Optimizing Smoking Cessation Treatment for Patients with Bladder Cancer

优化膀胱癌患者的戒烟治疗

• 批准号: 10371383
• 负责人: Richard Steven Matulewicz
• 金额: $ 19.41万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10371383
• 关键词: Academic Medical Centers; Active Learning; Address; Adult; Biometry; Cancer Patient; Cancer Survivor; Caring; Clinic; Clinic Visits; Collaborations; Computerized Medical Record; Counseling; Development Plans; Diagnosis; Drug Prescriptions; Evidence based practice; Evidence based treatment; Face; Familiarity; Focus Groups; Future; Goals; Health Services Research; Institution; Interview; Investigation; K-Series Research Career Programs; Malignant Neoplasms; Malignant neoplasm of urinary bladder; Medical; Mentors; Methodology; Methods; Modeling; Morbidity - disease rate; Oncology; Outcome; Patient-Focused Outcomes; Patients; Peripheral; Pharmaceutical Preparations; Pharmacotherapy; Phase; Positioning Attribute; Prevalence; Primary Health Care; Process; Provider; Qualitative Methods; Quality of life; Research; Research Methodology; Research Personnel; Research Priority; Research Project Grants; Research Proposals; Research Training; Risk; Risk Factors; Science; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Time; Training; Treatment outcome; United States; Urologic Oncology; Urologist; Urology; Variant; Veterans; Veterans Health Administration; Vulnerable Populations; Work; base; cancer diagnosis; cancer recurrence; care delivery; career development; clinical decision support; comorbidity; data warehouse; effectiveness/implementation study; evidence base; implementation science; implementation strategy; implementation study; improved; member; mortality; multidisciplinary; nicotine replacement; novel; patient screening; preservation; primary care setting; recruit; research and development; screening; skills; smoking cessation; support tools; theories

Smoking is the leading risk factor for bladder cancer and is estimated to account for half of the 80,000 new diagnoses each year in the United States. Patients who quit after diagnosis have improved quality-of-life, lower risk of recurrence, and a 3-fold lower chance of dying from bladder cancer compared to those who continue to smoke. Yet only one in 5 urologists delivers smoking cessation treatment to patients, and considerable gaps in patient awareness and guideline-concordant screening and referral exist in the urology setting. These factors contribute to adults with bladder cancer being the least likely to quit smoking after diagnosis, compared to all other cancer survivors. Increased use of evidence-based smoking cessation treatment will improve outcomes for the estimated 100,000 patients with bladder cancer who continue to smoke. The proposed research project aims to investigate and optimize the delivery of evidence-based smoking cessation treatment for patients with bladder cancer at Memorial Sloan Kettering Cancer Center (MSK). Specific Aim 1 will evaluate how smoking cessation treatment is given to patients with bladder cancer by quantifying practice patterns and exploring factors associated with sub-optimal care delivery. Specific Aim 2 will identify determinants of smoking cessation treatment using qualitative methods that will help elucidate multi-level determinants of evidence-based practices. Specific Aim 3 will adapt our current tobacco treatment strategy to the urology context using theory-based implementation science methods informed by our mixed-methods explanatory study (Aims 1 and 2) and will pilot promising strategies. The proposed research represents a significant step towards understanding and improving the delivery of evidence-based smoking cessation treatment for patients with bladder cancer. Our findings will establish a theory-based paradigm to facilitate smoking cessation treatment within diverse surgical oncology contexts at MSK while improving patient outcomes and advancing the field of implementation science. The proposed research project is accompanied by a training plan that will provide the candidate with critical expertise in advanced biostatistics and data science, qualitative research methods, and implementation science. This will be accomplished through a detailed plan that involves coursework, collaboration, and experiential learning corresponding to each Specific Aim of the study. This career development and training plan will give the candidate a set of skills unique among urologists and will be guided by a world-class group of mentors and collaborators at a premier academic medical center and partner hospitals. The members of this multidisciplinary team will each contribute unique expertise to the candidate’s novel and innovative career development plan and research proposal. This career development award will position him to make significant contributions in the future as an independent investigator in health services research and urologic oncology.

吸烟是膀胱癌的主要风险因素，据估计，在美国每年8万例新诊断病例中，吸烟占到了一半。与继续吸烟的患者相比，确诊后戒烟的患者生活质量提高，复发风险降低，死于膀胱癌的可能性降低3倍。然而，只有五分之一的泌尿科医生为患者提供戒烟治疗，而且在患者意识和指南一致性筛查和转诊方面，泌尿科存在相当大的差距。与所有其他癌症幸存者相比，这些因素导致膀胱癌患者在确诊后戒烟的可能性最小。增加循证戒烟治疗的使用将改善估计为10万名继续吸烟的膀胱癌患者的预后。 这项拟议的研究项目旨在调查和优化斯隆-凯特琳纪念癌症中心(MSK)为膀胱癌患者提供的循证戒烟治疗。具体目标1将通过量化实践模式和探索与次优护理提供相关的因素来评估如何为膀胱癌患者提供戒烟治疗。具体目标2将使用定性方法确定戒烟治疗的决定因素，这将有助于阐明循证实践的多层次决定因素。具体目标3将利用我们的混合方法解释性研究(目标1和2)所提供的以理论为基础的实施科学方法，使我们目前的烟草治疗战略适应泌尿外科的情况，并将试点有希望的战略。这项拟议的研究是朝着了解和改进膀胱癌患者循证戒烟治疗的方向迈出的重要一步。我们的发现将建立一个基于理论的范例，在MSK的不同外科肿瘤学背景下促进戒烟治疗，同时改善患者结果并推进实施科学领域。 拟议的研究项目伴随着一项培训计划，该计划将为候选人提供高级生物统计学和数据科学、定性研究方法和实施科学方面的关键专业知识。这将通过一项详细的计划来实现，该计划涉及与研究的每个具体目标相对应的课程作业、协作和体验式学习。这项职业发展和培训计划将为应聘者提供一套在泌尿科医生中独一无二的技能，并将由一流学术医学中心和合作医院的世界级导师和合作者团队指导。这个多学科团队的成员将各自为候选人的新颖和创新的职业发展计划和研究提案贡献独特的专业知识。这一职业发展奖将使他在未来作为一名卫生服务研究和泌尿外科肿瘤学的独立研究员做出重大贡献。