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Phone Enabled Implementation of Cessation Support (PHOENICS)

通过电话实施戒烟支持 (PHOENICS)

基本信息

批准号：
10701705
负责人：
Rima Nakkash
金额：
$ 52.47万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-09 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10701705
关键词：
Abstinence Address Administrator Adoption Adult American Behavioral Cancer Control Carbon Monoxide Cigarette Smoker Clinic Counseling Country Exploration, Preparation, Implementation, and Sustainment Female Focus Groups Fostering Goals Health Personnel Health system Hybrids Incidence Income Infrastructure Institution Intervention Interview Lebanon Malignant neoplasm of lung Measures Medical center Mediterranean Region Methods Modeling Morbidity - disease rate Patient Self-Report Patients Persons Pharmacotherapy Population Prevalence Primary Care Primary Health Care Protocols documentation Provider Public Health Recommendation Research Resource-limited setting Resources Services Smoke Smoker Smoking Cessation Intervention Surveys System Telephone Testing Tobacco Tobacco Dependence Tobacco use Universities World Health Organization arm brief advice cancer prevention comparative effectiveness contextual factors cost cost effective cost effectiveness design dissemination science effectiveness testing evidence base follow-up health training hookah implementation determinants implementation evaluation implementation process implementation science implementation/effectiveness interest low and middle-income countries male mortality multi-component intervention nicotine replacement primary care patient primary care setting primary health center programs public health relevance randomized trial reduce tobacco use safety net smoking cessation standard care success treatment program trial comparing

项目摘要

PROJECT SUMMARY The objective of this proposal is to evaluate the comparative effectiveness of promising multi-component interventions for implementing evidence-based tobacco treatment in Lebanon’s national system of safety net primary healthcare centers, which serves more than 50% of the population. This objective is directly responsive to NCI Notice of Special Interest (NOT-CA-20-025): Dissemination and Implementation Science for Cancer Prevention and Control in Low Resource Environments. The tobacco use burden in Lebanon is exceptionally high: 35% of adults are current cigarette smokers, 39% are waterpipe smokers, and 5% are dual smokers. The WHO endorses three interventions as the standard of practice for population-level tobacco dependence treatment: smoking cessation advice integrated into primary care settings; easily-accessible phone-based counseling; and low-cost nicotine replacement therapy (NRT). However, the evidence for these interventions comes primarily from high-income countries and they have rarely been evaluated in low- and middle-income countries (LMICs). Further, recommended interventions are not integrated as a routine part of primary care in Lebanon, as is the case in other low-resource settings. Addressing this evidence-to-practice gap requires research on multilevel interventions and contextual factors for implementing integrated, scalable, and sustainable cessation treatment within low-resource settings. We will conduct a group-randomized trial comparing three arms: 1) Ask about tobacco use, advise to quit, assist with brief counseling (AAA) as standard care; 2) Ask, advise, connect to phone-based counseling (AAC); and 3) AAC+NRT. Our central hypothesis is that connecting patients to phone-based counseling with NRT is the most effective alternative. Our hybrid design is informed by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework which emphasizes key steps and multilevel factors to optimize implementation success. We will pursue the following specific aims: 1) adapt and tailor an existing smoking cessation program to deliver phone-based counseling to smokers in Lebanon; 2) test the effectiveness and cost-effectiveness of a referral-based program that delivers smoking cessation services to primary care patients; and 3) identify the multilevel determinants of implementation and sustainability using mixed methods. The proposed project addresses the evidence-to- practice gap in the provision of tobacco dependence treatment within low-resource settings by developing and testing contextually-tailored multilevel interventions and optimizing implementation success and sustainability. This research is significant for its potential to guide the large-scale adoption of cost-effective strategies for implementing tobacco dependence treatment in low-resource settings thereby reducing tobacco-related morbidity and mortality.

项目概要该提案的目的是评估有前途的多组分的比较有效性在黎巴嫩国家安全网系统中实施循证烟草治疗的干预措施初级保健中心，为 50% 以上的人口提供服务。这个目标直接是响应 NCI 特别关注通知 (NOT-CA-20-025)：传播和实施科学资源匮乏环境中的癌症预防和控制。黎巴嫩的烟草使用负担是极高：35% 的成年人目前吸烟，39% 吸水烟，5% 吸双烟吸烟者。世界卫生组织认可三项干预措施作为人口层面烟草的实践标准依赖性治疗：将戒烟建议纳入初级保健机构；容易到达电话咨询；和低成本尼古丁替代疗法（NRT）。然而，这些证据干预措施主要来自高收入国家，很少在低收入和低收入国家进行评估中等收入国家（LMIC）。此外，建议的干预措施并未纳入日常干预措施的一部分。黎巴嫩的初级保健与其他资源匮乏地区的情况一样。解决这一从证据到实践的问题差距需要对多层次干预措施和背景因素进行研究，以实施综合的、可扩展的、以及资源匮乏环境下可持续的戒烟治疗。我们将进行分组随机试验比较三组：1) 询问烟草使用情况、建议戒烟、协助简短咨询 (AAA) 作为标准关心; 2) 询问、建议、连接电话咨询 (AAC)； 3) AAC+NRT。我们的中心假设是将患者与 NRT 进行电话咨询联系起来是最有效的选择。我们的混合动力设计以探索、准备、实施、维持 (EPIS) 框架为基础，该框架强调优化实施成功的关键步骤和多层次因素。我们将追求以下目标具体目标： 1) 调整和定制现有的戒烟计划，以提供基于电话的咨询黎巴嫩的吸烟者； 2) 测试基于推荐的计划的有效性和成本效益为初级保健患者提供戒烟服务； 3）确定多层次的决定因素使用混合方法的实施和可持续性。拟议的项目解决了证据到通过制定和实施在资源匮乏环境中提供烟草依赖治疗方面的实践差距测试根据具体情况量身定制的多层次干预措施并优化实施的成功率和可持续性。这项研究具有重要意义，因为它有可能指导大规模采用具有成本效益的策略在资源匮乏地区实施烟草依赖治疗，从而减少与烟草相关的发病率和死亡率。