Healthcare Team Approach to Tobacco Cessation

描述（申请人提供）： 医生处于一个独特的地位，作为国家的基石， 烟草预防和戒烟工作， 清单戒烟艾滋病和指挥的尊重程度，使他们 特别有影响力。然而，尽管有影响力，研究表明， 大多数医生报告说，由于 缺乏时间、培训和补偿。增加医生/药剂师 合作可以用来解决时间限制，因为药剂师有 被认为是社区中最容易获得的医疗服务提供者。 此外，对医生、他们的支持人员和药剂师的培训， 被证明可以提高戒烟咨询的技能和动机。 这个项目是M。D. 安德森癌症中心（德克萨斯州休斯顿）和SRI国际（加利福尼亚州门洛帕克）， 将整合和加强现有的三项医疗保健培训计划， 提供有效的戒烟咨询。创建和 实施针对具体专业的培训模块（一个针对医生， 他们的工作人员，一个药剂师）将建立一个训练有素的网络， 供应商，以及由媒体传播促进的联系系统， 用于促进提供者之间的转介和支持。附加媒体 将用于通知社区成员（需要的潜在患者）， 停止支持）的可用性的培训保健提供者 网络这种培训卫生保健提供者和告知所有人 患者和提供者网络的水平预计将大大提高， 临床实践指南的交付和使用 烟草使用和依赖。 将使用队列、横断面和前后测量。保健 提供者实践、患者烟草使用行为变化和社区水平 将审查外联工作。这项研究的具体目标是： 目标1：为每个人制定一个经过认可的继续教育培训计划， 目标医疗保健提供者群体。 目标2：在至少560名提供者（280名）中实施培训方案 医生和280名药剂师）在位于整个得克萨斯州的七个社区， 利用现场演示、卫星广播、录像演示， 基于Web的培训。 目的3：目的3：评估培训计划在以下方面的影响： 在医疗保健提供者及其患者中进行的分组随机试验， 将七个经过培训和联网的干预社区与七个 控制社区。 目标4：利用媒体和意见领袖网络渠道， 卫生保健从业人员之间以及从业人员与 社区宣传一个经过培训和可获得的戒烟网络 辅导员此外，为了鼓励和促进卫生保健提供者的外展， 社会各界 目的5：评估建议的戒烟咨询策略， 成本和收益。

Description (provided by applicant): Physicians are in a unique position to serve as a cornerstone for the nation's tobacco prevention and cessation efforts, having both access to the entire inventory of quitting aids and commanding a level of respect which makes them particularly influential. While influential, however, studies show that the majority of physicians report not counseling patients in smoking cessation due to lack of time, training and reimbursement. Increased physician/pharmacist collaboration can be used to address time constraints, since pharmacists have been identified as the most accessible health care providers in the community. In addition, training of physicians, their support staff, and pharmacists has been shown to improve skills and motivation for cessation counseling. The proposed project, a collaborative effort of researchers at the M. D. Anderson Cancer Center (Houston, TX) and SRI International (Menlo Park, CA), will integrate and enhance three existing initiatives for training health care providers in effective tobacco cessation counseling. The creation and implementation of specialty-specific training modules (one for physicians and their staff, one for pharmacists) will establish a network of trained providers, and a linkage system facilitated by media communications will be used to facilitate referrals and support among providers. Additional media will be used to inform community members (potential patients in need of cessation support) of the availability of the trained healthcare provider network. This combination of training health care providers and informing all levels of patient and provider networks is expected to greatly increase both delivery and utilization of the Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Cohort, cross-sectional and pre-post measures will be used. Health care provider practices, patient tobacco use behavior change, and community-level outreach will be examined. Specific aims of this study are: AIM 1: To develop an accredited continuing education training program for each of the target health care provider groups. AIM 2: To implement the training program among a minimum of 560 providers (280 physicians and 280 pharmacists) in seven communities located throughout Texas, using live presentations, broadcasts via satellite, videotaped presentations, and web-based training. AIM 3: AIM 3: To evaluate the impact of the training program in group-randomized trials among healthcare providers and their patients, comparing seven trained and networked intervention communities to seven control communities. AIM 4: To use media and opinion leader networking channels to facilitate linkages among health care practitioners and between practitioners and the community publicizing a web of trained and accessible tobacco cessation counselors. Also, to encourage and facilitate health care provider outreach in the community. AIM 5: To evaluate the proposed tobacco cessation counseling strategies for their costs and benefits.