权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Integrating Evidence-Based Smoking Cessation Interventions into Lung Cancer Screening Programs: A Randomized Trial

将循证戒烟干预措施纳入肺癌筛查计划：随机试验

基本信息

批准号：
9161984
负责人：
Kathryn L Taylor
金额：
$ 70.2万
依托单位：
GEORGETOWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-01 至 2021-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9161984
关键词：
Abstinence Address Adherence Adopted Advisory Committees Affect Age Appointment Cancer Intervention and Surveillance Modeling Network Cessation of life Clinic Communities Cost Effectiveness Analysis Counseling Data Disease Early treatment Economics Enrollment Future Gender Goals Health Individual Insurance Carriers Intervention Life Lung Malignant neoplasm of lung Mediator of activation protein Methods Modeling Motivation Nicotine Dependence Outcome Participant Patient-Focused Outcomes Persons Policy Maker Population Preventive service Primary Care Physician Primary Health Care Process Measure Professional counselor Protocols documentation Public Health Quality-Adjusted Life Years Readiness Risk Screening Result Site Smoker Smoking Smoking Cessation Intervention Societies Specialist Staging Subgroup Telephone Testing Tobacco United States Centers for Medicare and Medicaid Services Withholding Treatment arm base brief advice cost cost effective design evidence base experience high risk improved lung cancer screening mortality network models novel prevent programs quitline randomized trial screening smoking cessation treatment as usual

项目摘要

Abstract Lung cancer mortality can be reduced by 20% via CT screening and treatment of early stage disease. Maximum health impact from screening will only be achieved if high-risk smokers undergoing lung screening receive assistance to stop smoking. While there are several known effective cessation interventions, many of these are not scalable within diverse community-based lung cancer screening programs or with smokers who are not seeking cessation treatment. Our goal is to develop a scalable and cost-effective cessation intervention for widespread implementation to yield the greatest benefits and the lowest costs to both individuals and society. Guided by the RE-AIM Framework, we are proposing a pragmatic telephone counseling RCT, designed at the intersection of scalability and intensity, for future implementation within the national tobacco quitline. Our experienced team will conduct a randomized trial of 1330 smokers who have registered for screening at 5 diverse screening sites, comparing: 1) usual care (UC): telephone counseling, in which smokers receive a standard protocol of up to 3 counseling sessions and free NRT, vs. 2) a multi-faceted, 8-session, intensive telephone counseling (ITC) protocol, tailored on screening result, with free NRT. Both arms receive brief advice to quit, with primary care engagement, both English and Spanish speakers are included, and tobacco treatment specialists will conduct the telephone counseling. The goal of the ITC arm is to leverage the increased motivation provided by the teachable moment of lung screening and to counteract the potential for reduced motivation to quit following a normal result. Further, two important aspects of our approach include a cost-effectiveness analysis and use of the Cancer Intervention and Surveillance Modeling Network (CISNET) to evaluate the costs of the interventions relative to their impact on short- and long-term smoking-related outcomes. By including all smokers, regardless of readiness to quit, personalizing their tobacco-related health risks, and providing an evidence-based cessation intervention, we expect that the ITC arm will yield substantially higher quit rates with excellent potential for widespread implementation, resulting in a cost-effective intervention. The aims are: 1) To compare intensive telephone counseling (ITC) vs. usual care (UC) standard telephone counseling on biochemically verified 7-day, 30-day, and sustained abstinence. Intervention mediators and moderators will be assessed. 2) To evaluate reach and engagement of the interventions. 3) To conduct a cost-effectiveness analysis of ITC vs UC, in terms of cost per 3-, 6- and 12-month abstinence rates and quit attempts. The CISNET model will project the long-term impact of the interventions on cost per life year saved and quality-adjusted life years saved, lung cancer mortality reduction, and overall population mortality. This study will have a substantial public health impact by providing critical data to address scalability efforts by screening centers, insurers, and policy-makers.

摘要