Implementing Evidence-Based Tobacco Cessation Strategies in Campus Health Clinics

描述（由申请人提供）：美国公共卫生服务（PHS）通过广泛传播的指南（“PHS指南”）为临床医生和医疗保健系统提供基于证据的烟草控制和治疗实践。短短三分钟的干预就能显著提高成年每日吸烟者的戒烟率。尽管美国估计有300万大学生吸烟者，其中大多数人至少尝试过一次戒烟，但关于大学生和戒烟的研究却很少。虽然《公共卫生服务指南》已广为传播，并打算在各种临床环境中实施，但学生诊所似乎并未完全采用这些战略。学生健康诊所为大量学生提供护理，使其成为鼓励这一人群戒烟的理想场所。本提案旨在提供形成性数据，测试在北卡罗莱纳州大学校园的学生健康诊所实施基于证据的戒烟策略。具体目标是：(1)通过系统层面的改变，增加学生健康中心对小灵通指南的组织采用和实施；(2)增加大学生卫生保健提供者对PHS指南的采纳和实施，促进大学生烟草使用者的戒烟行为。次要目的是初步评估在学生健康中心实施PHS指南对学生戒烟准备程度的影响，以估计未来更大规模疗效试验的样本量。采用临床水平的随机设计，通过系统级别的改变和增加的提供者培训，干预针对提供医疗保健的组织和这些组织内的临床医生。干预措施将通过关键信息提供者访谈、环境扫描、提供者调查和患者退出调查进行评估。拟议的试点研究将标志着PHS指南的实施首次在大学生健康中心进行测试。结果将用于：(1)估计未来试验的效应大小，该试验将在更大的样本中测试实施和有效性；(2)告知该干预措施在其他临床机构的实施情况，包括社区大学。拟议的研究回应了大学生成功实施基于证据的戒烟策略的未满足需求。这项研究的总体意图是最终缩小烟草控制领域的研究发现和项目实施之间的差距。

DESCRIPTION (provided by applicant): The United States Public Health Services (PHS) provides clinicians and healthcare systems with evidence- based practices for tobacco control and treatment through widely disseminated guidelines ("PHS Guidelines"). Interventions as brief as three minutes can significantly increase quit rates among adult daily smokers. Despite an estimated three million college student smokers in the U.S., the majority of who have made at least one quit attempt, little research exists on college students and smoking cessation. Although the PHS Guidelines have been widely disseminated and are intended to be implemented in a variety of clinical settings, student health clinics do not appear to have fully adopted these strategies. Student health clinics provide care to a large number of students, making them an ideal setting to encourage tobacco cessation in this population. This proposal seeks to provide formative data testing the implementation of evidence-based tobacco cessation strategies in student health clinics on college campuses in North Carolina. Specific aims are to: (1) Increase student health centers' organizational adoption and implementation of the PHS Guidelines through system- level changes; and (2) Increase college student health care providers' adoption and implementation of the PHS Guidelines to promote tobacco cessation behaviors among college student tobacco users. A Secondary Aim is to preliminarily assess the efficacy of implementing the PHS Guidelines in student health centers on students' readiness to quit to estimate sample sizes for a future larger efficacy trial. Using a clinic-level randomized design, the intervention targets both organizations providing healthcare and clinicians within those organizations through system-level changes and increased provider training. The intervention will be evaluated using key informant interviews, environmental scans, provider surveys, and patient exit surveys. The proposed pilot study will mark the first time implementation of the PHS Guidelines has been tested in a college student health center setting. Results will be used to: (1) estimate effect sizes for a future trial that will test both implementation and efficacy in a larger sample; and (2) inform implementation of this intervention in other clinical settings, including community colleges. The proposed research study responds to an unmet need for the successful implementation of evidence-based tobacco cessation strategies for college students. The overall intent of this research is to ultimately close the gap between research discovery and program delivery in the area of tobacco control. PUBLIC HEALTH RELEVANCE: Despite an estimated three million college student smokers in the U.S., little is known about college students and smoking cessation. The United States Public Health Services has widely disseminated guidelines for tobacco treatment which are intended to be implemented in a variety of clinical settings; however, student health clinics do not appear to have fully adopted these strategies. The goal of the proposed research is to test the implementation of evidence-based tobacco cessation strategies in student health clinics on college campuses.