Strategier til at forbinde patienter på føderalt kvalificerede sundhedsklinikker med evidensbaseret behandling for tobaksafvænning
Interventioner på flere niveauer for at øge tobaksafvænningen på føderalt kvalificerede sundhedsklinikker (FQHC'er)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
PRIMÆRE MÅL:
I. At evaluere interventioner på klinik og patientniveau med hensyn til at øge rækkevidden af evidensbaseret behandling for tobaksbrug (leveret via Utah Quitline).
II. At evaluere interventioner på klinik og patientniveau med hensyn til at øge effekten af Quitline-behandling. Effekt er defineret som Reach X Efficacy. Ved beregning af effekt er effekt defineret som andelen af rygere, der melder sig til Quitline, der har leveret behandling, som med succes holdt op.
III. At evaluere karakteristika ved både klinikker og patienter, der kan påvirke resultaterne af tobaksbrug.
OMRIDS:
INTERVENTION PÅ KLINIKNIVEAU
Alle klinikker vil modtage en intervention på klinikniveau fra Ask Advise Connect (AAC). AAC består af en elektronisk sundhedsjournal (EPJ) intervention, der bruger EPJ til at lette klinikpersonalet til at spørge patienter om tobaksbrug, rådgive patienter til at holde op med at bruge tobak og direkte og elektronisk forbinde patienter til Utah Tobacco Quit Line.
FASE I (PATIENTNIVEAU): Patienter, der ikke tilmelder sig afslutningslinjen efter klinikbesøget, vil være berettiget til fase 1-randomisering for at modtage enten TM eller fortsætte med kun EPJ-tilstand (CO).
GRUPPE I: Patienter modtager en tekstbesked (TM) ugentligt i en måned efterfulgt af en månedlig tekstbesked med et one-touch-svar for at oprette forbindelse til Quit Line i løbet af de næste 5 måneder (dvs. 6 måneders tekstbeskeder efter klinikbesøget ).
GRUPPE II: Patienter modtager kun fortsat EPJ-intervention på klinikniveau (CO).
FASE II (patientniveau): Ikke-responderere (dvs. ikke tilmeldte sig Quit Line-behandling efter 6 måneder) i gruppe 1 i fase I (TM/CO) vil blive randomiseret til 1 ud af 2 grupper:
GRUPPE I: Patienter vil fortsat modtage tekstbeskeder (motiverende beskeder med simpelt berøringssvar for at forbinde direkte til Quit Line) plus 2 korte telefonopkald fra sundhedscoacher i 6-12 måneder efter klinikbesøget. Korte telefonopkald vil blive udført ved hjælp af Motivation and Problem Solving (MAPS) for en TM+MAPS-tilstand.
GRUPPE II: Patienter modtager fortsat en månedlig tekstbesked med et one-touch-svar for at oprette direkte forbindelse til Quit Line i månederne 6-12 efter klinikbesøget, dvs. sms fortsættes (TM-Cont).
Omtrent tolv måneder efter klinikbesøget vil kvalificerede patienter blive inviteret til at gennemføre en 12-måneders undersøgelse om livskvalitet og abstinensvurderinger.
Et spytsæt vil blive sendt til 300 tilfældigt udvalgte patienter, som angiver abstinens ved 12-måneders opfølgningen og accepterer spytprøven.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Chelsey Schlechter, PhD, MPH
- Telefonnummer: 801-213-5704
- E-mail: chelsey.schlechter@hci.utah.edu
Studiesteder
-
-
Utah
-
Salt Lake City, Utah, Forenede Stater, 84112
- Huntsman Cancer Institute/University of Utah
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Deltagerne vil være nuværende tobaksbrugere.
- Deltagere, der taler engelsk eller spansk.
- Deltagerne vil have en fungerende mobiltelefon, der kan modtage tekster og opkald.
- Deltagere, der præsenterer på deltagende community health center (CHC) klinikker.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: Randomiseret
- Interventionel model: Sekventiel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Ask-Advise-Connect (AAC)
Subjects who enrolled in Quitline within 2 weeks of the AAC intervention were not randomized to other interventions.
|
AAC utilizes EHR capabilities to prompt clinic practice team members to assess patients' tobacco use status, advise them to quit, and directly and electronically connect interested patients w/ Quitline treatment.
Patients were then called by the Quitline to enroll w/in 48 hours.
Andre navne:
Quitlines provide free behavioral phone counseling, text messaging, online programs, and pharmacotherapy (e.g.
Nicotine Replacement Therapy).
|
|
Eksperimentel: AAC, Text Messaging (TM)
Subjects who did not enroll in Quitline within 2 weeks of AAC were randomized to TM. Subjects who enrolled in Quitline within 6 months of TM were not randomized to other interventions. TM: weekly text message for one month, followed by a monthly text message over the next 5 months. |
AAC utilizes EHR capabilities to prompt clinic practice team members to assess patients' tobacco use status, advise them to quit, and directly and electronically connect interested patients w/ Quitline treatment.
Patients were then called by the Quitline to enroll w/in 48 hours.
Andre navne:
Quitlines provide free behavioral phone counseling, text messaging, online programs, and pharmacotherapy (e.g.
Nicotine Replacement Therapy).
Patients received text messages that offer opportunities to enroll in the Quitline.
Text messages were sent on behalf of each patient's CHC system included a brief motivational message, the Quit Line website/phone number, and response options to opt-out (stop receiving study interventions) or connect to Quitline.
|
|
Eksperimentel: AAC, Clinic Only (CO)
Subjects who did not enroll in Quitline within 2 weeks of the AAC intervention were randomized to CO. Patients receive continued clinic-level EHR intervention only. |
AAC utilizes EHR capabilities to prompt clinic practice team members to assess patients' tobacco use status, advise them to quit, and directly and electronically connect interested patients w/ Quitline treatment.
Patients were then called by the Quitline to enroll w/in 48 hours.
Andre navne:
Quitlines provide free behavioral phone counseling, text messaging, online programs, and pharmacotherapy (e.g.
Nicotine Replacement Therapy).
|
|
Eksperimentel: AAC, TM, Motivation And Problem-Solving (TM+MAPS)
Subjects who did not enroll in Quitline w/in 2 weeks of AAC were randomized to TM. Subjects who did not enroll in Quitline w/in 6 months of TM were randomized to MAPS. TM: weekly text message for one month, then a monthly text message for 5 months MAPS: monthly text message plus up to 2 phone calls for 6-12 months after their clinic visit |
AAC utilizes EHR capabilities to prompt clinic practice team members to assess patients' tobacco use status, advise them to quit, and directly and electronically connect interested patients w/ Quitline treatment.
Patients were then called by the Quitline to enroll w/in 48 hours.
Andre navne:
Quitlines provide free behavioral phone counseling, text messaging, online programs, and pharmacotherapy (e.g.
Nicotine Replacement Therapy).
Patients received text messages that offer opportunities to enroll in the Quitline.
Text messages were sent on behalf of each patient's CHC system included a brief motivational message, the Quit Line website/phone number, and response options to opt-out (stop receiving study interventions) or connect to Quitline.
Patients received MAPS calls from Community health workers (CHWs) trained in MAPS.
MAPS is designed to help patients address the larger context in which tobacco use occurs, motivate patients towards a long-term goal of quitting tobacco, and identify and address barriers to quitting and engaging in treatment.
|
|
Eksperimentel: AAC, TM, Text Messaging Continued (TM-Cont)
Subjects who did not enroll in Quitline within 2 weeks of AAC were randomized to TM. Subjects who did not enroll in Quitline within 6 months of TM were randomized to TM-Cont. TM: weekly text message for one month, followed by a monthly text message over the next 5 months. TM-Cont: monthly text message for 6-12 months following each tobacco user's clinic visit |
AAC utilizes EHR capabilities to prompt clinic practice team members to assess patients' tobacco use status, advise them to quit, and directly and electronically connect interested patients w/ Quitline treatment.
Patients were then called by the Quitline to enroll w/in 48 hours.
Andre navne:
Quitlines provide free behavioral phone counseling, text messaging, online programs, and pharmacotherapy (e.g.
Nicotine Replacement Therapy).
Patients received text messages that offer opportunities to enroll in the Quitline.
Text messages were sent on behalf of each patient's CHC system included a brief motivational message, the Quit Line website/phone number, and response options to opt-out (stop receiving study interventions) or connect to Quitline.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Reach
Tidsramme: Up to 12 months
|
Defined as the count of tobacco users who enter Quitline treatment.
This outcome measure will report the number of participants in each group who enrolled in Quitline treatment.
|
Up to 12 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Impact
Tidsramme: At 12 months
|
Impact is defined as reach x efficacy. Reach is defined as the count of tobacco users who enter Quitline treatment. Efficacy is defined as the proportion of tobacco users entering Quitline treatment who quit (i.e., achieve abstinence). This outcome measure will report 7-day point prevalence and 30-day point prevalence impact. This is the proportion of patients who enroll in the Quitline and are abstinent from any tobacco/nicotine product for the past 7 or 30 days at 12 months after study enrollment. |
At 12 months
|
|
Abstinence From Tobacco
Tidsramme: At 12 months
|
Abstinence assessments are based on recommendations for cessation induction trials. This outcome measure will report the count of participants who achieved abstinence. This outcome measure will report the count of participants who achieved 7-Day Point Prevalence Abstinence and 30--Day Point Prevalence Abstinence. This outcome measure will report 7-day point prevalence and 30-day point prevalence abstinence. This is the count of people who report not using any tobacco/nicotine product for the past 7 or 30 days at 12 months after study enrollment. Results of abstinence analyses where people who had missing abstinence outcomes were considered as using tobacco are provided. |
At 12 months
|
|
Health-related Quality of Life
Tidsramme: At 12 months
|
Health-related quality of life will be measured with the Short Form Health Survey (SF-12). SF-12 is a 12-item questionnaire assessing both physical (6 items) and mental (6 items) health-related quality of life. Scores from the SF-12 survey range from 0-100, with lower scores indicating worse health-related quality of life and higher scores indicating better health-related quality of life. This assessment provides two subscores: SF-12 Physical Component Score and SF-12 Menta lComponent Score. The mean component score by group was used to assess the quality of life impact on the patients, up to 12 months after study enrollment |
At 12 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: David Wetter, Huntsman Cancer Institute
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 111985
- HCI111985 (Anden identifikator: Huntsman Cancer Institute/University of Utah)
- NCI-2019-00502 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Plan for individuelle deltagerdata (IPD)
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