The Minnesota Department of Health proposes the implementation of two physician-based office interventions for cancer prevention and control. The first intervention will be for smoking cessation and the second for improved nutrition. The West Metro Minneapolis CCOP and The Duluth Clinic CCOP will provide access to primary care physicians in two locations with substantially different demographic characteristics. For the smoking cessation intervention in each locality 300 patients will be randomized into the treatment and 300 into the standard care condition. Treatment includes a quit recommendation and brief discussion from the physician and an in-office referral to a nurse health educator for counseling and support for smoking cessation. Standard care will consist of a quit recommendation and brief discussion with the physician but no referral. During the last phase of the study, training will be provided to in-house personnel of those physicians requesting integration of the program into standard clinical practice. Implementing the protocol in the two CCOP localities will extend generalizability and utility of the protocol as this provides comparison between both suburban white-collar and blue-collar patient populations. The nutrition intervention is exploratory; 100 patients will be randomized into each condition, treatment and standard care. The purpose of the nutrition study is to assess the efficacy and acceptability to patients and staff of an office-based nutrition protocol.
