Evaluating racial and ethnic disparities in the success of national health care efforts to promote smoking cessation

 描述（由申请人提供）：美国曾多次尝试缩小不同种族和民族亚群在医疗保健质量方面的差距。2010年，卫生与公众服务部启动了《2020年健康人计划》。该计划的四个主要目标中有两个是减少种族和民族健康差距，实现没有可预防疾病的高质量生活。由于这一计划和其他计划，医疗保健方面的一些改进已经取得，这应该有助于减少美国的健康差距。尽管做出了这些努力，但一些种族/少数民族群体的癌症和其他吸烟引起的疾病和疾病的死亡率仍然比非西班牙裔（NH）白色人高得多。此外，关于公众对少数种族/族裔戒烟方法的认识、有效性和可用性的研究结果有限。拟议研究的总体目标是确定不同种族和族裔群体的戒烟相关（SCR）医疗保健质量、SCR医疗保健质量随时间的变化、吸烟者对当前可用戒烟方法和治疗的认识和态度，以及确定已用于成功戒烟的方法。主要研究将侧重于评估美国最大的种族/族裔亚群（即，NH白色、NH黑人/非裔美国人和西班牙裔）;二次调查将涉及较小的美国亚群：NH美洲印第安人/阿拉斯加原住民、NH亚洲人和NH多种族。初步研究结果证实了区分相对较大和较小亚群的必要性。将使用当前人口调查烟草使用补充（TUS-CPS）的数据。TUS-CPS是有关不同种族/民族（包括美国小型亚群）吸烟行为数据的主要来源。拟议的研究是创新的，因为它是第一项使用美国成年人口的代表性样本评估不同种族/民族戒烟工作的可行性和有效性的研究，也是第一项研究SCR医疗保健服务质量的纵向变化，以及为不同种族/民族少数民族和非少数民族提供的SCR医疗保健服务的差异。预计拟议研究的结果将在改善整个卫生保健系统方面发挥重要作用，有助于缩小向少数民族/族裔和非少数民族提供的卫生保健服务质量方面的差距，并进一步降低所有亚群体吸烟引起的疾病和疾病的发病率。研究结果将有助于进一步完善针对不同吸烟者亚群的戒烟计划，提高对可用戒烟干预措施和药物治疗的认识，并降低吸烟率和吸烟引起的疾病和病症的发病率，特别是在服务不足的美国人中。

 DESCRIPTION (provided by applicant): There have been multiple attempts in the U.S. to close the gap in the quality of health care for diverse racial and ethnic subpopulations. In 2010, the Department of Health and Human Services launched the Healthy People 2020 plan. Two of four main goals of the plan are decreasing racial and ethnic health disparities and attaining high-quality lives free of preventable diseases. Because of this and other programs, a number of improvements in health care have been made that should help reduce health disparities in the U.S. Despite these efforts, some racial/ethnic minority groups still have considerably higher mortality rates from cancer and other smoking-caused conditions and diseases than Non-Hispanic (NH) White people. In addition, there are limited research findings regarding public awareness, efficacy and availability of smoking cessation methods for racial/ethnic minorities. The overall goals of the proposed study are to determine the quality of smoking- cessation-related (SCR) health care for diverse racial and ethnic groups, over-time changes in the quality of the SCR health care, and smokers' awareness and attitudes regarding currently available smoking cessation methods and treatments, as well as identify methods that have been used to successfully quit smoking. The primary investigation will focus on assessing potential differences with respect to each of these factors across the largest racial/ethnic U.S. subpopulations (i.e., NH White, NH Black/African American, and Hispanic); the secondary investigation will concern smaller U.S. subpopulations: NH American Indian/Alaska Native, NH Asian, and NH Multiracial. The necessity of differentiating between relatively large and small subpopulations is confirmed by the preliminary research findings. The data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) will be used. The TUS-CPS is the key source of data on smoking behaviors among diverse racial/ethnic groups, including small U.S. subpopulations. The proposed research is innovative because it is the first study to assess the feasibility and effectiveness of smoking cessation efforts across diverse racial/ethnic groups using a representative sample of the adult U.S. population and the first to examine longitudinal changes in the quality of the SCR health care services, as well as differences in the SCR health care services offered to diverse racial/ethnic minorities and non-minorities. Results of the proposed study are expected to play a vital role in improving the health care system as a whole, helping to close the gap in the quality of health care services offered to racial/ethnic minorities and non-minorities, and further decreasing rates of smoking-caused conditions and diseases across all subpopulations. The research findings will be beneficial for further refining smoking cessation programs for diverse subpopulations of smokers, increasing awareness of available smoking cessation interventions and medical treatments, and reducing smoking prevalence and rates of smoking-caused diseases and conditions, especially in underserved Americans.