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

项目摘要/摘要 二手烟暴露影响了超过40%的美国儿科人口，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干预地位，但 在不到3%的时间里，适当的治疗会提供给父母吸烟者。更大范围内的主要障碍 采用包括缺乏对有关烟草的儿科医生与父母的有效沟通的理解 戒烟治疗和机制，以系统化、始终如一地提供和推广有效的干预措施。 融合决策科学和临床信息学的多学科研究方法可以使 烟草亲本处理简单化、规范化、系统化的干预效果 在儿科临床中的应用。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伤害来预防癌症的科学家，我的 培训目标涉及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，3)临床和实用试验方法论。我的 职业发展将通过我的多学科指导团队来促进，包括亚历山大·菲克斯， 医学博士，MSCE(使用医疗信息技术改善临床决策的主要导师和专家)，Robert Schnoll， 博士(共同导师，烟草治疗试验专家)和David Asch，医学博士，MBA(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 在临床试验、人为因素工程、定性方法和传播方面的数据分析方面的专长 和卫生系统整合。 在我前期工作的基础上，这次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)的用于烟草治疗的临床决策支持(CDS)工具 在儿科环境中，以行为经济学为基础，采用严格的信息学设计 方法，这两个方法都没有应用于此上下文。研究方法包括：发展 让父母参与戒烟治疗的基于理论的信息(目标1)，确定有效的 使用CDS工具传递这些消息的方法(目标2)，并衡量这些消息的影响 关于父母离职率(目标3)。这些目标的结果，在逻辑上朝着一个 可测试、理论驱动的干预措施将导致未来的R01拨款，以支持CDS干预措施的测试 针对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。

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.