RCT for Smoking Cessation in 10 Medical Schools

10 所医学院的戒烟随机对照试验

• 批准号: 8472335
• 负责人: JUDITH K OCKENE
• 金额: $ 57.22万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-06 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8472335
• 关键词: Academic Detailing; Accounting; Address; Adult; Attention; Behavior; Cessation of life; Clinical; Clinical Practice Guideline; Collaborations; Control Groups; Cost of Illness; Counseling; Crowding; Data; E-learning; Education; Educational Curriculum; Educational process of instructing; Effectiveness; Elements; Enrollment; Epidemic; Evaluation; Evidence based intervention; Feedback; Geographic Locations; Goals; Hour; Impact evaluation; Individual; Instruction; Intervention; Knowledge; Learning; Measures; Mediating; Medical; Medical Education; Medical Students; Methods; Modality; Modeling; Online Systems; Outcome; Patient Self-Report; Patients; Performance; Physicians; Play; Policies; Process; Randomized; Reporting; Research; Research Design; Research Methodology; Research Personnel; Role; Schedule; Schools; Self Efficacy; Site; Smoke; Smoker; Smoking; Societies; Structure; Students; Surveys; System; Teaching Method; Testing; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Training; United States Public Health Service; Update; Withholding Treatment; Work; abstracting; base; cohort; combat; compare effectiveness; control trial; design; evidence base; experience; follow-up; improved; innovation; interest; killings; medical schools; next generation; premature; primary outcome; programs; randomized trial; secondary outcome; skill acquisition; skills; skills training; smoking cessation; smoking prevalence; theories; tobacco control

6. Abstract Each year smoking kills 430,000 U.S citizens, exacerbates a myriad of diseases, and costs society approximately $100 billion. Despite the proliferation of information and restrictive smoking policies, adult smoking prevalence has remained relatively stable during the past five years, currently at 21%. Brief physician- delivered tobacco treatment, commonly known as "the 5As", is an evidence-based intervention demonstrated to double a smoker's likelihood of quitting. Given that 70% of smokers see a physician each year, it is imperative that all clinicians have the appropriate knowledge and skill level to counsel smokers. However, few physicians and physicians-in-training receive adequate training to develop these skills. Using a pair-matched, randomized group-controlled (RGC) design (implemented in 10 medical schools), we will compare two methods of teaching the 5As to medical students: 1) traditional medical education (TE), and 2) multi-modal education (MME) that adds two components to TE: a web-based instructional program for students and preceptor training. The primary outcome is observed tobacco treatment counseling skill as measured by the Objective Structured Clinical Examination (OSCE), the standard method for evaluating medical student skill level at all U.S. medical schools. A secondary outcome is self-reported tobacco treatment counseling skill level. In a nested cohort design, during the second year of the study a cohort of medical students will be followed from early in their first year of medical school (MS1) through the end of their third year (MS3) which occurs in the 4th year of the study. The Primary Aim of this RGC trial is to compare the effectiveness of MME for teaching the 5As counseling skills in medical school against TE. Hypothesis 1: MME will outperform TE on observed 5As counseling skills (OSCE). Hypothesis 2: MME will outperform TE on self-reported 5As counseling skills. Strengths of this study include: 1) the innovative study design that tests common and integrative teaching methods and 2) the potential to disseminate throughout US medical schools effective educational methods that can build physicians' skills to assist the millions of patients who continue to smoke. This is a unique window of opportunity to build on our team's prior research in medical education and tobacco dependence treatment. This study involves close collaboration among researchers, practitioners, educators, and stakeholders at 10 U.S. medical schools. This unique team is comprised of investigators with extensive experience developing and teaching an evidence-based, physician-delivered 5A tobacco treatment model; developing and evaluating a web-based tobacco dependence treatment course; implementation of academic detailing with physician preceptors; and experience in building a large medical school consortium for tobacco curriculum reform.

6.摘要 每年，吸烟导致43万美国公民死亡，加剧多种疾病，并给社会带来代价 大约1000亿美元。尽管信息激增和限制吸烟的政策，成年人 在过去五年中，吸烟率保持相对稳定，目前为21%。简要的医生- 递送烟草治疗，俗称“5A”，是一种循证干预。 使吸烟者戒烟的可能性增加一倍。考虑到70%的吸烟者每年都会去看医生，所以 所有临床医生必须具备适当的知识和技能水平来为吸烟者提供咨询。然而，几乎没有人 医生和受训医生接受适当的培训，以发展这些技能。使用配对的， 随机分组对照(RGC)设计(在10所医学院实施)，我们将比较两种 向医学生传授5A的方法：1)传统医学教育(TE)；2)多模式 教育(MME)为TE增加了两个组成部分：面向学生的基于网络的教学计划和 教官培训。主要结果是观察到烟草治疗咨询技能，由 目的结构化临床考试--评估医学生技能的标准方法 在美国所有的医学院都达到了这一水平。次要结果是自我报告的烟草治疗咨询技能水平。 在嵌套队列设计中，在研究的第二年，将跟踪一组医科学生 从他们医学院第一年的开始(MS1)到他们第三年结束(MS3)，这发生在 研究的第四个年头。这项研资局试验的主要目的是比较MME对 针对TE在医学院传授5A辅导技巧。 假设1：在观察到的5A咨询技能(欧安组织)上，MME的表现优于TE。 假设2：在自我报告的5A咨询技能上，MME会比TE表现更好。 本研究的优点包括：1)创新的学习设计，测试一般的和综合的教学 方法和2)在整个美国医学院传播有效的教育方法的潜力 可以培养医生的技能，帮助数百万继续吸烟的患者。 这是一个独特的机会之窗，可以在我们团队先前在医学教育和 烟草依赖治疗。这项研究涉及研究人员、实践者、 10所美国医学院的教育工作者和利益相关者。这个独特的团队由调查人员组成，他们 开发和教授循证、医生提供的5A烟草疗法的丰富经验 模式；开发和评估基于网络的烟草依赖治疗课程；实施 与医生讲授学术细节；以及为以下项目建立大型医学院联盟的经验 烟草课程改革。

项目成果

Developing a Rational Approach to Tobacco Use Treatment in Pulmonary Practice: A Review of the Biological Basis of Nicotine Addiction.

• DOI: 10.1097/cpm.0b013e318247cada
• 发表时间: 2012-03-01
• 期刊: Clinical pulmonary medicine
• 作者: Leone FT;Evers-Casey S
• 通讯作者: Evers-Casey S

Tobacco counseling experience prior to starting medical school, tobacco treatment self-efficacy and knowledge among first-year medical students in the United States.

美国一年级医学生在进入医学院之前的烟草咨询经验、烟草治疗自我效能和知识。

• DOI: 10.1016/j.ypmed.2015.02.003
• 发表时间: 2015
• 期刊: Preventive medicine
• 影响因子: 5.1
• 作者: Xiao,RuiS;Hayes,RashelleB;Waring,MollyE;Geller,AlanC;Churchill,LindaC;Okuyemi,KolawoleS;Adams,Michael;Huggett,KathrynN;Ockene,JudithK
• 通讯作者: Ockene,JudithK

Tobacco dependence treatment teaching by medical school clerkship preceptors: survey responses from more than 1,000 US medical students.

医学院实习导师进行的烟草依赖治疗教学：来自 1,000 多名美国医学院学生的调查回复。

• DOI: 10.1016/j.ypmed.2013.04.006
• 发表时间: 2013
• 期刊: Preventive medicine
• 影响因子: 5.1
• 作者: Geller,AlanC;Hayes,RashelleB;Leone,Frank;Churchill,LindaC;Leung,Katherine;Reed,George;Jolicoeur,Denise;Okuliar,Catherine;Adams,Michael;Murray,DavidM;Liu,Qin;Waugh,Jonathan;David,Sean;Ockene,JudithK
• 通讯作者: Ockene,JudithK