Fax to Quit: Linking Smokers Visiting Clinics to State Quitlines

描述（由申请人提供）：在今天的美国，尽管有有效的干预措施，但烟草使用仍然是独特的致命性，流行性和忽视的条件。这一系列令人不安的情况突出表明，需要传播有效的干预措施，以便有意义地减少烟草使用流行率。在现有的循证治疗方案中，电话戒烟热线可能是帮助大部分美国吸烟者成功戒烟的最大未实现的承诺。电话戒烟热线是治疗烟草依赖的有效方法。由于强有力的经验支持，所有50个州现在都提供全州范围的戒烟服务。然而，戒烟热线的覆盖范围或人口覆盖率一直很低（每年吸烟者的1-3%），传统的促进戒烟热线使用的手段-付费媒体宣传和与戒烟热线使用相关的药物赠送-对于正在努力减少烟草控制资金的州来说，往往过于昂贵。传真戒烟-一个战略，连接国家戒烟热线的70%的吸烟者谁访问初级保健医生每年-已被确定为一种手段，增加戒烟线达到潜在的较低成本。在操作上，每一个烟草使用者进行初级保健访问被问到她/他是否有兴趣戒烟和接受戒烟咨询。如果她/他同意，转介传真（或电子传输）到国家戒烟热线，然后主动联系烟草用户。这一战略的潜力已经导致40多个州实施某种形式的传真戒烟。然而，这一有前途的方法尚未得到充分的评价，一些证据表明，传真戒烟转介率和连接率往往很低。本提案旨在系统地评估两种形式的传真戒烟：传真戒烟（FQ）和传真戒烟加增强的学术细节（FQ + EAD），EAD包括持续的培训/技术援助和绩效反馈。在收集基线戒烟转诊率后，40家诊所将随机接受FQ或FQ + EAD。诊所转介率，戒烟线患者接触，和“质量接触”（当转介导致个人参加戒烟线咨询服务）将被测量。此外，定性研究部分将评估两种干预措施的关键方面，经济分析将比较两种传真戒烟干预措施的成本与媒体和其他现行戒烟宣传战略的成本。该提案旨在实现RFA的研究目标;使用循证干预措施进行转化研究，有可能促进2010年健康人群的目标，即加强健康促进和疾病预防。

DESCRIPTION (provided by applicant): In America today, tobacco use stands out as a condition of unique lethality, prevalence, and neglect, despite the availability of effective interventions. This troubling set of circumstances highlights the need to disseminate effective interventions so as to meaningfully reduce tobacco use prevalence. Among available evidence-based treatment options, telephone quitlines may offer the greatest unrealized promise to help a large proportion of U.S. smokers to successfully quit. Telephone quitlines are effective treatments for tobacco dependence. As a result of strong empirical support, all 50 states now provide statewide quitline services. Yet the reach, or population penetrance, of quitlines has been low (1-3% of smokers annually) and traditional means of boosting quitline use - paid media campaigns and medication give-aways linked to quitline use - are often prohibitively expensive for states struggling with declining tobacco control funding. Fax to Quit - a strategy to link state quitlines to the 70% of smokers who visit a primary care physician each year - has been identified as a means of increasing quitline reach at potentially lower cost. Operationally, every tobacco user making a primary care visit is asked if s/he is interested in quitting and receiving quitline counseling. If s/he agrees, a referral is faxed (or transmitted electronically) to the state quitline, which then proactively contacts the tobacco user. The potential of this strategy has led more than 40 states to implement some form of Fax to Quit. Yet, this promising approach has not been adequately evaluated and some evidence indicates that Fax to Quit referral and connection rates are often low. This proposal is designed to systematically evaluate two forms of Fax to Quit: Fax to Quit alone (FQ) and Fax to Quit plus Enhanced Academic Detailing (FQ + EAD) with EAD comprising ongoing training/technical assistance and performance feedback. After collecting baseline rates of quitline referrals, 40 clinics will be randomized to receive either FQ or FQ + EAD. Clinic referral rates, quitline-patient contacts, and "quality contacts" (when referrals result in the individual enrolling in quitline counseling services) will be measured. In addition, a qualitative research component will evaluate key aspects of the two interventions and an economic analysis will compare the cost of the two Fax to Quit interventions to the costs of media and other current quitline promotional strategies. The proposal is designed to meet the research objectives of this RFA; to conduct translational research using an evidence-based intervention that has the potential to foster the Healthy People 2010 goals of enhanced health promotion and disease prevention.