Dental Tobacco Control Net Improving Practice

描述(由申请人提供)：牙科实践中的烟草控制既重要又未得到充分利用，部分原因是对将烟草咨询指南转化为实践的有效方法知之甚少。我们提出了一项随机对照试验(RCT)来测试一种互动的多模式干预措施，旨在增加牙科实践中的戒烟咨询。方法：利用先进的互联网编程技术，在牙科医生、牙科卫生师、牙科助理员等焦点小组的指导下，开发DentalTobaccoControl.Net(DTC.Net)进行干预。干预措施将包括基于病例的培训、在线意见领袖声明、可下载的戒烟工具箱、“询问专家”功能和牙科提供者可以交流的“协作室”。DTC.Net将提供24个月的服务，并提供更新和电子邮件提醒。在我们的随机对照研究中，我们将检验假设1：与对照组相比，在随机分配到DTC.Net的牙科实践中，接受提供者戒烟咨询的患者比例更大。假设2：与对照组相比，那些从干预牙科诊所登记的患者戒烟的比例更大。我们将从阿拉巴马州牙科实践研究网络招募100名医生，该网络是一个独特的、全州范围的社区牙科实践网络；并在就诊时使用简短的出境卡对患者进行调查。50个实践将被随机分配到DTC.Net干预，50个被随机分配给与吸烟无关的对照继续牙科教育网站。我们将在实践登记后的2个月、8个月、14个月和26个月(假设1)从不同的患者队列中获得退出卡，评估提供者的咨询行为。我们将在戒烟卡后6个月和12个月对每个诊所随机抽取40名患者进行电话调查，以评估戒烟率(假设2)。意义：通过将严谨的方法、最先进的技术、经验丰富的研究团队和独特的基于社区的牙科网络相结合，我们将通过牙科实践增进我们对烟草控制的理解，并为临床医生提供一种创新且易于复制的烟草控制方法。

DESCRIPTION (provided by applicant): Tobacco control in dental practices is both important and under-used, in part because not enough is known about effective methods for translating tobacco counseling guidelines into practice. We propose a randomized controlled trial (RCT) to test an interactive, multimodal intervention designed to increase tobacco cessation counseling in dental practices. Methods: Using advanced Internet programming, and informed by focus groups with dentists, dental hygienists, and dental assistants we will develop DentalTobaccoControl.Net (DTC.Net) to deliver the intervention. The intervention will include case-based training, online opinion leader statements, a downloadable tobacco cessation toolbox, an "Ask the Expert" function, and a "collaboratory" where dental providers can communicate. DTC.Net will be available for 24 months, with updates and email reminders. In our RCT, we will test Hypothesis 1: The proportion of patients receiving provider tobacco cessation counseling will be greater in dental practices randomized to DTC.Net, compared with controls. Hypothesis 2: The proportion of tobacco using patients who quit will be greater in those enrolled from intervention dental practices compared with those at controls. We will recruit 100 practices from the Alabama Dental Practice Research Network, a unique, state-wide network of community-based dental practices; and survey patients with brief exit cards at time of dental visit. Fifty practices will be randomized to the DTC.Net intervention, and fifty to a control continuing dental education website unrelated to smoking. We will obtain the exit cards, assessing provider counseling behavior, from cohorts of unique patients, at 2, 8, 14, and 26 months after practice enrollment (Hypothesis 1). We will contact for follow-up telephone survey at 6 and 12 months after exit cards a random sample of 40 patients per practice, to assess tobacco quit rates (Hypothesis 2). Significance: By combining rigorous methodology, state-of-the-art technology, an experienced research team, and a unique community-based dental network, we will advance our understanding of tobacco control through dental practice and provide clinicians with an innovative and easily replicable approach to tobacco control.