Competency-based training to advance clinical proficiencies and reduce disparities in the treatment of tobacco dependence

尽管烟草使用量显著减少，但烟草控制努力的好处并不公平。 分布式的。与烟草有关的差异包括较高的日常吸烟率，较低的戒烟率， 对标准循证治疗的反应较差，较少获得循证治疗，变异 在卫生保健提供者提供烟草治疗方面，以及与烟草相关的癌症负担增加 以及其他与烟草有关的疾病。许多烟草使用者属于不止一个不同的群体。寻址 这些差异是癌症和烟草控制工作的高度优先事项。减少烟草的关键障碍- 相关的差异包括烟草处理工作人员没有准备好了解、评估和处理烟草 来自不同群体的使用者；关于与烟草有关的差异的性质和影响的知识不足； 在不同人群中治疗烟草使用所需的临床熟练程度方面已知的研究与实践之间的差距 更有效的分组；以及对决定因素的一维或本质主义概念化 加剧了这些不平等。这些障碍阻碍了个性化、相关性的发展 针对这些个人的全面烟草治疗计划。统一的、基于多学科能力的 由烟草治疗差异研究、实践和培训专家和 在全国范围内传播将代表着在解决这些障碍方面取得的重大进展。这样做的目的是 该项目是在不同人群中开发一种创新的、基于能力的烟草使用疗法 (TUT-DP)培训模块，将提高临床和研究人员的熟练程度，以满足 经历与烟草相关的差异的群体的生物医学、行为和临床需求。该领域的专家 来自多个学科的领域感知到对该资源的需求。该项目的创新方面包括 利用交叉性整合差异模型并制定理解指导原则 在不同人群中产生与烟草相关的差异的生物、心理和社会影响。具体的 目标一：使用由烟草研究、实践和培训专家以及 迭代过程，开发基于能力的、高度可传播的TUT-DP培训模块，包括 培训讲师资源、幻灯片和基于问题的体验式学习活动，由High- 高质量录制的演示和触发视频、培训手册和学员评估工具。目标 第二：与来自不同专业的培训者和学习者一起试行和完善TUT-DP培训模块 背景。目标三：在烟草治疗培训中广泛传播TUT-DP培训模块 计划和相关的专业组织。这个项目预计将有一个持续和强大的 通过传播创新的、引人入胜的多学科培训经验对现场产生影响 提高临床熟练程度，并作为烟草差异临床培训的基本工具。我们会 通过适当机制寻求额外资金，以审查图坦卡蒙国家方案的效力 培训模块下一阶段的癌症教育工作。

Despite remarkable decreases in tobacco use, the benefits of tobacco control efforts are not equitably distributed. Tobacco-related disparities include a higher prevalence of daily smoking, lower rates of quitting, poorer responses to standard evidence-based treatments, less access to evidence-based treatments, variation in health care providers' delivery of tobacco treatment, and an increased burden of tobacco-related cancers and other tobacco-related diseases. Many tobacco users belong to more than one disparate group. Addressing these disparities is a high priority for cancer and tobacco control efforts. Critical barriers to reducing tobacco- related disparities include a tobacco treatment workforce unprepared to understand, assess, and treat tobacco users from disparate groups; knowledge deficits regarding the nature and impact of tobacco-related disparities; known research-to-practice gaps in the clinical proficiencies needed to treat tobacco use among disparate groups more effectively; and a unidimensional or essentialist conceptualization of the determinants that contribute to these inequities. These barriers prevent the development of personalized, relevant comprehensive tobacco treatment plans for these individuals. A unified, multidisciplinary competency-based curriculum developed by tobacco treatment disparities research, practice, and training experts and disseminated nationally would represent significant progress toward addressing these barriers. The goal of this project is to develop an innovative, competency-based Tobacco Use Treatment among Disparate Populations (TUT-DP) Training Module that will advance the proficiencies of the clinical and research workforce to meet the biomedical, behavioral, and clinical needs of groups that experience tobacco-related disparities. Experts in the field from multiple disciplines perceive a need for this resource. Among the innovative aspects of this project is the use of Intersectionality to integrate models of disparities and develop guiding principles for understanding biopsychosocial influences that produce tobacco-related disparities across disparate populations. The specific aims are: Aim One: Using a multidisciplinary team of tobacco research, practice, and training experts and an iterative process, develop a competency-based, highly disseminable TUT-DP Training Module that includes train-the-trainer resources, slides, and problem-based and experiential learning activities supported by high- quality recorded demonstration and trigger videos, a training manual, and learner evaluation instruments. Aim Two: Pilot test and refine the TUT-DP Training Module with trainers and learners from diverse professional backgrounds. Aim Three: Disseminate the TUT-DP Training Module broadly among tobacco treatment training programs and relevant professional organizations. This project is expected to have a sustained and powerful impact on the field by disseminating an innovative and engaging multidisciplinary training experience that advances clinical proficiencies and serves as an essential tool for clinical training in tobacco disparities. We will seek additional funding through the appropriate mechanism to examine the effectiveness of the TUT-DP Training Module in the next phase of this cancer education work.