Automated Tobacco Cessation Intervention for Parents in Pediatric Primary Care
Notice bibliographique
Résumé
Importance: Treatment for tobacco use for parents in pediatric primary care settings is rarely provided but may support cessation and reduce childhood tobacco smoke exposure. Objective: To study the integration of the automated Clinical Effort Against Secondhand Smoke Exposure (eCEASE) tobacco cessation intervention into pediatric primary care via the electronic health record (EHR). Design, Setting, and Participants: This cluster-randomized clinical trial was conducted from July 16, 2021, to August 15, 2023, at 12 pediatric primary care practices in the Philadelphia, Pennsylvania, region. Participants included parents who used combusted tobacco in the past 7 days and attended a child's preventive health care visit. Intervention: In all practices, household members completed EHR previsit questionnaires about tobacco use. Parents in intervention practices were proactively offered eCEASE (automated delivery of nicotine replacement therapy [NRT], quitline and/or SmokefreeTXT enrollment, and navigator support). Control practice parents received usual care. Main Outcomes and Measures: The primary outcome was biochemically confirmed 7-day abstinence from combusted tobacco use by parents at the 1-year follow-up. Secondary outcomes included NRT and quitline and/or SmokefreeTXT use and recent quit attempts. Changes in cigarettes per day and smoking frequency (daily or nondaily) from baseline to 1-year follow-up were also examined. Results: Of 817 enrolled smoking parents (672 [82.3%] female), 323 of 408 (79.2%) in the intervention arm (6 practices) and 326 of 409 (79.7%) in the control arm (6 practices) were mothers; mean (SD) age was 36.17 (8.67) years. The follow-up survey was completed by 367 of 408 parents (90.0%) in the intervention arm and 368 of 409 (90.0%) in the control arm. Biochemically confirmed 7-day abstinence rates were 34 of 408 (8.3%) in the intervention arm vs 26 of 409 (6.4%) in the control arm (adjusted odds ratio, 1.34; 95% CI, 0.79-2.29). Among those who completed follow-up, 177 of 367 (48.2%) in the intervention arm vs 59 of 368 (16.0%) in the control arm reported using NRT; 93 of 367 (22.8%) and 8 of 368 (2.2%), respectively, reported using quitline and/or SmokefreeTXT messaging; and 294 of 367 (80.1%) vs 258 of 368 (70.1%), respectively, reported a quit attempt in the last 3 months. Compared with control practices, intervention practices reported a greater reduction in the mean (SD) number of cigarettes smoked daily (-3.32 [5.39] vs -1.81 [5.84]) and a greater reduction in the mean (SD) percentage of daily smokers (-35.2% [2.6%] vs -25.8% [2.6%]). Conclusions and Relevance: In this cluster-randomized clinical trial of an automated intervention to treat parental tobacco use in pediatric practices, the intervention did not significantly improve the primary outcome of quit rate at 1 year. Findings in this trial demonstrated increased treatment engagement and reductions in cigarette consumption, but additional strategies are needed to improve quit rates. Trial Registration: ClinicalTrials.gov Identifier: NCT04974736.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».