QUIT-PRIMO:Web-delivered Clinical Microsystem Intervention for Tobacco Control

描述(由申请人提供)：这是我们首次根据PA-06-226信息技术和互联网在卫生服务和干预提供方面的信息技术和互联网提供的微系统优化而重新提交的戒烟-Primo质量改进随机试验。我们的总体目标是通过以初级保健临床微系统为目标，促进与互联网在卫生服务提供中的使用和影响相关的科学，特别是戒烟。临床微系统被定义为最小的功能医疗单位。临床微系统不仅仅等同于医生和护士的临床团队，还包括由提供者护理的患者小组和使用的护理过程。卫生保健改进研究所(IHI)指出，针对临床微系统的干预措施是提高卫生保健质量的关键组成部分。我们有以下具体目标：目的1.将160个基于社区的初级保健微系统随机纳入一项试验，比较戒烟-Primo和纸质信息处方；目的2.使用患者报告的测量方法评估Quit-Primo对转诊率的影响；目的3.评估Quit-Primo对初级保健患者戒烟6个月的影响。Quit-PRIIMO干预是一种由互联网提供的多组件临床微系统干预：1.参考2Quit医疗保健点患者转介门户网站提供者可以用来将患者登记到自我管理系统中，其中包含提供者和患者活动的摘要报告，以及安全的消息传递模板，提供者可以使用这些模板来有效地鼓励患者在后续行动期间戒烟；以及2.Decide2Quit患者自我管理门户网站组织互动、量身定制的患者教育、戒烟计划、到其他高质量网站(Smokefre.gov)和离线资源(1-800-QUIT-NOW)的链接，以及患者可以使用的安全消息传递。The Control是一种纸质信息，处方提供者打印出来，将患者推荐到以前开发的患者自我管理网站，该网站没有链接到临床微系统。这项拟议的研究的意义在于，它将是第一个针对临床微系统的互联网干预，其特定目的是增加戒烟。我们的干预在戒烟网络资源中也是独一无二的，因为一个主要目标是加强随访和增加寻求治疗。Quit-Primo建立在我们之前由NCI资助的R21(福特，PI)的基础上，在那里我们控制了本研究的自我管理系统。公共卫生相关性：这是我们首次重新提交针对PA-06-226信息技术和互联网在卫生服务和干预提供中的戒烟质量改进和互联网微系统优化的随机试验。我们的总体目标是通过以初级保健临床微系统为目标，促进与互联网在卫生服务提供中的使用和影响相关的科学，特别是戒烟。Quit-PRIIMO干预是一种由互联网提供的多组件临床微系统干预：1.参考2Quit医疗保健点患者转介门户网站提供者可以用来将患者登记到自我管理系统中，其中包含提供者和患者活动的摘要报告，以及安全的消息传递模板，提供者可以使用这些模板来有效地鼓励患者在后续行动期间戒烟；以及2.Decide2Quit患者自我管理门户网站组织互动、量身定制的患者教育、戒烟计划、到其他高质量网站(Smokefre.gov)和离线资源(1-800-QUIT-NOW)的链接，以及患者可以使用的安全消息传递。

DESCRIPTION (provided by applicant): This is our first resubmission of a randomized trial of QUIT-PRIMO Quality Improvement in Tobacco - Provider Referrals & Internet-delivered Microsystem Optimization in response to PA-06-226 Information Technologies and the Internet in Health Services and Intervention Delivery. Our Overall Goal is to advance science related to the use and impact of the Internet in health services delivery, specifically smoking cessation, by targeting primary care clinical microsystems. A clinical microsystem is defined as the smallest functional healthcare unit. A clinical microsystem is not simply equivalent to a clinical team doctors and nurses, but also includes the panel of patients cared for by the providers and the processes of care that are used. The Institute for Healthcare Improvement (IHI) states interventions targeted to clinical microsystems are a crucial component in improving health care quality. We have the following Specific AIMS: Aim 1. Randomize 160 community- based primary care microsystems into a trial comparing the QUIT-PRIMO with a paper- based information prescription; Aim 2. Evaluate the impact of QUIT-PRIMO on referral rates using patient-reported measures; Aim 3. Evaluate the impact of QUIT- PRIMO on six-month smoking cessation of primary care patients. The QUIT-PRIIMO Intervention is a multi-component Internet-delivered clinical microsystem intervention with: 1. Refer2Quit A point-of-care patient referral portal providers can use to enroll patients into a self-management system, with summary reports of provider and patient activity, and secure messaging templates providers can use to efficiently encourage patients to quit during follow-up; AND 2. Decide2Quit A patient self-management portal organizing interactive, tailored, patient education, cessation planning, links to other high-quality web (smokefree.gov) and offline resources (1-800-QUIT-NOW), and secure messaging patients can use. The Control is a paper-based information prescription providers print to refer patients to a previously developed patient self-management website not linked into the clinical microsystem. The significance of the proposed study is that it will be the first Internet-delivered Intervention targeted to the clinical microsystem with the specific purpose of increasing smoking cessation. Our intervention is also unique among web resources for smoking cessation because a major goal is to enhance follow-up and increase treatment-seeking. QUIT-PRIMO builds upon our previous NCI-funded R21 (Ford, PI), where we our control self-management system for this study. PUBLIC HEALTH RELEVANCE: This is our first resubmission of a randomized trial of QUIT-PRIMO Quality Improvement in Tobacco - Provider Referrals & Internet-delivered Microsystem Optimization in response to PA-06-226 Information Technologies and the Internet in Health Services and Intervention Delivery. Our Overall Goal is to advance science related to the use and impact of the Internet in health services delivery, specifically smoking cessation, by targeting primary care clinical microsystems. The QUIT-PRIIMO Intervention is a multi-component Internet-delivered clinical microsystem intervention with: 1. Refer2Quit A point-of-care patient referral portal providers can use to enroll patients into a self-management system, with summary reports of provider and patient activity, and secure messaging templates providers can use to efficiently encourage patients to quit during follow-up; AND 2. Decide2Quit A patient self-management portal organizing interactive, tailored, patient education, cessation planning, links to other high-quality web (smokefree.gov) and offline resources (1-800-QUIT-NOW), and secure messaging patients can use.