Electronic Pediatric Office Systems to Support Treatment for Parental Tobacco Use

电子儿科办公系统支持父母吸烟治疗

• 批准号: 10548739
• 负责人: Alexander Gabriel Fiks
• 金额: $ 94.5万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10548739
• 关键词: Accounting; Address; Adoption; Adult; Affect; Cancer Burden; Cancer Patient; Carbon Monoxide; Cessation of life; Child; Child health care; Childhood; Community Health; Contracts; Cotinine; Counseling; Data; Developmental Delay Disorders; Disease; Documentation; Early Diagnosis; Effectiveness; Electronic cigarette; Electronics; Enrollment; Ensure; Exposure to; Family; Fire - disasters; Funding; Future; Goals; Health; Health Benefit; Health Services Accessibility; Health system; Home; Home visitation; Household; Insurance Coverage; Intervention; Interview; Life Expectancy; Link; Malignant Neoplasms; Medicaid; Minority; Morbidity - disease rate; Outcome; Parents; Persons; Population; Pregnancy Outcome; Prevention; Quality of life; Randomized; Randomized, Controlled Trials; Research; Resources; Risk; Schools; Services; Smoke; Smoke-free home; Smoker; Smoking; Smoking Cessation Intervention; Surveys; System; Telephone; Testing; Time; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco smoke; Tobacco use; United States; Visit; Work; arm; compare effectiveness; comparison intervention; cost; cost effective; cost effectiveness; design; eVisit; effectiveness testing; electronic health record system; evidence base; follow-up; free behavior; health care delivery; health care settings; household tobacco use; implementation framework; implementation intervention; improved; incremental cost; innovation; medically underserved; member; mortality; nicotine replacement; nicotine use; pediatrician; quitline; screening; service delivery; smoking cessation; suburb; success; survivorship; thirdhand smoke; three-arm study; tobacco cessation intervention; tobacco control; tobacco smoke exposure; tobacco user; tobacco-free; treatment arm; treatment as usual

Project Summary/Abstract When parents quit smoking, their life expectancy is increased by an average of over 10 years, future tobacco- related poor pregnancy outcomes are eliminated, their children have much lower odds of becoming adult smokers, and their children may no longer be exposed to high levels of tobacco smoke, decreasing the odds of contracting diseases caused by tobacco smoke exposure and resulting in fewer missed school days. Helping parents and household members quit smoking also improves the financial resources of families, decreases the risk of developmental delays, and lowers the risk of house fires. Parents who smoke are often medically underserved, visiting their child's healthcare provider more often than they see their own clinician, if they even have one. Despite this extraordinary opportunity for intervention, child healthcare settings deliver effective tobacco dependence treatment to parents less than 2% of the time. Routinely delivered tobacco control to parents in child healthcare settings would benefit the overall health of the nation. The goal of the proposed study is to ensure that every parent who smokes tobacco or is a dual user of tobacco and e-cigarettes and visits their child's doctor receives evidence-based assistance to quit. We propose testing an innovative EHR systems platform (iEHR) in pediatric practices. The iEHR will facilitate universal screening for household tobacco use and routine offering and provision, if desired, of tobacco cessation services. We will compare this intervention to iEHR + navigator to test the effectiveness of additional support by a community health navigator. The navigator will work with pediatric offices to assist household tobacco users in cessation through telephone follow-up, ensuring access to services, and home visits, based on what they want to help them quit smoking. This trial will address critical unanswered questions of effectiveness, sustainability, and cost-effectiveness of a parental tobacco cessation intervention that supports delivery of tobacco cessation services using iEHR, with or without a navigator. This proposal is in exact alignment with NCI's objective to fund research to reduce the burden of cancer for patients and other affected persons through improvements in early detection, prevention, healthcare delivery, quality of life, and/or survivorship related to cancer. Aims are: A1. To compare parents' combusted tobacco quit rates, and adoption of tobacco free behaviors between the two intervention arms (1°: iEHR+Navigator vs. iEHR; 2°: each intervention vs. usual care control) A2. To establish the incremental cost per quit of the two intervention arms vs. usual care control A3. To assess the delivery and sustainability of the interventions Building on the success of past trials, this application will evaluate an innovative EHR-linked tobacco cessation intervention addressing household tobacco use with and without navigator support. The study is designed to yield fully-integrated, cost-effective, disseminable, and sustainable strategies to optimize parental cessation outcomes throughout child healthcare settings nationally.

项目总结/摘要 当父母戒烟时，他们的预期寿命平均增加10年以上，未来的烟草- 相关的不良妊娠结局被消除，他们的孩子长大成人的几率要低得多 吸烟者和他们的孩子可能不再接触到高水平的烟草烟雾， 由于接触烟草烟雾而感染疾病，导致缺课的天数减少。帮助 父母和家庭成员戒烟也改善了家庭的经济来源，减少了 发育迟缓的风险，并降低房屋火灾的风险。吸烟的父母通常在医学上 服务不足，拜访他们孩子的医疗保健提供者比他们看自己的临床医生更频繁，如果他们甚至 吃一个吧。尽管有这个非凡的干预机会，儿童保健机构提供有效的 父母接受烟草依赖治疗的时间不到2%。烟草控制委员会将烟草控制交付给 儿童保健机构的父母将有利于国家的整体健康。建议的目标 这项研究旨在确保每一位吸烟或同时使用烟草和电子烟的父母 去看孩子的医生，接受循证戒烟的帮助。我们建议测试一个 创新的EHR系统平台（iEHR）在儿科实践中的应用。iEHR将促进普遍筛查 家庭烟草使用和常规提供戒烟服务（如需要）。我们将 将此干预措施与iEHR +导航器进行比较，以测试社区提供的额外支持的有效性 健康领航员导航员将与儿科办公室合作，协助家庭烟草使用者戒烟 通过电话跟踪，确保获得服务，并根据他们想要帮助的内容进行家访 他们戒烟了。这项试验将解决有效性、可持续性和 支持戒烟的父母戒烟干预的成本效益 使用iEHR的服务，有或没有导航器。这一建议与NCI的目标完全一致， 资助研究，通过改善以下方面来减轻癌症患者和其他受影响者的负担： 早期检测、预防、医疗保健提供、生活质量和/或与癌症相关的生存率。目标是： A1.比较两组父母的戒烟率和无烟草行为的采用情况， 两个干预组（1°：iEHR+Navigator vs. iEHR; 2°：每次干预vs.常规护理对照） A2.确定两个干预组与常规护理对照组每次戒烟的增量成本 A3.评估干预措施的交付和可持续性 在过去试验成功的基础上，该应用程序将评估一种创新的EHR相关烟草 在有和没有导航员支持的情况下，针对家庭烟草使用的戒烟干预措施。的 研究旨在产生完全集成的、具有成本效益的、可传播的和可持续的战略， 在全国范围内的儿童医疗机构中优化父母戒烟的结果。