This K07 proposal in cancer prevention, control, and population sciences will enable the applicant to integrate two areas--business management and clinical psychology--into a research career on cost-efficient dissemination of primary and secondary cancer prevention interventions. The goals are to: a) gain experience in interventions for hard-to-treat smokers; b) build knowledge of statistical methods in economic research; c) apply methods from management science to research on cost- efficiency; and, d) develop a programmatic line and research on dissemination and cost-efficiency of interventions for cancer prevention and control. Cancer prevention through smoking cessation involves a paradox. Low cost/low intensity/low efficacy public health approaches have greater reach, while high cost/high intensity/low reach clinical interventions have greater efficacy. The difference in efficacy is greatest for hard-to-treat smokers who have greater levels of nicotine dependence, depression and problem alcohol use. Recently, some have called for integration of these contrasting intervention approaches through use of tailored stepped-care models that maximize cost- efficient allocation of healthcare resources. The research plan in this career development proposal calls for two studies that e amine costs and efficiencies of targeting subsets of smokers. Study 1 will use data from adult respondents to the 1997-1999 the National Health Interview Surveys (N = +/- 100,000) and the 1993 National Mortality Followback Survey (N = 22,957) to examine the medical utilization of subgroups of smokers who have high-risk alcohol consumption, sedentary lifestyle or depression. The costs of medical utilization will be estimated with data from the Medical Expenditure Panel Survey. Study 1 hypothesizes that smoking interacts with other health risk factors to predict greater costs for subgroups of smokers. Study 2 will examine the cost-effectiveness and operational efficiency of a telephone based tailored smoking intervention. Study 2 hypothesizes that tailored interventions will be more cost-effective than more standardized ones, particularly among smokers with other high-risk factors. Study 2 will also use tools from management science to evaluate clinical system factors affecting intervention efficiency. These studies will inform future dissemination research on cost-efficient and effective smoking cessation interventions that address the economic imperatives of healthcare delivery systems while maximizing the benefit to public health.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA090961-05
Application #
7072635
Study Section
Subcommittee G - Education (NCI)
Program Officer
Gorelic, Lester S
Project Start
2002-07-01
Project End
2006-09-28
Budget Start
2006-07-01
Budget End
2006-09-28
Support Year
5
Fiscal Year
2006
Total Cost
$1
Indirect Cost
Name
Miriam Hospital
Department
Type
DUNS #
063902704
City
Providence
State
RI
Country
United States
Zip Code
02906