SMOKING EXPERT SYSTEM FOR TEENS IN PRIMARY MEDICAL CARE

这项随机对照试验将测试短期疗效 临床医生的建议和路径改变专家系统互动 用于减少3，200名青少年吸烟率的计算机程序 正在接受常规医疗护理 无论是吸烟者还是不吸烟者， 基线时年龄为14至17岁，将有资格参加这项基于人群的 这是一种高度适应个人需求的干预措施。 的 主要终点将是30天的吸烟率，根据两年的测量结果 随机分组后。 次要指标将包括对以下疾病的易感性： 吸烟、吸烟获得或吸烟改变的阶段以及其他烟草 使用措施。 我们还将在随访时确定吸烟的预测因素， 影响干预效果的因素。 干预将 利用初级保健医生提供的教育机会， 预约和计算机的吸引力和多媒体 青少年互动项目。 这一战略的其他主要特点是： 1)重点关注整个青少年人口（无论是吸烟， 2）一个高度定制的基于理论驱动的阶段 3）干预的方便性和实用性， 临床医生;和4）提供相对较低的可变成本， 在常规医疗护理中看到的青少年人口的干预。 虽然这项研究将在HMO环境中进行，但干预 将在任何初级CRE医疗护理环境中实用， 照顾青少年。

This randomized controlled trial will test the long-term efficacy of brief clinician advice and the Pathways to Change expert system interactive computer program for reducing the prevalence of smoking among 3,200 teens who are being seen for routine medical care. Both smokers and nonsmokers, ages 14 to 17 at baseline, will be eligible for this population-based intervention that is highly tailored to the needs of the individual. The primary endpoint will be 30-day smoking prevalence, as measured two years after randomization. Secondary measures will include susceptibility to smoking, stage of smoking acquisition or smoking change, and other tobacco use measures. We will also identify predictors of smoking at follow- and factors that moderate intervention effects. The intervention will capitalize on the teachable moment offered by a primary care physician appointment and the attractiveness of computers and this multimedia interaction program to teens. Others key attributes of this strategy are; 1) a focus on the whole population of adolescents (whether smoking at entry or not); 2) a highly tailored stage based theory-driven intervention; 3) the ease and practicality of the intervention for clinicians; and 4) the relatively low variable cost of delivering the intervention to the teen population seen during routine medical care. Although this study will be conducted in an HMO setting, the intervention would be practical in any primary cre medical care setting that provides care to adolescents.