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评估在联邦合格健康中心内开展的强化多成分主动导航辅助戒烟项目(EMPACT-Us)的效果:一项方案研究。

Assessing the effects of Enhanced Multicomponent Proactive Navigator-Assisted Cessation of Tobacco Use within a federally qualified health center (EMPACT-Us): a protocol study.

作者信息

Ramirez Gabriela Favela, Badii Nathaniel Zall, Mohn Paloma, Northrup Adam, Smoot Charles, Doran Neal, Brouwer Kimberly, Myers Mark, Godino Job, Liu Jie, Ghobrial-Sedky Karim, Strong David

机构信息

Laura Rodriguez Research Institute, Family Health Centers of San Diego, 1750 5th Ave, San Diego, CA, 92101, USA.

Moore's Cancer Center, University of California, San Diego, 3855 Health Sciences Dr, San Diego, CA, 92037, USA.

出版信息

BMC Public Health. 2024 Dec 18;24(1):3496. doi: 10.1186/s12889-024-20997-6.

DOI:10.1186/s12889-024-20997-6
PMID:39695566
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11656875/
Abstract

BACKGROUND

California's relatively low smoking rate (10.1% in 2019-2020) (About CHIS, UCLA Center for Health Policy Research, 2024) masks deep disparities among low-income populations, where smoking rates are nearly double that of their middle- to upper-income peers. Low-income smokers report a similar desire to quit and similar rates of recent quit attempts as smokers from other groups; yet, they often face barriers in accessing effective resources to facilitate successful cessation.

METHODS

Our team will conduct a pragmatic stepped-wedge cluster, randomized controlled trial of Enhanced Multicomponent Proactive Navigator-Assisted Cessation of Tobacco Use (EMPACT-Us), a suite of tobacco cessation services supported by patient navigators, designed in close partnership with patients, providers, and community stakeholders. The study will take place at Family Health Centers of San Diego (FHCSD), the largest federally qualified health center (FQHC) in San Diego. Eight primary care clinics are included, where 70% (n = 13,496) of smokers at FHCSD receive care.

DISCUSSION

We hypothesize that multiple points of engagement and integration of navigation services into the workflow of existing staff will improve utilization and cessation success. This study will examine if the enhanced suite of services offers insights on how to best integrate evidence-based tobacco treatment services into usual care.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05750537, Registered on March 1, 2023. https://clinicaltrials.gov/study/NCT05750537 .

摘要

背景

加利福尼亚州的吸烟率相对较低(2019 - 2020年为10.1%)(加州健康访谈调查,加州大学洛杉矶分校健康政策研究中心,2024年),但这掩盖了低收入人群中存在的严重差异,该群体的吸烟率几乎是中高收入同龄人吸烟率的两倍。低收入吸烟者表示与其他群体的吸烟者有相似的戒烟意愿和近期戒烟尝试率;然而,他们在获取有效资源以促进成功戒烟方面往往面临障碍。

方法

我们的团队将进行一项实用的阶梯式楔形整群随机对照试验,即强化多成分主动导航辅助戒烟项目(EMPACT - Us),这是一套由患者导航员支持的戒烟服务,与患者、提供者和社区利益相关者密切合作设计而成。该研究将在圣地亚哥家庭健康中心(FHCSD)进行,这是圣地亚哥最大的联邦合格健康中心(FQHC)。纳入了8家初级保健诊所,圣地亚哥家庭健康中心70%(n = 13496)的吸烟者在这些诊所接受治疗。

讨论

我们假设多个参与点以及将导航服务整合到现有工作人员的工作流程中会提高利用率和戒烟成功率。本研究将检验这套强化服务是否能为如何最好地将循证烟草治疗服务整合到常规护理中提供见解。

试验注册

ClinicalTrials.gov,NCT0*********,于2023年3月1日注册。https://clinicaltrials.gov/study/NCT05750537 。 (注:原文中NCT编号不完整,这里用*代替)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e233/11656875/0258a8b57b05/12889_2024_20997_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e233/11656875/0258a8b57b05/12889_2024_20997_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e233/11656875/0258a8b57b05/12889_2024_20997_Fig1_HTML.jpg

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12-Month Evaluation of an EHR-Supported Staff Role Change for Provision of Tobacco Cessation Care in 8 Primary Care Safety-Net Clinics.
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