation process implementation science interest low and middle-income countries male mortality multi-component intervention nicotine replacement primary care setting programs public health relevance randomized trial reduce tobacco use safety net smoking cessation standard care success sustainability framework treatment program trial comparing

项目摘要

PROJECT SUMMARY The objective of this proposal is to evaluate the comparative effectiveness of promising multi-component interventions for implementing evidence-based tobacco treatment in Lebanon’s national system of safety net primary healthcare centers, which serves more than 50% of the population. This objective is directly responsive to NCI Notice of Special Interest (NOT-CA-20-025): Dissemination and Implementation Science for Cancer Prevention and Control in Low Resource Environments. The tobacco use burden in Lebanon is exceptionally high: 35% of adults are current cigarette smokers, 39% are waterpipe smokers, and 5% are dual smokers. The WHO endorses three interventions as the standard of practice for population-level tobacco dependence treatment: smoking cessation advice integrated into primary care settings; easily-accessible phone-based counseling; and low-cost nicotine replacement therapy (NRT). However, the evidence for these interventions comes primarily from high-income countries and they have rarely been evaluated in low- and middle-income countries (LMICs). Further, recommended interventions are not integrated as a routine part of primary care in Lebanon, as is the case in other low-resource settings. Addressing this evidence-to-practice gap requires research on multilevel interventions and contextual factors for implementing integrated, scalable, and sustainable cessation treatment within low-resource settings. We will conduct a group-randomized trial comparing three arms: 1) Ask about tobacco use, advise to quit, assist with brief counseling (AAA) as standard care; 2) Ask, advise, connect to phone-based counseling (AAC); and 3) AAC+NRT. Our central hypothesis is that connecting patients to phone-based counseling with NRT is the most effective alternative. Our hybrid design is informed by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework which emphasizes key steps and multilevel factors to optimize implementation success. We will pursue the following specific aims: 1) adapt and tailor an existing smoking cessation program to deliver phone-based counseling to smokers in Lebanon; 2) test the effectiveness and cost-effectiveness of a referral-based program that delivers smoking cessation services to primary care patients; and 3) identify the multilevel determinants of implementation and sustainability using mixed methods. The proposed project addresses the evidence-to- practice gap in the provision of tobacco dependence treatment within low-resource settings by developing and testing contextually-tailored multilevel interventions and optimizing implementation success and sustainability. This research is significant for its potential to guide the large-scale adoption of cost-effective strategies for implementing tobacco dependence treatment in low-resource settings thereby reducing tobacco-related morbidity and mortality.

项目总结