TOBACCO REDUCTION AND CANCER CONTROL II

医疗保健系统在传播疾病方面做得相对较差 预防干预措施，尽管研究表明 干预措施是有效的。本计划项目侧重于 开发和提供具有成本效益的戒烟计划， 建立乳腺癌和宫颈癌的安全网络体系 筛选，并测试有效的方法，让雇主参与 癌症预防活动。它解决了定义的人口基数 375,000名卫生组织成员，并将这些干预措施传播给其他 医疗车系统。医疗保健系统需要整合有效的 将癌症控制活动转化为护理服务。这个目标是 可以使用社区干预方法来实现，其中医疗保健 系统被视为社区。在TraCC的前四年，有五个 将吸烟干预融入医疗保健的途径 过程在随机试验中进行了测试。这个应用程序采用下一个 合乎逻辑的步骤，包括两个第四阶段吸烟项目和一个第三至第四阶段 筛选项目。干预措施被提供给特定的人群 通过专注于医院、门诊和紫外线的活动来建立基地 直接邮寄。TraCC II还利用了 预付费团体实践设置，如患者跟踪系统和 基于人群而不是以患者为基础的计划的机会是 降低吸烟率，提高吸烟发生率 停止HMO成员，并确保妇女不超过 可接受的乳腺癌和宫颈癌筛查的最长间隔时间。 这个计划可以直接推广到其他医疗保健组织，而且大多数元素都是 适用于任何大型医疗机构。一个明确的目标是 将这些干预扩展到其他Kaiser Permanente地区和 用成本效益分析来支持这种扩展 实施经验。

Medical care systems do a relatively poor job of delivering disease prevention interventions despite research studies showing that such interventions are effective. This program project focuses on the development and delivery of cost-effective smoking cessation programs, the establishment of a safety net system for breast and cervical cancer screening, and the testing of effective methods for involving employers in cancer prevention activities. It addresses the defined population base of a 375,000 member HMO and the dissemination of those interventions to other medical car systems. Medical care systems need to integrate effective cancer control activities into the delivery of care. This goal is achievable using a community intervention approach in which medical care systems are treated as communities. In the first four years of TRACC, five approaches to integrating smoking interventions into the medical care process were tested in randomized trials. This application takes the next logical step with two phase IV smoking projects and a phase III-IV screening project. The interventions are delivered to a defined population base through activities focused in hospitals, outpatient clinics, and UV direct mail. TRACC II also takes advantage of other resources inherent in prepaid group practice settings such as patient tracking systems and the opportunity for a population based, rather than patient-based, program is to reduce the prevalence of smoking and raise the incidence of smoking cessation among HMO members, and to assure that women do not exceed acceptable maximum intervals for screening for breast and cervical cancers. This program is generalizable directly to other HMOs, and most elements are applicable to any large medical organization. An explicit objective is to extend these interventions to other Kaiser Permanente regions and to support such extensions with cost effectiveness analyses of the implementation experiences.