Parents Quit IT: Tailored Messaging and Decision Support to Help Parents Quit Smoking in Pediatric Settings

家长戒烟：量身定制的消息传递和决策支持，帮助家长在儿科环境中戒烟

• 批准号: 10213666
• 负责人: Brian P. Jenssen
• 金额: $ 18.64万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10213666
• 关键词: Address; Adoption; Adult; Advisory Committees; Advocate; Affect; Area; Asthma; Caring; Cessation of life; Child; Child Health; Childhood; Chronic; Clinical Decision Support Systems; Clinical Informatics; Clinical Trials; Communication; Data Analyses; Data Collection; Decision Making; Development; Doctor of Philosophy; Effectiveness; Effectiveness of Interventions; Electronic Health Record; Engineering; FDA approved; Family; Fostering; Future; General Population; Goals; Grant; Health; Health Benefit; Health system; Healthcare; Healthy People 2020; Household; Human; Informatics; Interdisciplinary Study; Intervention; Intervention Trial; Knowledge; Lead; Life Expectancy; Low income; Lung diseases; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Mentors; Methodology; Methods; Modality; Morbidity - disease rate; Not Hispanic or Latino; Outpatients; Parents; Pharmaceutical Preparations; Population; Positioning Attribute; Preparation; Preventive service; Public Health; Qualitative Methods; Research; Research Personnel; Risk; Science; Scientist; Smoke; Smoker; Smoking; Smoking Cessation Intervention; Source; Standardization; Structure; Sudden infant death syndrome; Systems Integration; Testing; Time; Tobacco; Tobacco Dependence; Tobacco Use Cessation; Tobacco use; Training; United States Dept. of Health and Human Services; Vulnerable Populations; Work; base; behavioral economics; cancer prevention; career; career development; clinical decision support; clinical decision-making; clinical practice; cost; design; disorder risk; effective intervention; environmental tobacco smoke exposure; evidence base; experience; health care service; improved; mortality; multidisciplinary; novel; pediatrician; pilot trial; practice setting; pragmatic trial; prevent; preventable death; skills; smoking cessation; smoking-related cancer; socioeconomic disadvantage; support tools; tailored messaging; theories; tobacco cessation intervention; tobacco control; tobacco prevention; treatment trial

Project Summary/Abstract Secondhand smoke exposure affects more than 40% of the US pediatric population and exacerbates and/or increases the risk of disease morbidity and mortality. By helping parents quit smoking, pediatricians protect children and families from the harms of tobacco. Pediatricians are uniquely positioned to intervene but appropriate treatments are delivered to parent smokers less than 3% of the time. Major barriers to wider adoption include lack of understanding of effective pediatrician-parent communication regarding tobacco cessation treatment and mechanisms to systematize, consistently deliver, and scale effective interventions. A multi-disciplinary research approach incorporating decision science and clinical informatics could maximize intervention effectiveness while simplifying, standardizing, and systematizing parental treatment for tobacco use in pediatric clinical practice. To lead this research and establish my long-term career goal as a clinician- scientist dedicated to preventing cancer by protecting families and vulnerable populations from tobacco, my training objectives involve developing skills in critical theoretical and methodological areas including: 1) behavioral economics, 2) human factors engineering, and 3) clinical and pragmatic trial methodology. My career development will be fostered through my multidisciplinary mentoring team, including Alexander Fiks, MD, MSCE (primary mentor, expert in using health IT to improve clinical decision making), Robert Schnoll, PhD (co-mentor, expert in tobacco treatment trials), and David Asch, MD, MBA (co-mentor, expert in behavioral economics). My advisory committee will further guide my career development and will provide expertise in data analysis in clinical trials, human factors engineering, qualitative methods, and dissemination and health system integration. Building upon my preliminary work, this training will be leveraged to create and evaluate a novel intervention, a clinical decision support (CDS) tool embedded within the electronic health record (EHR), for tobacco treatment in the pediatric setting, grounded in behavioral economics and developed using rigorous informatics design methods, neither of which have been applied to this context. The research approach includes: developing theory-based messages that engage parents in tobacco cessation treatment (Aim 1), identifying effective methods for delivering these messages using CDS tools (Aim 2), and measuring the impact of these messages on parent quit rates (Aim 3). The results from these aims, which logically build towards the development of a testable, theory-driven intervention, will lead to future R01 grants that support the testing of CDS interventions optimized for effectively and systematically addressing parent smoking in pediatric settings.

项目概要/摘要 二手烟暴露影响超过 40% 的美国儿童，并会加剧和/或 增加疾病发病率和死亡率的风险。通过帮助父母戒烟，儿科医生可以保护 儿童和家庭免受烟草的危害。儿科医生在干预方面具有独特的地位，但 向父母吸烟者提供适当治疗的比例不到 3%。更广泛的主要障碍 采用包括缺乏儿科医生与家长关于烟草的有效沟通的了解 戒烟治疗和系统化、持续提供和扩大有效干预措施的机制。 结合决策科学和临床信息学的多学科研究方法可以最大限度地提高 干预有效性，同时简化、标准化和系统化父母烟草治疗 在儿科临床实践中的应用。为了领导这项研究并确立我作为临床医生的长期职业目标- 致力于通过保护家庭和弱势群体免受烟草侵害来预防癌症的科学家，我的 培训目标涉及培养关键理论和方法领域的技能，包括：1) 行为经济学，2）人为因素工程，3）临床和实用试验方法。我的 我的多学科指导团队将促进职业发展，其中包括 Alexander Fiks、 MD、MSCE（主要导师，利用健康 IT 改善临床决策的专家），Robert Schnoll， 博士（联合导师，烟草治疗试验专家）和 David Asch，医学博士、MBA（联合导师，烟草治疗试验专家） 行为经济学）。我的顾问委员会将进一步指导我的职业发展，并将提供 临床试验数据分析、人因工程、定性方法和传播方面的专业知识 和卫生系统整合。 在我的初步工作的基础上，这次培训将被用来创建和评估一种新颖的干预措施， 嵌入电子健康记录 (EHR) 中的临床决策支持 (CDS) 工具，用于烟草治疗 在儿科环境中，以行为经济学为基础，并使用严格的信息学设计开发 方法，这两种方法都没有应用于此上下文。研究方法包括：开发 基于理论的信息，让父母参与戒烟治疗（目标 1），确定有效的 使用 CDS 工具传递这些消息的方法（目标 2），并衡量这些消息的影响 父母戒烟率（目标 3）。这些目标的结果，从逻辑上讲是为了发展一个 可测试的、理论驱动的干预措施，将导致未来的 R01 拨款支持 CDS 干预措施的测试 经过优化，可有效、系统地解决儿科环境中家长吸烟问题。