Efficiency of Tailoring Treatment to Smoker Subgroup

针对吸烟者亚群量身定制治疗的效率

• 批准号: 6906474
• 负责人: CHARLES J NEIGHBORS
• 金额: $ 10.25万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6906474
• 关键词: absenteeism; adult human (21+); alcoholic beverage consumption; behavior therapy; body physical activity; cancer prevention; clinical research; clinical trials; combination therapy; comorbidity; cost effectiveness; depression; health care cost /financing; health care service utilization; high risk behavior /lifestyle; human data; human subject; human therapy evaluation; mental health epidemiology; nicotine replacement; patient care management; patient oriented research; postdoctoral investigator; smoking cessation; telemedicine

DESCRIPTION (provided by applicant): This K07 proposal in cancer prevention, control, and population sciences will enable the applicant to integrate two areas--business management and clinical psychology--into a research career on cost-efficient dissemination of primary and secondary cancer prevention interventions. The goals are to: a) gain experience in interventions for hard-to-treat smokers; b) build knowledge of statistical methods in economic research; c) apply methods from management science to research on cost- efficiency; and, d) develop a programmatic line and research on dissemination and cost-efficiency of interventions for cancer prevention and control. Cancer prevention through smoking cessation involves a paradox. Low cost/low intensity/low efficacy public health approaches have greater reach, while high cost/high intensity/low reach clinical interventions have greater efficacy. The difference in efficacy is greatest for hard-to-treat smokers who have greater levels of nicotine dependence, depression and problem alcohol use. Recently, some have called for integration of these contrasting intervention approaches through use of tailored stepped-care models that maximize cost- efficient allocation of healthcare resources. The research plan in this career development proposal calls for two studies that e amine costs and efficiencies of targeting subsets of smokers. Study 1 will use data from adult respondents to the 1997-1999 the National Health Interview Surveys (N = +/- 100,000) and the 1993 National Mortality Followback Survey (N = 22,957) to examine the medical utilization of subgroups of smokers who have high-risk alcohol consumption, sedentary lifestyle or depression. The costs of medical utilization will be estimated with data from the Medical Expenditure Panel Survey. Study 1 hypothesizes that smoking interacts with other health risk factors to predict greater costs for subgroups of smokers. Study 2 will examine the cost-effectiveness and operational efficiency of a telephone based tailored smoking intervention. Study 2 hypothesizes that tailored interventions will be more cost-effective than more standardized ones, particularly among smokers with other high-risk factors. Study 2 will also use tools from management science to evaluate clinical system factors affecting intervention efficiency. These studies will inform future dissemination research on cost-efficient and effective smoking cessation interventions that address the economic imperatives of healthcare delivery systems while maximizing the benefit to public health.

描述（由申请人提供）：这个关于癌症预防的K07提案，