TOBACCO REDUCTION AND CANCER CONTROL II

医疗保健系统在提供疾病方面做得相对较差 尽管研究表明， 干预措施是有效的。 该项目的重点是 制定和实施具有成本效益的戒烟计划， 建立乳腺癌和宫颈癌安全网系统 筛选和测试让雇主参与的有效方法， 癌症预防活动。 它涉及的人口基数界定， a有375，000名成员的HMO，并将这些干预措施传播给其他 汽车医疗系统 医疗保健系统需要有效整合 将癌症控制活动纳入医疗服务。 这一目标 可以通过社区干预的方法来实现， 系统被视为社区。 在TRACC的头四年， 将吸烟干预纳入医疗护理的方法 在随机试验中进行了测试。 此应用程序需要下一个 两个第四阶段吸烟项目和一个第三至第四阶段吸烟项目 筛选项目。 干预措施针对特定人群 通过在医院、门诊诊所和紫外线中心开展活动， 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 一个基于人口而不是基于病人的计划的机会是 降低吸烟率，提高吸烟率 在HMO成员之间停止，并确保妇女不超过 乳腺癌和宫颈癌筛查可接受的最长间隔。 该计划可直接推广到其他HMO，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 将这些干预措施扩展到其他Kaiser Permanente地区， 通过成本效益分析支持这种扩展， 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.