RE-AIM Evaluation of Tailored Smoking Harm Reduction

RE-AIM 定制吸烟危害减少评估

• 批准号: 6726777
• 负责人: RUSSELL E GLASGOW
• 金额: $ 58.85万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-01 至 2007-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6726777
• 关键词: behavior therapy; behavioral /social science research tag; carbon monoxide; clinical research; cost effectiveness; counseling; endoscopy; gas chromatography; hospital utilization; human subject; longitudinal human study; medically underserved population; nicotine; physicians; smoking; smoking cessation; substance abuse related behavior; surgery; tobacco abuse

DESCRIPTION (provided by applicant): This revised proposal will address several limitations of existing programs to help hospitalized smokers, including reach and exportability. We will use the RE-AIM evaluation model to investigate an innovative intervention for reaching and involving smokers about to have out-patient surgery or an invasive endoscopic medical procedure (sigmoidoscopy/colonoscopy) in Kaiser Permanente-Colorado, but who decline to participate in cessation-based smoking activities. Based upon preliminary work and previous experience with harm reduction interventions with smokers, we will offer a harm reduction program with the goal of helping smokers achieve a 2/3 reduction in daily cigarette intake. The theory-based intervention will include goal setting and frequent feedback, barriers-based problem-solving, and other social-cognitive procedures tailored to the smoker and his or her social environment. It will be delivered both before surgery (or endoscopic procedures) and after, by a combination of phone counseling and tailored mailings, similar to that of the smoking cessation program (Project 1) proposed as part of this Interactive RO1 application. Previous work in our lab and by other investigators indicates that 50-75 percent reduction in number of cigarettes smoked is achievable and can be done in a way that does not result in compensatory smoking, so that reductions in biochemical exposures are achieved and maintained.Following a year of developmental work, we will conduct a randomized trial with 340 smokers to compare the harm reduction program to a control condition that will receive generic mailings. Following the RE-AIM model, key outcomes of the project will be 1) Reach (percent and representativeness of smokers who participate in this program); 2) Effectiveness: reductions in number of cigarettes, cotinine, and CO levels at 3 months follow-up; 3) Adoption: the percent of physicians who participate in the program; 4) Implementation: the percent of participants who receive and use each of several intervention components; and 5) Maintenance: the cessation rate, reduction in number of cigarettes and saliva cotinine, and CO levels at one-year follow-up.This is one of two projects being submitted using the Interactive Research Project Grant funding mechanism. Crossproject analyses will be conducted on various RE-AIM dimensions related to dissemination and economic outcomes. Taken together, both projects will provide an important test of an integrated program for an underserved population (patients in the hospital setting) that recognizes cessation and harm reduction as complementary strategies.

描述（由申请人提供）：该修订后的提案将解决帮助住院吸烟者的现有计划的一些限制，包括覆盖范围和可出口性。我们将使用 RE-AIM 评估模型来研究一种创新干预措施，以吸引和参与科罗拉多州凯撒永久医院即将进行门诊手术或侵入性内窥镜医疗程序（乙状结肠镜检查/结肠镜检查）但拒绝参加基于戒烟活动的吸烟者。根据前期工作和以往对吸烟者进行减害干预的经验，我们将提供一项减害计划，目标是帮助吸烟者将每日香烟摄入量减少 2/3。基于理论的干预将包括目标设定和频繁反馈、基于障碍的问题解决以及其他适合吸烟者及其社会环境的社会认知程序。它将在手术（或内窥镜手术）之前和之后通过电话咨询和定制邮件相结合的方式提供，类似于作为此交互式 RO1 申请的一部分提出的戒烟计划（项目 1）。我们实验室和其他研究人员之前的工作表明，吸烟数量减少 50-75% 是可以实现的，并且可以通过不导致补偿性吸烟的方式来实现，从而实现并维持生化暴露的减少。经过一年的开发工作，我们将对 340 名吸烟者进行一项随机试验，将减少危害计划与将收到通用邮件的对照条件进行比较。根据 RE-AIM 模型，该项目的主要成果将是 1) 覆盖范围（参与该计划的吸烟者的百分比和代表性）； 2) 有效性：3个月随访时香烟数量、可替宁和一氧化碳水平减少； 3) 采用率：参与该计划的医生的百分比； 4) 实施：接受并使用各个干预措施的参与者的百分比； 5) 维持：戒烟率、香烟和唾液可替宁数量的减少以及一年随访时的一氧化碳水平。这是使用互动研究项目拨款资助机制提交的两个项目之一。将针对与传播和经济成果相关的各个 RE-AIM 维度进行跨项目分析。 总而言之，这两个项目将为服务不足的人群（医院环境中的患者）提供一项综合计划的重要测试，该计划将戒烟和减少伤害视为补充策略。