Parents Quit IT: Tailored Messaging and Decision Support to Help Parents Quit Smoking in Pediatric Settings

家长戒烟：量身定制的消息传递和决策支持，帮助家长在儿科环境中戒烟

• 批准号: 10460163
• 负责人: Brian P. Jenssen
• 金额: $ 18.64万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10460163
• 关键词: Address; Adoption; Adult; Advisory Committees; Advocate; Affect; Area; Asthma; Black race; Caring; Cessation of life; Child; Child Health; Childhood; Clinical Decision Support Systems; Clinical Informatics; Clinical Trials; Communication; Data Analyses; Data Collection; Decision Making; Development; Doctor of Philosophy; Effectiveness; Effectiveness of Interventions; Electronic Health Record; Engineering; FDA approved; Family; Fostering; Future; General Population; Goals; Grant; Health; Health Benefit; Health system; Healthcare; Healthy People 2020; Household; Human; Informatics; Interdisciplinary Study; Intervention; Intervention Trial; Knowledge; Lead; Life Expectancy; Low income; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Mentors; Methodology; Methods; Modality; Morbidity - disease rate; Not Hispanic or Latino; Outpatients; Parents; Pharmaceutical Preparations; Population; Positioning Attribute; Preparation; Preventive service; Public Health; Qualitative Methods; Research; Research Personnel; Risk; Science; Scientist; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Source; Standardization; Structure; Sudden infant death syndrome; Systems Integration; Testing; Time; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Training; United States Dept. of Health and Human Services; Vulnerable Populations; Work; base; behavioral economics; cancer prevention; career; career development; chronic respiratory disease; clinical decision support; clinical decision-making; clinical practice; cost; design; disorder risk; effective intervention; environmental tobacco smoke exposure; evidence base; experience; health care service; improved; mortality; multidisciplinary; novel; pediatrician; pilot trial; practice setting; pragmatic trial; prevent; preventable death; skills; smoking cessation; smoking-related cancer; socioeconomic disadvantage; support tools; tailored messaging; theories; tobacco cessation intervention; tobacco control; tobacco prevention; treatment trial

Project Summary/Abstract Secondhand smoke exposure affects more than 40% of the US pediatric population and exacerbates and/or increases the risk of disease morbidity and mortality. By helping parents quit smoking, pediatricians protect children and families from the harms of tobacco. Pediatricians are uniquely positioned to intervene but appropriate treatments are delivered to parent smokers less than 3% of the time. Major barriers to wider adoption include lack of understanding of effective pediatrician-parent communication regarding tobacco cessation treatment and mechanisms to systematize, consistently deliver, and scale effective interventions. A multi-disciplinary research approach incorporating decision science and clinical informatics could maximize intervention effectiveness while simplifying, standardizing, and systematizing parental treatment for tobacco use in pediatric clinical practice. To lead this research and establish my long-term career goal as a clinician- scientist dedicated to preventing cancer by protecting families and vulnerable populations from tobacco, my training objectives involve developing skills in critical theoretical and methodological areas including: 1) behavioral economics, 2) human factors engineering, and 3) clinical and pragmatic trial methodology. My career development will be fostered through my multidisciplinary mentoring team, including Alexander Fiks, MD, MSCE (primary mentor, expert in using health IT to improve clinical decision making), Robert Schnoll, PhD (co-mentor, expert in tobacco treatment trials), and David Asch, MD, MBA (co-mentor, expert in behavioral economics). My advisory committee will further guide my career development and will provide expertise in data analysis in clinical trials, human factors engineering, qualitative methods, and dissemination and health system integration. Building upon my preliminary work, this training will be leveraged to create and evaluate a novel intervention, a clinical decision support (CDS) tool embedded within the electronic health record (EHR), for tobacco treatment in the pediatric setting, grounded in behavioral economics and developed using rigorous informatics design methods, neither of which have been applied to this context. The research approach includes: developing theory-based messages that engage parents in tobacco cessation treatment (Aim 1), identifying effective methods for delivering these messages using CDS tools (Aim 2), and measuring the impact of these messages on parent quit rates (Aim 3). The results from these aims, which logically build towards the development of a testable, theory-driven intervention, will lead to future R01 grants that support the testing of CDS interventions optimized for effectively and systematically addressing parent smoking in pediatric settings.

项目总结/摘要 二手烟暴露影响超过40%的美国儿科人群，并加剧和/或 增加疾病发病率和死亡率的风险。通过帮助父母戒烟，儿科医生保护 儿童和家庭免受烟草的危害。儿科医生处于独特的位置进行干预， 只有不到3%的时间向父母吸烟者提供适当的治疗。扩大的主要障碍 包括缺乏对儿科医生与父母之间关于烟草问题的有效沟通的了解 戒烟治疗和机制，以系统化，一贯提供和规模有效的干预措施。 结合决策科学和临床信息学的多学科研究方法可以最大限度地提高 在简化、标准化和系统化父母烟草治疗的同时， 用于儿科临床实践。领导这项研究并确立我作为临床医生的长期职业目标- 致力于通过保护家庭和弱势群体免受烟草危害来预防癌症的科学家，我 培训目标包括发展关键理论和方法领域的技能，包括：1） 行为经济学，2）人因工程学，以及3）临床和实用试验方法学。我 职业发展将通过我的多学科指导团队，包括亚历山大菲克斯， 医学博士，MSCE（初级导师，使用卫生IT改善临床决策的专家），Robert Schnoll， 博士（共同导师，烟草治疗试验专家）和大卫阿什，医学博士，工商管理硕士（共同导师，烟草治疗试验专家）。 行为经济学）。我的顾问委员会将进一步指导我的职业发展，并将提供 临床试验数据分析、人因工程、定性方法和传播方面的专业知识 卫生系统一体化。 在我的初步工作的基础上，这项培训将被用来创建和评估一种新的干预措施， 嵌入电子健康记录（EHR）的临床决策支持（CDS）工具，用于烟草治疗 在儿科环境中，基于行为经济学并使用严格的信息学设计开发 方法，这两种方法都没有应用于此上下文中。研究方法包括：开发 以理论为基础的信息，使父母参与戒烟治疗（目标1）， 使用CDS工具传递这些信息的方法（目标2），并衡量这些信息的影响 父母戒烟率（目标3）。这些目标的结果，从逻辑上说，是朝着发展一个 可测试的，理论驱动的干预，将导致未来的R 01赠款，支持CDS干预措施的测试 为有效和系统地解决儿科环境中的父母吸烟问题进行了优化。

项目成果

Response to: More Detail Needed for Pilot E-Cigarette Treatment Trial in Youth and Young Adults.

回应：青少年和年轻人电子烟治疗试点试验需要更多细节。

• DOI: 10.1093/ntr/ntab103
• 发表时间: 2021
• 期刊: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
• 作者: Jenssen,BrianP;Hannan,Chloe;Kelly,MaryKate;Ylioja,Thomas;Schnoll,RobertA;Fiks,AlexanderG
• 通讯作者: Fiks,AlexanderG

Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients.

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
• 发表时间: 2022
• 期刊: Applied clinical informatics
• 影响因子: 2.9
• 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
• 通讯作者: Fiks,AlexanderG

Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping.

• DOI: 10.1016/j.acap.2020.07.018
• 发表时间: 2021-01
• 期刊: Academic pediatrics
• 影响因子: 3.1
• 作者: Jenssen BP;Kelly MK;Faerber J;Hannan C;Asch DA;Shults J;Schnoll RA;Fiks AG
• 通讯作者: Fiks AG

A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance.

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
• 发表时间: 2023
• 期刊: Applied clinical informatics
• 影响因子: 2.9
• 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
• 通讯作者: Fiks,AlexanderG