Tobacco Cessation among American Indian Cancer Survivors in Cherokee Nation

切罗基族美洲印第安人癌症幸存者戒烟

• 批准号: 10264048
• 负责人: Amanda E Janitz
• 金额: $ 4.08万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10264048
• 关键词: Accounting; Adult; Age; American Indians; Area; Cancer Center; Cancer Patient; Cancer Survivor; Caring; Cessation of life; Cherokee Indian; Cherokee Nation, Oklahoma; Chronic; Clinic; Consolidated Framework for Implementation Research; Counseling; Data; Diagnosis; Enrollment; Ethnic group; Evidence based intervention; Future; General Population; Goals; Health Expenditures; Health system; Healthcare; High Prevalence; Incidence; Individual; Intervention; Intervention Studies; Interview; Malignant Neoplasms; Mental Health; Mentors; Methods; Morbidity - disease rate; National Health Interview Survey; Oklahoma; Oncologist; Oncology; Participant; Patients; Pharmaceutical Preparations; Population; Prevalence; Primary Health Care; Provider; Race; Relapse; Reporting; Research; Research Personnel; Reservations; Resources; Risk; Role; Second Primary Cancers; Smoking; Students; Survivors; System; Time; Tobacco; Tobacco Use Cessation; Tobacco use; Tobacco-Related Carcinoma; Tribes; United States; United States Indian Health Service; Universities; Work; anticancer research; cancer care; cancer diagnosis; care providers; care systems; career; compare effectiveness; education research; evidence base; experience; former smoker; health care service; health disparity; implementation research; implementation strategy; improved; insight; medical specialties; member; mortality; productivity loss; programs; quitline; reduce tobacco use; smoking cessation; success; tobacco cessation intervention; tobacco user; tribal health; undergraduate student; vaping

Abstract Tobacco use is the leading cause of morbidity and mortality in the US, accounting for 30% of cancer deaths and resulting in more than $300 billion in annual health care expenditures and productivity loss. American Indian (AI) adults continue to have a higher prevalence of tobacco use (32%) compared to any other race/ethnic group (13%-25%) in the US and experience disproportionate rates of tobacco-related morbidity and mortality. In addition, AI individuals in Oklahoma have the highest age-adjusted cancer incidence (637 per 100,000) and mortality (255 per 100,000) rates compared to other racial groups. Continued use of tobacco after a cancer diagnosis increases the risk of secondary cancers and mortality compared to non-tobacco users. Cherokee Nation is the largest tribe in the United States with more than 378,000 enrolled members, and reducing tobacco use is one of the tribe's top priorities. Cherokee Nation works with Indian Health Service (IHS) to provide healthcare services for the AI population within their reservation area. Because of this system, any referral for specialty care not provided by Cherokee Nation must obtain approval through the IHS Purchased and Referred Care system, which may complicate oncology care. Furthermore, it is unclear whether AI cancer survivors routinely receive tobacco cessation treatment during their oncology care or while receiving primary care within the Cherokee Nation Health System. Our long-term goal is to reduce the prevalence of tobacco use among cancer survivors in Cherokee Nation. Our study aims to 1) evaluate tobacco cessation experiences among AI cancer survivors in Cherokee Nation; 2) identify current tobacco cessation practices in primary care and oncology settings, along with facilitators and barriers to delivering cessation treatment to Cherokee Nation cancer patients; and 3) develop tailored strategies to increase implementation and reach of tobacco cessation treatment for cancer survivors in Cherokee Nation. This study will provide insight into current practices and needs related to tobacco cessation for AI cancer survivors in Cherokee Nation. This project will provide preliminary data for an R01 proposal to compare the effectiveness of implementation strategies aimed at improving tobacco cessation treatment provided to cancer survivors. It will also provide opportunities for future implementation research focused on other evidence-based interventions for cancer survivors in Cherokee Nation.

抽象的 烟草使用是美国发病率和死亡率的主要原因，占癌症死亡的30％ 并导致超过3000亿美元的年度医疗保健支出和生产力损失。美国人 与其他任何人相比 美国的种族/族裔群体（13％-25％），与烟草相关的发病率的比例不成比例 死亡。此外，俄克拉荷马州的AI个人的年龄调整后癌症发生率最高（每人637 与其他种族群体相比，100,000）和死亡率（每100,000次255）。继续使用烟草 癌症诊断后，与非烟草使用者相比，诊断会增加次级癌症和死亡率的风险。 切诺基国家是美国最大的部落，有378,000多名成员， 减少烟草使用是该部落的首要任务之一。切诺基国家与印度卫生服务部合作 （IHS）为其预订区内的AI人群提供医疗服务。由于这个系统， 切诺基国家未提供的任何专业护理转诊都必须通过IHS获得批准 购买和推荐的护理系统可能会使肿瘤学护理复杂化。此外，还不清楚 AI癌症幸存者是否在肿瘤学护理期间经常接受戒烟治疗 在切诺基国家卫生系统内获得初级保健。我们的长期目标是减少 切诺基国家癌症幸存者中使用烟草的患病率。我们的研究目的是1）评估烟草 切诺基国家的AI癌症幸存者之间的戒烟经历； 2）确定当前的烟草戒烟 初级保健和肿瘤设置的实践，以及暂停的促进者和障碍 切诺基国家癌症患者的治疗； 3）制定量身定制的策略以增加实施 以及切诺基国家癌症幸存者的烟草戒烟治疗。这项研究将提供 了解与切诺基的AI癌症幸存者有关的当前实践和需求 国家。该项目将为R01提案提供初步数据，以比较 实施策略旨在改善为癌症幸存者提供的戒烟治疗。会 还为未来的实施研究提供了机会，该研究的重点是其他循证干预措施 对于切诺基国家的癌症幸存者。