Web-based Smoking Cessation Intervention: transition from inpatient to outpatient

描述（由申请人提供）： 该项目名为“基于网络的戒烟干预：从住院患者到门诊患者的过渡”，旨在解决住院患者的吸烟问题，住院患者的吸烟率高于一般人群。住院治疗提供了独特的干预机会，因为它需要暂时禁欲，并且患者关注健康问题。假设：为当前吸烟者量身定制的基于网络和电子消息的戒烟计划，在出院后让患者过渡到回家后继续尝试戒烟（Transition2Quit）将是有效的。此外，我们假设这种方法将具有成本效益。具体目标： 1. 测试基于网络的戒烟干预措施的有效性。 2. 确定该方法的成本效益。研究设计-方法：将使用随机双臂随访设计来测试为住院后设计的基于证据和理论的戒烟计划的有效性。接受过烟草治疗过渡专家培训的医院工作人员将与随机分配到这一组的患者联系，参与 TransitionZQuit，这是一个基于网络的交互式计划，提供个性化和量身定制的信息、电子团体支持和促进戒烟的短信。所有住院患者都将收到 DVD 格式的标准化戒烟信息，医生可以通过医院的电子医嘱系统订购这些信息（以及 NRT 和研究转诊）。我们的主要结果是在 12 个月的随访中从生物学上证实了戒烟情况；我们还将评估 3 个月和 6 个月时自我报告的戒烟率以及预测戒烟成功的假设变量。我们将衡量医疗保健利用率和生活质量，以便从医院、医疗保健支付者、患者和社会的角度测试该计划的成本效益。结果的意义：研究完成后，我们将知道将戒烟纳入常规医院护理中（以最小的医院工作人员负担）以及基于网络的交互式定制干预计划是否是降低住院患者吸烟率的有效方法，以及是否具有成本效益。该计划将是一种“易于传播的现成方法”。 相关性（参见说明）：本研究旨在实现《2010 年健康人》目标 27-1，即减少成年人的烟草使用。此外，它的目的是在弱势群体中传播有关减少烟草使用的知识，以增强他们的健康，使他们能够活得更长久、更充实的生活。这将减轻吸烟对医疗保健系统以及整个社会的负担。 （摘要完）

DESCRIPTION (provided by applicant): This project, "Web-based Smoking Cessation Intervention: transition from inpatient to outpatient," addresses smoking among hospitalized patients, whose rates are higher than among the general population. Hospitalization offers a unique opportunity to intervene, as it requires temporary abstinence and patients are focused on health concerns. Hypotheses: A tailored web-based and e-message smoking cessation program for current smokers that upon hospital discharge, transitions the patient to continue a quit attempt when home (Transition2Quit) will be effective. Further, we hypothesize that this approach will be cost-effective. Specific Aims: 1. To test the effectiveness of a web-based smoking cessation intervention. 2. To determine the cost- effectiveness of this approach. Research Design - Methods: A randomized two-arm follow-up design will be used to test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post- hospitalization. Patients randomized to this arm will be contacted by hospital staff, trained as tobacco treatment transition specialists, to engage in TransitionZQuit, an interactive web-based program that offers personalized and tailored messages, e-group support, and text messages promoting tobacco abstinence. All hospitalized patients will receive standardized smoking cessation messages via DVD format that physicians can order (along with NRT and study referral) via the hospital's electronic order system. Our primary outcome is biologically confirmed tobacco abstinence at 12 months follow-up; we will also assess self-reported quit rates at 3 and 6 months and variables hypothesized to predict quit success. We will measure health care utilization and quality of life to allow testing the cost-effectiveness of this program conducted from the perspective of a hospital, health care payers, patients and society. Significance of results: At study completion we will know whether imbedding smoking cessation into usual hospital care, with minimal hospital-staff burden, and an interactive web-based tailored intervention program is an effective way to reduce smoking rates among hospitalized patients, and if it is cost-effective. This program will be an "off the shelf approach that could be disseminated easily. RELEVANCE (See instructions): This study aims to address the Health People 2010 objective 27-1 to reduce tobacco use by adults. Further it aims to extend knowledge about reducing tobacco use among a vulnerable group of people to enhance their health so that they can live longer and more fulfilling lives. This would result in a reduction of the burden of smoking on the health care system as well as society as a whole. (End of Abstract)