Sustainability of Tobacco Cessation Programs at NCI-Designated Cancer Centers

项目总结/摘要 2014年卫生局局长的报告提供了明确的证据，表明癌症幸存者吸烟会导致不良反应。 健康结果和2020年的报告得出结论，癌症诊断后戒烟可以改善 生存虽然戒烟可以改善预后，并被提倡作为肿瘤学的标准治疗， 烟草治疗并不总是作为癌症护理的一部分提供。为了应对这一挑战， 美国国家癌症研究所（NCI）于2017年启动了癌症中心戒烟计划（C3 I）。C3I 通过协调中心向52个国家癌症研究所指定的癌症患者提供财政和技术援助 中心实施循证烟草治疗计划，并将戒烟纳入 在肿瘤学环境中的常规患者护理。所有受资助的中心都必须维持其项目一段时间 在NCI资助期之后至少三年。然而， 这些癌症中心的烟草治疗方案的可持续性是未知的。更广泛地说，实现 随着时间的推移，持续提供基于证据的计划已被确定为最重要的一个 被低估的挑战我们的长期目标是建立一个可推广的模型来维持证据- 基于烟草的癌症治疗方案。本研究的目的是调查的轨迹 和C3 I循证烟草治疗计划可持续性的决定因素，并确定 采用实施规划方法促进可持续性的适当战略（即， “可持续性绘图”）。我们将可持续性定义为项目保持核心组件的程度， 实施战略和项目成果。我们已经证明了这些方法的可行性 与C3 I协调中心和参与的癌症中心合作进行评估。拟议 这项研究将扩大这种合作，并利用国家癌症研究所在C3 I方面的大量投资， 以下具体目标：1）描述癌症中心内烟草治疗计划的持续性; 2)详细说明多层次的决定因素，战略和可持续发展的结果之间的关系， 癌症中心内的烟草治疗计划;以及3）开发和测试工具包，以指导选择 癌症护理中烟草治疗计划的可持续战略。拟议的研究提供了一个 这是一个前所未有的机会，可以确定如何将建立循证项目的投资转化为 可持续的医疗保健系统的变化。

PROJECT SUMMARY/ABSTRACT The 2014 Surgeon General’s report provided clear evidence that smoking by cancer survivors causes adverse health outcomes and the 2020 report concluded that smoking cessation after a cancer diagnosis improves survival. Though smoking cessation improves outcomes and is advocated as a standard of care in oncology, tobacco treatment is not consistently delivered as a part of cancer care. To address this challenge, the National Cancer Institute (NCI) launched the Cancer Center Cessation Initiative (C3I) in 2017. The C3I provides financial and technical assistance through a Coordinating Center to 52 NCI-designated cancer centers to implement evidence-based tobacco treatment programs and integrate smoking cessation into routine patient care in oncology settings. All funded centers were required to sustain their programs for a minimum of three years following the NCI-funded period. However, the trajectories and determinants of sustainability for tobacco treatment programs in these cancer centers are unknown. More broadly, achieving sustained delivery of evidence-based programs over time has been identified as one of the most crucial yet understudied challenges. Our long-term goal is to develop a generalizable model for sustaining evidence- based tobacco treatment programs in cancer care. The objective of this study is to investigate the trajectories and determinants of sustainability across evidence-based tobacco treatment programs in C3I and to identify appropriate strategies for promoting sustainability using an implementation mapping approach (i.e., “sustainability mapping”). We define sustainability as the extent to which programs maintain core components, implementation strategies, and program outcomes over time. We have demonstrated the feasibility of these assessments in collaboration with the C3I Coordinating Center and participating cancer centers. The proposed study will extend this collaboration and leverage the NCI’s substantial investment in the C3I to pursue the following specific aims: 1) Characterize the sustainment of tobacco treatment programs within cancer centers; 2) Specify the relationships between multilevel determinants, strategies, and outcomes of sustainability for tobacco treatment programs within cancer centers; and 3) Develop and test a toolkit to guide the selection of sustainment strategies for tobacco treatment programs in cancer care. The proposed research offers an unprecedented opportunity for identifying how investment in building evidence-based programs is converted into sustainable healthcare systems change.