Smoking Cessation in Pediatric Pratice: Phase 1

描述(申请人提供)：美国有300多万青少年吸烟。虽然已经有相当多的关于儿童吸烟预防和成人临床戒烟干预的研究，但很少有研究研究针对青少年的戒烟干预。罗切斯特大学与美国儿科学会-办公室儿科研究(PROS)基于实践的研究网络合作，在601个初级保健儿科实践中由1700多名临床医生组成--提议对初级保健儿科环境中的青少年进行戒烟咨询干预的试点研究。 我们的长期目标是提高PBRN环境中临床预防服务的质量。我们的具体目标是：1a)招募和随机化专业戒烟实践的试点程序，1b)现场试验/试点专业实践从业人员戒烟咨询和实践在青少年患者中的登记；以及，2)评估儿科临床医生转介青少年患者至基于互联网的戒烟辅助设备的可行性。我们将在10个专业实践场所试用公共卫生服务指南5A的模式进行招募和培训；评估1,000名青少年的青少年登记和筛查程序，并在100名吸烟者就诊后两到三周调查他们，以评估干预措施，并在三个月内提供戒烟结果的初步估计。我们将实地测试措施，描述青少年吸烟的模式，并探索干预措施如何影响动机、戒烟、禁欲、态度和吸烟行为。 PROS网络提供了与将实际使用它们的临床医生合作开发干预措施的独特机会。这项研究将为未来更大规模的研究开发方法，并将增加我们对青少年戒烟在初级保健实践中的实施过程的理解。如果有效，这些干预措施将对降低青少年吸烟流行率产生广泛的公共卫生影响。

DESCRIPTION (provided by applicant): More than three million adolescents in the United States smoke cigarettes. Although there has been considerable research on smoking prevention for children and on clinical smoking cessation interventions for adults, few studies examine smoking cessation interventions for youth. The University of Rochester--in collaboration with the American Academy of Pediatrics-Pediatrics Research in Office Settings (PROS) practice-based research network of more than 1,700 clinicians in 601 primary care pediatric practices--proposes pilot studies of tobacco cessation counseling interventions for adolescents in primary care pediatric settings. Our long-term goal is to improve the quality of clinical preventive services in PBRN settings. Our specific aims are to: 1a) pilot procedures for recruitment and randomization of PROS practices, 1b) field trial/pilot PROS practitioner cessation counseling and practices' enrollment of adolescent patients; and, 2) assess the feasibility of pediatric clinician referral of adolescent patients to internet-based adjuncts for smoking cessation. We will pilot recruitment and training using the Public Health Service Guideline 5A's model in 10 PROS practice sites; assess adolescent enrollment and screening procedures with 1,000 adolescents, and survey 100 smokers two to three weeks after their visits to assess the interventions and at three months to provide preliminary estimates of cessation outcomes. We will field test measures, describe the patterns of smoking among youth, and explore how interventions affect motivation, quitting, abstinence, attitudes, and smoking behaviors. The PROS network offers the unique opportunity to develop interventions in collaboration with clinicians who will actually use them. This study will develop methods for future larger scale studies and will add to our understanding of the process of implementation of adolescent smoking cessation in primary care practice. If effective, these interventions will have broad public health implications for reducing smoking prevalence among youth.