Integrating Smoking Cessation with Lung Cancer Screening

将戒烟与肺癌筛查相结合

• 批准号: 8866798
• 负责人: Steven Bacchus Zeliadt
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8866798
• 关键词: Address; Advisory Committees; Age; Belief; Chest; Clinic Visits; Clinical; Communication; Counseling; Data; Development; Dose; Early Diagnosis; Effectiveness; Ensure; Future; Goals; Guidelines; Health; Health behavior; Image; Individual; Intervention; Intervention Trial; Interview; Letters; Lung; Malignant neoplasm of lung; Measures; Medical center; Modeling; Modification; Motivation; Nurses; Participant; Patient Education; Patients; Pilot Projects; Predisposition; Preventive; Primary Health Care; Process; Professional Organizations; Professional counselor; Protocols documentation; Race; Reaction; Recommendation; Reporting; Resources; Risk; Sampling; Screening Result; Screening for cancer; Self Efficacy; Services; Site; Smoker; Smoking; Smoking Behavior; Staging; Techniques; Telephone; Test Result; Testing; Time; Tobacco Use Cessation; Training; Transcript; Veterans; Writing; X-Ray Computed Tomography; arm; base; cost; design; efficacy testing; evidence base; health literacy; high risk; literacy; lung cancer screening; mortality; motivational enhancement therapy; nursing intervention; parallel processing; prototype; quitline; routine care; screening; smoking cessation; therapy development; tool; treatment as usual

 DESCRIPTION (provided by applicant): Lung cancer screening with low-dose computed tomography chest (CT) imaging among current smokers may be a valuable opportunity to engage in discussions about individualized risks associated with smoking, and help motivate smokers to consider exploring available tobacco cessation resources including the VA Quit Line. Time constraints make it challenging to have in depth discussions during clinic visits, and mailed test results and written patient education materials may not be adequate to comprehensively address tobacco cessation. This pilot study will test a prototype tele-nurse intervention that consists of two contacts. A nurse will call patients after they are referred for screening, but prior to undergoing screening, to review any additional questions patients may have about the screening process. Second, the nurse will contact patients to review the results of the screening test. The prototype intervention will be tested in 28 patients who are offered screening as part of VA's Lung Cancer Screening Clinical Demonstration Project (Aim 1). Patients from two sites - NY Harbor and Portland VA Medical Centers - will be approached remotely by a tele-nurse based in the Seattle COIN. The intervention sessions will incorporate evidence-based motivational interviewing techniques guided by the parallel process model which motivates health behavior actions through helping individuals understand their individual susceptibility and strengthen motivation and self-efficacy. An assessment call will be conducted four weeks after the second intervention session in order to assess utilization of the VA Quit Line and other tobacco cessation resources. A convenient sample of 28 subjects, also offered lung cancer screening as part of the Demonstration Project, will be contacted for a single assessment call to measure utilization of tobacco cessation resources and smoking behaviors in the absence of the intervention (Aim 2). We will qualitatively review the transcripts from the intervention sessions to identify key messages that motivate participants to use cessation resources, and explore for potential differences in receptivity to the intervention by race and literacy (Aim 3). Our goal is to refine the interventio to ensure we target vulnerable Veteran smokers with low health literacy who may underestimate their individual health risks associated with smoking as a result of being offered lung cancer screening. Findings from this study will inform a larger intervention trial testing telephone-based counseling integrated into lung cancer screening, with the goal of increasing quit rates through promoting the use of the VA Quit Line and tobacco cessation tools.

 描述(由申请人提供)： 在当前吸烟者中进行低剂量计算机断层扫描(CT)肺癌筛查可能是一个宝贵的机会，可以参与与吸烟相关的个性化风险的讨论，并有助于激励吸烟者考虑探索可用的戒烟资源，包括VA戒烟热线。时间限制使得在诊所访问期间进行深入讨论具有挑战性，邮寄的测试结果和书面患者教育材料可能不足以全面解决戒烟问题。这项先导性研究将测试由两个联系人组成的远程护士干预原型。护士将在患者被转介进行筛查后打电话给他们，但在进行筛查之前，审查患者可能对筛查过程提出的任何其他问题。第二，护士会联系病人，复核筛查结果。原型干预将在28名患者中进行测试，这些患者作为退伍军人管理局肺癌筛查临床示范项目(AIM 1)的一部分进行筛查。来自两个地点-纽约港和波特兰退伍军人医疗中心-的患者将由西雅图硬币上的远程护士远程联系。干预课程将纳入以证据为基础的动机访谈技术，该技术由平行过程模式指导，通过帮助个人了解他们的个体易感性并增强动机和自我效能来激励健康行为行动。 将在第二次干预会议后四周进行一次评估电话，以评估退伍军人戒烟热线和其他戒烟资源的利用情况。作为示范项目的一部分，还提供肺癌筛查的28名受试者的方便样本将被联系进行单一评估电话，以衡量在没有干预的情况下戒烟资源的利用情况和吸烟行为(目标2)。我们将定性地审查干预会议的记录，以确定激励参与者使用戒烟资源的关键信息，并探索种族和文化程度在接受干预方面的潜在差异(目标3)。我们的目标是完善干预措施，以确保我们的目标是健康素养较低的脆弱的资深吸烟者，他们可能会低估自己因接受肺癌筛查而与吸烟相关的个人健康风险。这项研究的结果将为一项更大规模的干预试验提供参考，该试验以电话为基础 咨询整合到肺癌筛查中，目标是通过推广VA戒烟热线和戒烟工具的使用来提高戒烟率。

项目成果

Stakeholder Research Priorities for Smoking Cessation Interventions within Lung Cancer Screening Programs. An Official American Thoracic Society Research Statement.

• DOI: 10.1164/rccm.201709-1858st
• 发表时间: 2017-11-01
• 期刊: American journal of respiratory and critical care medicine
• 影响因子: 24.7
• 作者: Kathuria H;Detterbeck FC;Fathi JT;Fennig K;Gould MK;Jolicoeur DG;Land SR;Massetti GM;Mazzone PJ;Silvestri GA;Slatore CG;Smith RA;Vachani A;Zeliadt SB;Wiener RS;ATS Assembly on Thoracic Oncology
• 通讯作者: ATS Assembly on Thoracic Oncology