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

尽管烟草使用显著减少，但烟草控制工作的好处并不公平。 发放与烟草有关的差异包括每日吸烟率较高，戒烟率较低， 对标准循证治疗的反应较差，循证治疗的可及性较差， 在卫生保健提供者提供烟草治疗方面，以及与烟草有关的癌症负担增加 和其他与烟草有关的疾病。许多烟草使用者属于一个以上的不同群体。解决 这些差距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- 相关的差距包括烟草治疗工作人员对了解、评估和治疗烟草没有准备 来自不同群体的用户;对烟草相关差异的性质和影响缺乏了解; 已知的研究与实践之间的差距，需要治疗不同的烟草使用的临床专业， 更有效地分组;以及决定因素的一维或本质主义概念化， 造成了这些不平等。这些障碍阻碍了个性化、相关性 为这些人提供全面的烟草治疗计划。一个统一的、基于多学科能力的 烟草治疗差异研究、实践和培训专家开发的课程， 在全国范围内传播将是在消除这些障碍方面取得的重大进展。这个目标 一个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治疗 （TUT-DP）培训模块，将提高临床和研究人员的专业知识，以满足 烟草相关差异群体的生物医学、行为和临床需求。专家 来自多个学科领域的专家认为需要这种资源。该项目的创新之处在于 使用交叉性来整合差异模型，并制定理解的指导原则 在不同人群中产生烟草相关差异的生物心理社会影响。具体 目标一：利用一个由烟草研究、实践和培训专家组成的多学科小组， 迭代过程，开发一个基于能力的，高度可传播的TUT-DP培训模块，包括 培训师资源，幻灯片，以及基于问题的体验式学习活动， 高质量的录制演示和触发视频、培训手册和学习者评估工具。目的 第二：与来自不同专业的培训师和学习者一起对TUT-DP培训模块进行试点测试和完善 背景目标三：在烟草治疗培训中广泛传播TUT-DP培训模块 方案和相关专业组织。这一项目预计将有一个持续和强大的 通过传播创新的、具有吸引力的多学科培训经验， 提高临床专业水平，并作为烟草差异临床培训的重要工具。我们将 通过适当的机制寻求额外的资金，以检查TUT-DP的有效性 培训模块在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.