QUIT-PRIMO:Web-delivered Clinical Microsystem Intervention for Tobacco Control

描述（由申请人提供）：这是我们根据PA-06-226信息技术和互联网在卫生服务和干预提供中的作用，首次重新提交一项QUIT-PRIMO烟草质量改进-提供者推荐和互联网微系统优化的随机试验。我们的总体目标是通过针对初级保健临床微系统，推进与互联网在卫生服务提供中的使用和影响相关的科学，特别是戒烟。临床微系统被定义为最小的功能性医疗保健单元。临床微系统不仅仅等同于医生和护士的临床团队，还包括由提供者照顾的患者小组和所使用的护理过程。卫生保健改善研究所（IHI）指出，针对临床微系统的干预措施是提高卫生保健质量的关键组成部分。我们有以下具体目标：目标1。将160个基于社区的初级保健微系统随机纳入一项试验，将QUIT-PRIMO与基于纸张的信息处方进行比较；目标2。使用患者报告的措施评估QUIT-PRIMO对转诊率的影响；目标3。评估QUIT- PRIMO对初级保健患者六个月戒烟的影响。QUIT-PRIIMO干预是一种多组件互联网提供的临床微系统干预：Refer2Quit提供点护理患者转诊门户网站，提供者可以使用该门户网站将患者登记到自我管理系统中，并提供提供者和患者活动的摘要报告，以及安全消息传递模板，提供者可以使用该模板在随访期间有效地鼓励患者戒烟；和2。决定戒烟：一个患者自我管理门户网站，组织互动式、量身定制的患者教育、戒烟计划、与其他高质量网络（smokefree.gov）和离线资源（1-800-QUIT-NOW）的链接，以及患者可以使用的安全消息传递。控制是处方提供者打印的纸质信息，用于将患者转介到先前开发的患者自我管理网站，该网站未链接到临床微系统。该研究的意义在于，它将是第一个针对临床微系统的互联网干预，其具体目的是增加戒烟。我们的干预在戒烟网络资源中也是独一无二的，因为主要目标是加强随访和增加治疗寻求。QUIT-PRIMO建立在我们之前nci资助的R21 （Ford， PI）的基础上，我们在该研究中建立了控制自我管理系统。

DESCRIPTION (provided by applicant): This is our first resubmission of a randomized trial of QUIT-PRIMO Quality Improvement in Tobacco - Provider Referrals & Internet-delivered Microsystem Optimization in response to PA-06-226 Information Technologies and the Internet in Health Services and Intervention Delivery. Our Overall Goal is to advance science related to the use and impact of the Internet in health services delivery, specifically smoking cessation, by targeting primary care clinical microsystems. A clinical microsystem is defined as the smallest functional healthcare unit. A clinical microsystem is not simply equivalent to a clinical team doctors and nurses, but also includes the panel of patients cared for by the providers and the processes of care that are used. The Institute for Healthcare Improvement (IHI) states interventions targeted to clinical microsystems are a crucial component in improving health care quality. We have the following Specific AIMS: Aim 1. Randomize 160 community- based primary care microsystems into a trial comparing the QUIT-PRIMO with a paper- based information prescription; Aim 2. Evaluate the impact of QUIT-PRIMO on referral rates using patient-reported measures; Aim 3. Evaluate the impact of QUIT- PRIMO on six-month smoking cessation of primary care patients. The QUIT-PRIIMO Intervention is a multi-component Internet-delivered clinical microsystem intervention with: 1. Refer2Quit A point-of-care patient referral portal providers can use to enroll patients into a self-management system, with summary reports of provider and patient activity, and secure messaging templates providers can use to efficiently encourage patients to quit during follow-up; AND 2. Decide2Quit A patient self-management portal organizing interactive, tailored, patient education, cessation planning, links to other high-quality web (smokefree.gov) and offline resources (1-800-QUIT-NOW), and secure messaging patients can use. The Control is a paper-based information prescription providers print to refer patients to a previously developed patient self-management website not linked into the clinical microsystem. The significance of the proposed study is that it will be the first Internet-delivered Intervention targeted to the clinical microsystem with the specific purpose of increasing smoking cessation. Our intervention is also unique among web resources for smoking cessation because a major goal is to enhance follow-up and increase treatment-seeking. QUIT-PRIMO builds upon our previous NCI-funded R21 (Ford, PI), where we our control self-management system for this study.