Organizational readiness and engagement of community oncology practices in implementing tobacco use assessment and treatment

项目摘要/摘要 在美国，吸烟仍然是可预防的早产儿疾病、残疾和死亡的主要原因 各州。烟草使用评估和治疗对于被诊断为癌症的个人来说很重要，因为 持续吸烟会增加疾病负担，并导致负面治疗结果。尽管 国家综合癌症网络(NCCN)建议进行基于证据的烟草使用评估和 在治疗方面，实际提供的戒烟治疗在癌症护理方面一直不一致。一些 研究考察了组织层面的因素如何影响NCCN吸烟指南的采用 停止肿瘤学实践。以社区为基础的肿瘤学网络服务于不同的人群，包括 农村、经济/社会弱势群体、种族和族裔少数群体以及资源匮乏的社区。我们 建议加强家长资助的临床试验，实施虚拟烟草治疗 社区肿瘤学实践“(R01CA214427；MPIS Park博士和Ostroff博士)，通过：1)检查 影响在癌症护理环境中采用烟草治疗干预措施的组织环境；以及 2)确定促进执行《国家烟草控制框架公约》烟草使用评估和处理的战略 参加家长R01试验的癌症社区站点和少数族裔/服务不足的社区站点。 定量研究方法将被用来探索组织准备程度与 在NCORP中实施烟草使用评估和治疗以及癌症护理提供能力 社区肿瘤学实践。使用混合方法，我们将评估子分支机构级别 参与，评估社区参与研究(CENR)的障碍和促进者，并确定潜力 促进社区采用烟草使用评估和治疗的实施战略 肿瘤学设置，重点了解参与SSS 2.0的NCORP站点之间的差异 审判。这个项目的意义在于它对背景因素的有限认识做出了贡献 影响社区肿瘤学环境中烟草使用评估和治疗的采用。这 该项目还将确定如何最好地与社区肿瘤学分支机构接触，并为 促进社区肿瘤学实践中对戒烟的采纳和整合。调查结果将告知 设计一项计划中的大规模III型混合实施试验，以测试各种实施 制定烟草使用记录系统和促进采用烟草使用的战略 社区肿瘤学环境中的评估和治疗。

PROJECT SUMMARY/ABSTRACT Smoking remains a leading cause of preventable premature disease, disability, and death in the United States. Tobacco use assessment and treatment is important for individuals with cancer diagnoses, because persistent smoking can increase illness burden and contribute to negative treatment outcomes. Although the National Comprehensive Cancer Network (NCCN) recommends evidence-based tobacco use assessment and treatment, the actual delivery of smoking cessation in the context of cancer care has been inconsistent. Few studies have examined how organizational level factors influence the adoption of NCCN guidelines for smoking cessation in oncology practices. Community based oncology networks serve diverse populations including rural, economically/socially disadvantaged, racial and ethnic minorities, and low-resourced communities. We propose to enhance the clinical trial for the parent grant, “Implementing A Virtual Tobacco Treatment in Community Oncology Practices” (R01CA214427; MPIs Dr. Park and Dr. Ostroff) by: 1) examining organizational contexts that influence adoption of tobacco treatment interventions in cancer care settings; and 2) identifying strategies to facilitate implementation of tobacco use assessment and treatment in NCORP cancer Community Sites and Minority/Underserved Community Sites enrolled in the parent R01 trial. Quantitative research methods will be used to explore the association between organizational readiness to implement tobacco use assessment and treatment and the capacity for cancer care delivery in NCORP community oncology practices. Using a mixed methods approach, we will evaluate sub affiliate level engagement, assess barriers and facilitators to community-engaged research (CEnR), and identify potential implementation strategies to improve adoption of tobacco use assessment and treatment in community oncology settings with a focus on understanding variation among the NCORP sites participating in the SSS 2.0 trial. The significance of this project is its contribution to the limited knowledge about contextual factors influencing the adoption of tobacco use assessment and treatment in community oncology settings. This project will also identify how best to engage community oncology sub affiliates and inform strategies for improving adoption and integration of smoking cessation in community oncology practices. Findings will inform the design of a planned large-scale type III hybrid implementation trial that will test various implementation strategies for developing systems for tobacco use documentation and improving adoption of tobacco use assessment and treatment in community oncology settings.