Community Based Training Models for Tobacco Cessations

描述（申请人提供）： 戒烟计划是全面烟草控制的一个关键组成部分， 更快地产生公共卫生效益，规模更大， 比任何其他组件。目前，各国已经或正在准备 在培训模型上投入大量资金，以开发和/或扩大烟草 戒烟计划作为他们在全州烟草控制投资的一部分， 在国家一级已经开始讨论， 培训和认证计划。PHS治疗指南 烟草依赖再次证实了先前的荟萃分析， 戒烟的短期干预措施的有效性， 作为干预者的一系列提供者类型的有效性。虽然延长 咨询和药物治疗可以产生更高的长期戒烟率， 功效的增加不足以抵消更高的成本，导致成本 p e r戒烟者的人数比在 低强度的短暂干预最大限度地减少吸烟 在特定的烟草控制预算下， 低强度治疗的优势表明， 让尽可能多的吸烟者。对医疗保健的重视 提供者和系统，以广泛传播 社区一级的能力不足，缺少机会， 广泛的人类服务提供者（如社会服务、教育、人类 资源、法律和惩戒、神职人员和社区外展工作者）， 干涉主义者迫切需要审查培训模式 在以下方面， 有效性、成本、可获得性和可接受性。该项目将 将两种简短干预训练模式相互比较，并与通常的 人类服务目标人群中的实践控制组 提供商主要结果是对烟草进行短暂干预的比率 停止在社区中进行。作为第二项措施，该项目 将测试每种培训模式对转诊率的影响， 强化戒烟计划，以及 培训参与者，内容涉及：减少环境烟草烟雾 (ETS)在个人空间和支持烟草控制政策， 工作场所和社区。该项目将分四个阶段完成： 第一阶段将侧重于修订传统的面对面培训课程，供人类服务提供者使用， 设计和制作类似的交互式多媒体互联网（Web） 课程。第二阶段：通过万维网对网络课程进行Beta测试 Web（WWW），为随机对照有效性试验做准备。相 III：随机对照研究，测试相对有效性（和成本 有效性）的知识产权和网络模型，以对方和一个通常的做法 对照组第四阶段：培训模式的传播研究表明， 最有效的方法是参与社区合作伙伴。

Description (provided by applicant): Cessation programs are a key component of comprehensive tobacco control, producing public health benefits more quickly, and with greater magnitude, than any other component. Currently states have spent or are preparing to spend significant dollars on training models to develop and/or expand tobacco cessation programs as part of their investment in statewide tobacco control, and discussion has already begun at the national level regarding the need for training and certification programs. The PHS guidelines for treatment of tobacco dependence reaffirmed earlier meta-analyses demonstrating the effectiveness of brief interventions for tobacco cessation, and the effectiveness of a range of provider types as interventionists. While extended counseling and pharmacotherapy can generate higher long term quit rates, the gain in efficacy is insufficient to offset the higher cost, leading to costs p e r quitter that are several times higher than those found under low-intensity, brief intervention. To maximize the reduction in smoking attained under a given tobacco control budget, the cost-effectiveness advantages of low-intensity treatments suggest that brief interventions should be extended to as many smokers as possible. The emphasis on healthcare providers and systems for broad dissemination of brief interventions at the community level has been insufficient, missing opportunities to activate the broad range of human service providers (e.g. social services, education, human resources, law and corrections, clergy, and community outreach workers) as interventionists. There is an urgent need to examine training models a p p licable to large-scale community-based implementation in terms of effectiveness, cost, accessibility and acceptability. This project will compare two models of brief intervention training to each other and to a usual practice control group within the target population of human services providers. The primary outcome is the rate of brief interventions for tobacco cessation performed in the community. As a secondary measure, this project will test the effect of each model of training on rates of referral to more intensive tobacco cessation programs, and the attitudes and behaviors of training participants with regard to: reduction of environmental tobacco smoke (ETS) in personal spaces and support of tobacco control policies in the workplace and community. The project will be accomplished in four-phases: Phase I will focus on revision of traditional in-person (IP) training curriculum for use with a population of human services providers, followed by design and production of analogous interactive, multimedia Internet (Web) curriculum. Phase II: Beta testing of Web curriculum through the World Wide Web (WWW) in preparation for randomized controlled effectiveness trial. Phase III: Randomized controlled study testing the relative effectiveness (and cost effectiveness) of the IP and Web models to each other and to a usual practice control group. Phase IV: Dissemination study of the training model shown to be most effective though participating community partners.