MCH公共健康诊所采用宣传手段改善PHS戒烟指南的实施：试验评价结果和背景因素
2011/05/10
摘要
对在多个妇幼保健所采用宣传干预以改善戒烟指南实施的结果进行阐述。对单独试验结果中不明显的背景因素，我们分析各个保健所的结果。伊利诺州的12个保健所随机分组，采用3种宣传手段：(1)核心宣传（2000公共卫生系统的临床实践指南和测试的戒烟项目，包括项目提供的帮助和培训）；(2) 核心宣传和电话咨询；(3)核心宣传、电话咨询和保健所随访。实施的结果主要是与基线状态相比，宣传后收到(1)提供者建议、(2)自助性小册子、(3)影像资料、(4)海报、(5)辅助干预措施的吸烟者比率。
结果显示，接受小册子和辅助干预（组2和组3）的吸烟者比例显著增加。吸烟者主诉的提供者建议、视频资料和海报接触无显著增加。各保健所的研究结果显示，7个保健所基本覆盖了所有研究疗效。在这些保健所中，吸烟者主诉接触提供者戒烟建议增加。保健所的类型和缺少破坏性事件能区分那些宣传手段有效的和无效的保健所。
（陈欣 审校）
Health Educ Res. 2011 Mar 11. [Epub ahead of print]
Dissemination strategies to improve implementation of the PHS smoking cessation guideline in MCH public health clinics: experimental evaluation results and contextual factors.
Manfredi C, Cho YI, Warnecke R, Saunders S, Sullivan M.
1Center for Cancer Control.opulation Science, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
We report results from an experimental study that tested the effectiveness of dissemination interventions to improve implementation of smoking cessation guidelines in maternal and child public health clinics. We additionally examine individual clinic results for contextual explanations not apparent from the experimental findings alone. Twelve clinics in Illinois were randomized to three dissemination strategies: (i) core dissemination (provision of the 2000 Public Health System Clinical Practice Guideline and a tested smoking cessation program, including program supplies and training), (ii) core dissemination and access to telephone counseling and (iii) core dissemination, telephone counseling access and outreach visits to clinics. Implementation outcomes were post-dissemination improvements over baseline in the percent of smokers reporting receipt/exposure to (i) provider advice, (ii) self-help booklet, (iii) videos, (iv) posters and (v) an adjunct intervention. Results showed significant increases in the percent of smokers receiving a booklet (overall) and an adjunct intervention (Groups 2 and 3). There were no increases in smoker-reported provider advice or videos and poster exposure. Examination of individual clinic findings showed that seven clinics accounted for all the experimental effectiveness. Smoker-reported provider advice to quit also increased in these clinics. Type of clinic and the absence of disruptive events distinguished clinics with and without effective dissemination outcomes.
Health Educ Res. 2011 Mar 11. [Epub ahead of print]
对在多个妇幼保健所采用宣传干预以改善戒烟指南实施的结果进行阐述。对单独试验结果中不明显的背景因素，我们分析各个保健所的结果。伊利诺州的12个保健所随机分组，采用3种宣传手段：(1)核心宣传（2000公共卫生系统的临床实践指南和测试的戒烟项目，包括项目提供的帮助和培训）；(2) 核心宣传和电话咨询；(3)核心宣传、电话咨询和保健所随访。实施的结果主要是与基线状态相比，宣传后收到(1)提供者建议、(2)自助性小册子、(3)影像资料、(4)海报、(5)辅助干预措施的吸烟者比率。
结果显示，接受小册子和辅助干预（组2和组3）的吸烟者比例显著增加。吸烟者主诉的提供者建议、视频资料和海报接触无显著增加。各保健所的研究结果显示，7个保健所基本覆盖了所有研究疗效。在这些保健所中，吸烟者主诉接触提供者戒烟建议增加。保健所的类型和缺少破坏性事件能区分那些宣传手段有效的和无效的保健所。
（陈欣 审校）
Health Educ Res. 2011 Mar 11. [Epub ahead of print]
Dissemination strategies to improve implementation of the PHS smoking cessation guideline in MCH public health clinics: experimental evaluation results and contextual factors.
Manfredi C, Cho YI, Warnecke R, Saunders S, Sullivan M.
1Center for Cancer Control.opulation Science, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
We report results from an experimental study that tested the effectiveness of dissemination interventions to improve implementation of smoking cessation guidelines in maternal and child public health clinics. We additionally examine individual clinic results for contextual explanations not apparent from the experimental findings alone. Twelve clinics in Illinois were randomized to three dissemination strategies: (i) core dissemination (provision of the 2000 Public Health System Clinical Practice Guideline and a tested smoking cessation program, including program supplies and training), (ii) core dissemination and access to telephone counseling and (iii) core dissemination, telephone counseling access and outreach visits to clinics. Implementation outcomes were post-dissemination improvements over baseline in the percent of smokers reporting receipt/exposure to (i) provider advice, (ii) self-help booklet, (iii) videos, (iv) posters and (v) an adjunct intervention. Results showed significant increases in the percent of smokers receiving a booklet (overall) and an adjunct intervention (Groups 2 and 3). There were no increases in smoker-reported provider advice or videos and poster exposure. Examination of individual clinic findings showed that seven clinics accounted for all the experimental effectiveness. Smoker-reported provider advice to quit also increased in these clinics. Type of clinic and the absence of disruptive events distinguished clinics with and without effective dissemination outcomes.
Health Educ Res. 2011 Mar 11. [Epub ahead of print]
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