This Program Project aims to develop a comprehensive treatment approach that engages all smokers visiting healthcare settings in treatment that efficiently and effectively helps them stop smoking. This will be achieved by: 1) developing a smoker recruitment strategy to be used in real-world primary care clinics that is based on enhancements to the electronic health record (EHR), and 2) by developing a chronic care treatment for smoking that is effective across all phases of smoking treatment: enhancing quitting motivation, aiding cessation, preventing relapse, and aiding relapse recovery. The proposed research will use powerful research methods that call for testing multiple intervention components in multiple linked experiments. Thus, the proposed research requires implementation strategies that support effective modification of the EHR, the conduct of studies in healthcare settings, and the accurate delivery and evaluation of multiple intervention components with smokers at different phases of smoking treatment. The Implementation and Health Systems Integration Core will support the four proposed research projects by achieving four specific aims: 1) To support the development and implementation of an EHR enhanced to increase the documentation of smoking status and referral to smoking treatment for smokers visiting real-world primary care clinics. 2) To adapt, implement, and maintain a computerized database to prompt and track interventions and to ensure that research staff administer the appropriate study interventions and assessments for all four projects described in this Program Project application;3) To train all research staff to conduct all study interventions and assessments and to monitor competency and fidelity to study protocols;and 4) To support an integrated recruitment strategy to meet the recruitment goals for Projects 2-4 (N=1712 from 18 primary care clinics in three healthcare systems over 24 months). The achievement of these aims will be enhanced by the extensive prior experience of the Core investigators and staff in modifying EHRs, conducting research in healthcare settings, and conducting ambitious comparative effectiveness research on smoking treatments. This Core will ensure that the proposed work is conducted in a highly effective and timely manner.
This Program Project is aimed at improving smoking treatment in healthcare settings through four ambitious research projects requiring the evaluation of multiple smoking treatments in healthcare settings. To support this, the Implementation Core will take steps to recruit smoker participants, train healthcare and research staff, secures needed resources, and ensure that treatments and assessments are accurately conducted.