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

描述（由申请人提供）：这是我们首次重新提交的一项关于烟草供应商转介和互联网交付微系统优化的QUIT-PRIMO质量改进随机试验，以响应PA-06-226信息技术和互联网在卫生服务和干预交付中的作用。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有关的科学，特别是戒烟。临床微系统被定义为最小的功能医疗单元。临床微系统不仅仅等同于临床团队的医生和护士，还包括由提供者护理的患者小组和所使用的护理过程。医疗保健改善研究所（IHI）指出，针对临床微系统的干预措施是提高医疗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分配到一个试验中，比较QUIT-PRIMO与基于纸张的信息处方;目标2。使用患者报告的指标评价QUIT-PRIMO对转诊率的影响;目标3。评估QUIT-PRIMO对初级保健患者戒烟6个月的影响。QUIT-PRIMO Intervention是一种多组件互联网交付的临床微系统干预，具有：1. Refer 2 Quit护理点患者转诊门户提供商可用于将患者登记到自我管理系统中，提供商和患者活动的摘要报告，以及提供商可用于有效鼓励患者在随访期间退出的安全消息模板;以及2. Decide 2 Quit一个患者自我管理门户网站，组织互动的、定制的患者教育、戒烟计划、其他高质量网站（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。控制是一个基于纸张的信息处方提供者打印转介患者到以前开发的患者自我管理网站没有链接到临床微系统。这项拟议研究的意义在于，它将是第一个针对临床微系统的互联网干预措施，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寻求治疗。QUIT-PRIMO建立在我们以前的NCI资助的R21（福特，PI）的基础上，在那里我们为这项研究开发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.