PRIMARY CARE AND SELF HELP INTERVENTION FOR TEEN SMOKERS

描述：(申请者描述)超过300万青少年吸烟 香烟，每天有3000支开始。大多数人将继续吸烟，并且 据估计，1995年有500万年龄在0-17岁之间的人最终将死于 与吸烟有关的疾病。尽管研究工作主要集中在方法上 在预防青少年吸烟方面，关于如何预防吸烟的数据很少 帮助三分之一吸烟的青少年。有效戒烟 干预措施是降低这一人群吸烟流行率的关键。 临床医生和自助干预都特别适合于 这些人口，因为他们允许大量和地理上的目标 多样化的人群，同时保持保密联系，即 对这个年龄段的人来说，发展很重要。拟议的研究将 检查以医疗保健提供者为基础的干预的有效性 为14-18岁的青少年吸烟者提供的自助附件。90个儿科和 青少年实践活动将在6个县区招募，其中20人 青少年/练习共1800名受试者。实践将是 阻止关键变量并随机到：1)干预--医生， 吸烟干预方面的执业护士和医生助理培训 (遵循NCI和AHCPR准则)和自助附件(自助 人工、热线、主动呼叫、互联网资源)或2)常规护理。 干预措施和实践层面的实施将由重点指导 第一年的小组反馈。受试者将在3点和3点通过电话进行反馈 12个月，用于确定吸烟状况、使用自助资源、 和其他吸烟/健康变量。卫生保健提供者将接受调查 在培训前和培训后，并在12个月内对有关自我报告的情况进行跟踪 青少年吸烟筛查和干预；青少年受试者 也将被询问有关这些服务的接收情况。这项研究将 为有效的戒烟干预提供证据 青少年，并将协助规划未来的干预工作 这群人。

DESCRIPTION: (Applicant's Description) Over 3 million adolescents smoke cigarettes, with 3,000 starting each day. Most will continue to smoke, and an estimated 5 million people ages 0-17 in 1995 will ultimately die from a smoking-related disease. Although research efforts have focused on methods for preventing adolescent smoking, there are little data available on how to help the one-third of adolescents who smoke. Effective cessation interventions are key to reducing smoking prevalence in this population. Both clinician- and self-help interventions are particularly appropriate to this population, as they allow for targeting large and geographically diverse populations, while maintaining confidential contact that is developmentally important to this age group. The proposed study will examine the effectiveness of a health care provider-based intervention with self help adjuncts for adolescent smokers ages 14-18. Ninety pediatric and adolescent practices will be recruited in a 6 county area, with 20 adolescents/practice for a total of 1800 subjects. Practices will be blocked on key variables and randomized to: 1) Intervention - physician, nurse practitioner, and physician assistant training in smoking intervention (following NCI and AHCPR guidelines), and self-help adjuncts (self-help manual, hotline, proactive calls, Internet resources) or 2) Usual care. Interventions and practice level implementation will be guided by focus group feedback in year 1. Subjects will be followed by telephone at 3 and 12 months for determination of smoking status, use of self-help resources, and other smoking/health variables. Health care providers will be surveyed pre- and post training and at 12 month follow-up to regarding self-reported smoking screening and intervention with adolescents; adolescent subjects will also be queried regarding receipt of these services. This study will provide evidence for effective smoking cessation interventions for adolescents, and will assist in planning future intervention efforts with this population.