Optimizing Treatment for Brazilian Smokers through Community-Based Primary Care

通过基于社区的初级保健优化巴西吸烟者的治疗

• 批准号: 8109991
• 负责人: Ana Paula Cupertino
• 金额: $ 5.57万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8109991
• 关键词: Address; Adult; Attitude; Brazil; Case Management; Cessation of life; Cities; Clinic; Clinical; Clinical Research; Collaborations; Communities; Continuing Education; Counseling; Country; Data; Dentists; Developing Countries; Development; Educational workshop; Effectiveness; Faculty; Family Practice; Future; Grant; Health; Health Personnel; Health Services Accessibility; Healthcare Systems; Home environment; Home visitation; House Call; Household; Institution; International; Intervention; K-Series Research Career Programs; Knowledge; Latino; Link; Low income; Mentors; Modeling; Morbidity - disease rate; Nurses; Parents; Physicians; Pilot Projects; Population; Prevalence; Primary Health Care; Principal Investigator; Procedures; Recommendation; Recording of previous events; Registries; Relapse; Research; Research Infrastructure; Research Methodology; Research Personnel; Research Project Grants; Resources; Role; Rural; Services; Smoke; Smoker; Smoking Behavior; Social Workers; Structure; Surveys; Telemedicine; Telephone; Testing; Tobacco; Tobacco Use Cessation; Treaty; Universal Coverage; Universities; Work; World Health Organization; base; basica; cost; cost effectiveness; design; evidence base; global health; graduate student; improved; instrument; interest; lectures; mortality; parent grant; pilot trial; population based; preference; programs; public health relevance; randomized trial; respiratory; service utilization; skills; smoking cessation; smoking prevalence; therapy design; tobacco control; trend

DESCRIPTION (provided by applicant): By 2030, over 8 million people will die annually from tobacco, and 80% of these deaths will occur in developing countries. Many countries are attempting to contravene this trend by becoming signatories to the World Health Organization's international tobacco treaty-the Framework Convention on Tobacco Control (FCTC). Helping smokers quit is a core article of the FCTC. Although Brazil provides universal coverage for evidence-based tobacco treatments, it continues to have disparities in tobacco prevalence and access to treatment. The twofold purpose of this project is to 1) conduct a research project to understand and enhance access to tobacco treatment for Brazilian smokers, and 2) build a research collaboration between the U.S. and Brazil. The research project involves collaborating with community-based primary care clinics in Juiz de Fora, Brazil to achieve the following specific aims: 1) create a representative registry of smokers to determine tobacco prevalence and attitudes toward treatment; 2) describe health care provider perspectives on how best to reach low-income smokers; 3) develop and pilot test a community agent intervention to enhance access to tobacco treatment services. The Parent R01 for this project tests the effectiveness of telemedicine to increase access to evidence-based tobacco treatment among rural Anglo and Latino smokers in the U.S. through rural primary care facilities. The project also relies on a K-Award that tests the effects of a U.S.-based lay health worker intervention designed to increase access to tobacco treatment among unban Latinos. The project utilizes the multiple-P.I. mechanism to take advantage of the complementary strengths of the Principal Investigators of these projects. The project will be conducted in collaboration with Brazilian P.I. Dr. Oscarina da Silva Ezequiel and her staff at the Universidade Federal de Juiz de Fora (UFJF). Research capacity building activities include formal course offerings, mentored research projects, and community lectures designed to build knowledge and skills for conducting applied clinical research. The project addresses a significant global health problem and it is a highly relevant project for Brazil, which has a large population of very poor smokers. It also capitalizes on the unique structure of the Brazilian health care system to identify and link every smoker in the population to existing services. As such, it represents a paradigm shift from reactive to proactive treatment. Research project findings will be used to support an application for a large scale, definitive trial of the pilot intervention. If effective, the approach could achieve significant reductions in tobacco-related morbidity and mortality in Brazil and provide a model for population- based intervention internationally. PUBLIC HEALTH RELEVANCE: The twofold purpose of this project is to 1) enhance access to tobacco treatment for Brazilian smokers, and 2) build a research collaboration between the U.S. and Brazil. If effective, the project will provide a model for increasing access to tobacco treatment internationally and will strengthen the capacity of Brazilian researchers to conduct applied clinical research.

描述（由申请人提供）：到 2030 年，每年将有超过 800 万人死于烟草，其中 80% 将发生在发展中国家。许多国家试图通过成为世界卫生组织国际烟草条约——《烟草控制框架公约》（FCTC）的签署国来扭转这一趋势。帮助吸烟者戒烟是《烟草控制框架公约》的核心条款。尽管巴西提供了基于证据的烟草治疗的全民覆盖，但在烟草流行率和获得治疗的机会方面仍然存在差异。该项目的双重目的是 1) 开展研究项目，以了解和加强巴西吸烟者获得烟草治疗的机会，2) 在美国和巴西之间建立研究合作。该研究项目涉及与巴西茹伊斯德福拉的社区初级保健诊所合作，以实现以下具体目标：1）创建一个具有代表性的吸烟者登记册，以确定烟草流行率和对治疗的态度； 2) 描述医疗保健提供者对如何最好地接触低收入吸烟者的看法； 3) 制定并试点测试社区代理干预措施，以提高获得烟草治疗服务的机会。该项目的母版 R01 测试了远程医疗的有效性，以增加美国农村盎格鲁和拉丁裔吸烟者通过农村初级保健设施获得循证烟草治疗的机会。该项目还依赖于 K-Award，该奖项测试了美国非专业卫生工作者干预措施的效果，该干预措施旨在增加未禁止的拉丁裔人群获得烟草治疗的机会。该项目利用多 P.I.机制，以利用这些项目的主要研究者的优势互补。该项目将与巴西 P.I. 合作进行。 Oscarina da Silva Ezequiel 博士和她在 Universidade Federal de Juiz de Fora (UFJF) 的工作人员。研究能力建设活动包括正式课程、指导研究项目和社区讲座，旨在培养进行应用临床研究的知识和技能。该项目解决了一个重大的全球健康问题，对于拥有大量贫困吸烟者的巴西来说，这是一个高度相关的项目。它还利用巴西医疗保健系统的独特结构来识别人口中的每个吸烟者并将其与现有服务联系起来。因此，它代表了从被动治疗到主动治疗的范式转变。研究项目的结果将用于支持大规模、最终的试点干预试验的申请。如果有效，该方法可以显着降低巴西与烟草相关的发病率和死亡率，并为国际上基于人口的干预提供一个模型。 公共卫生相关性：该项目的双重目的是 1) 增强巴西吸烟者获得烟草治疗的机会，2) 在美国和巴西之间建立研究合作。如果有效，该项目将为国际上增加烟草治疗的机会提供一个模型，并将加强巴西研究人员进行应用临床研究的能力。