PDF(Pubmed)
Abstract：
BACKGROUND: Cigarette smoking among adults in the USA is a leading cause of preventable death worldwide, even though there has been a decline in prevalence since 2005. The addictive nature of nicotine is the chief reason smokers continue to use tobacco. Although the majority of smokers report a desire to quit smoking, a small minority who attempt to quit achieve long-term cessation. Combined, smoking cessation best practices include coordinated medication and behavioral treatments. However, these treatments are not currently adequately delivered to Medi-Cal beneficiaries in the publicly funded patient-centered medical homes (PCMHs) and community mental health clinics operated by Los Angeles County (LAC)-Department of Health Services (LACDHS) and LAC-Department of Mental Health (LACDMH).
METHODS: This is a 5-year implementation, cluster-randomized comparative effectiveness trial that will support the implementation of smoking cessation services delivered in LAC-LACDHS-operated outpatient primary care clinics and in LAC-LACDMH-operated community mental health clinics. We will enroll 1000 participants from clinics that will offer smoking cessation services and 200 from clinics that will offer treatment as usual. Participants will be asked to complete assessments at baseline, 3 months, 6 months, and 12 months. The assessments will include self-reports on smoking history, anxiety, stress, quality of life, and participant satisfaction. Participants who are assigned to clinics that provide smoking cessation services will also be asked about the frequency of their participation in the smoking cessation services during the 12-month period.
CONCLUSIONS: This study will evaluate the effectiveness and feasibility of implementing smoking cessation services in outpatient primary care and community mental health clinics. It will also determine if there will be higher rates of smoking cessation in the implementation sites as compared to the sites with treatment as usual. If the implementation proves to be effective, the plan is to sustain these services using a workflow we will develop in the LAC-operated sites. This would lead to ameliorating the significant smoking cessation treatment gaps among those served within the LAC Health Agency departments.
BACKGROUND: ClinicalTrials.gov NCT04717544 \"Embedding comprehensive smoking cessation programs into community clinics.\" Registered on January 22, 2021.
METHODS: This is a 5-year implementation, cluster-randomized comparative effectiveness trial that will support the implementation of smoking cessation services delivered in LAC-LACDHS-operated outpatient primary care clinics and in LAC-LACDMH-operated community mental health clinics. We will enroll 1000 participants from clinics that will offer smoking cessation services and 200 from clinics that will offer treatment as usual. Participants will be asked to complete assessments at baseline, 3 months, 6 months, and 12 months. The assessments will include self-reports on smoking history, anxiety, stress, quality of life, and participant satisfaction. Participants who are assigned to clinics that provide smoking cessation services will also be asked about the frequency of their participation in the smoking cessation services during the 12-month period.
CONCLUSIONS: This study will evaluate the effectiveness and feasibility of implementing smoking cessation services in outpatient primary care and community mental health clinics. It will also determine if there will be higher rates of smoking cessation in the implementation sites as compared to the sites with treatment as usual. If the implementation proves to be effective, the plan is to sustain these services using a workflow we will develop in the LAC-operated sites. This would lead to ameliorating the significant smoking cessation treatment gaps among those served within the LAC Health Agency departments.
BACKGROUND: ClinicalTrials.gov NCT04717544 \"Embedding comprehensive smoking cessation programs into community clinics.\" Registered on January 22, 2021.
摘要：
背景：美国成年人吸烟是全球可预防死亡的主要原因，尽管自2005年以来患病率有所下降。尼古丁的成瘾性是吸烟者继续使用烟草的主要原因。尽管大多数吸烟者表示希望戒烟，试图戒烟的少数人实现长期戒烟。合并,戒烟最佳实践包括协调的药物治疗和行为治疗。然而,在洛杉矶县(LAC)-卫生服务部(LACDHS)和LAC-精神卫生部(LACDMH)运营的公共资助的以患者为中心的医疗院(PCMHs)和社区精神卫生诊所中,这些治疗目前未充分提供给Medi-Cal受益人.
方法：这是一个为期5年的实施，群集随机比较有效性试验,该试验将支持在LAC-LACDHS运营的门诊初级保健诊所和LAC-LACDMH运营的社区精神卫生诊所中实施戒烟服务.我们将从提供戒烟服务的诊所招募1000名参与者，从提供照常治疗的诊所招募200名参与者。参与者将被要求在基线时完成评估，3个月,6个月,和12个月。评估将包括吸烟史的自我报告，焦虑,压力，生活质量,参与者满意度。被分配到提供戒烟服务的诊所的参与者也将被问及他们在12个月期间参与戒烟服务的频率。
结论：本研究将评估在门诊初级保健和社区精神卫生诊所实施戒烟服务的有效性和可行性。它还将确定与照常治疗的场所相比，实施场所的戒烟率是否更高。如果实施被证明是有效的，该计划是使用我们将在LAC运营的站点中开发的工作流程来维持这些服务。这将导致改善LAC卫生局各部门之间的戒烟治疗差距。
背景：ClinicalTrials.govNCT04717544\“将全面戒烟计划纳入社区诊所。“2021年1月22日注册。
方法：这是一个为期5年的实施，群集随机比较有效性试验,该试验将支持在LAC-LACDHS运营的门诊初级保健诊所和LAC-LACDMH运营的社区精神卫生诊所中实施戒烟服务.我们将从提供戒烟服务的诊所招募1000名参与者，从提供照常治疗的诊所招募200名参与者。参与者将被要求在基线时完成评估，3个月,6个月,和12个月。评估将包括吸烟史的自我报告，焦虑,压力，生活质量,参与者满意度。被分配到提供戒烟服务的诊所的参与者也将被问及他们在12个月期间参与戒烟服务的频率。
结论：本研究将评估在门诊初级保健和社区精神卫生诊所实施戒烟服务的有效性和可行性。它还将确定与照常治疗的场所相比，实施场所的戒烟率是否更高。如果实施被证明是有效的，该计划是使用我们将在LAC运营的站点中开发的工作流程来维持这些服务。这将导致改善LAC卫生局各部门之间的戒烟治疗差距。
背景：ClinicalTrials.govNCT04717544\“将全面戒烟计划纳入社区诊所。“2021年1月22日注册。
