A SMART approach to treating tobacco use disorder in persons with HIV (SMARTTT): Rationale and design for a hybrid type 1 effectiveness-implementation study

2021 ◽  
pp. 106379
Author(s):  
E. Jennifer Edelman ◽  
James Dziura ◽  
Yanhong Deng ◽  
Krysten W. Bold ◽  
Sean M. Murphy ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Implementation Study ◽  
Tobacco Use Disorder ◽  
Hybrid Type

scholarly journals Trauma Communications Center Coordinated Severity-Based Stroke Triage: Protocol of a Hybrid Type 1 Effectiveness-Implementation Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Toby I. Gropen ◽  
Nataliya V. Ivankova ◽  
Mark Beasley ◽  
Erik P. Hess ◽  
Brian Mittman ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Care Pathway ◽  
Trauma System ◽  
Stroke Severity ◽  
Implementation Study ◽  
Stakeholder Perceptions ◽  
Hybrid Type ◽  
Before And After ◽  
Timely Access

Background: Mechanical thrombectomy (MT) can improve the outcomes of patients with large vessel occlusion (LVO), but a minority of patients with LVO are treated and there are disparities in timely access to MT. In part, this is because in most regions, including Alabama, the emergency medical service (EMS) transports all patients with suspected stroke, regardless of severity, to the nearest stroke center. Consequently, patients with LVO may experience delayed arrival at stroke centers with MT capability and worse outcomes. Alabama's trauma communications center (TCC) coordinates EMS transport of trauma patients by trauma severity and regional hospital capability. Our aims are to develop a severity-based stroke triage (SBST) care model based on Alabama's trauma system, compare the effectiveness of this care pathway to current stroke triage in Alabama for improving broad, equitable, and timely access to MT, and explore stakeholder perceptions of the intervention's feasibility, appropriateness, and acceptability.Methods: This is a hybrid type 1 effectiveness-implementation study with a multi-phase mixed methods sequential design and an embedded observational stepped wedge cluster trial. We will extend TCC guided stroke severity assessment to all EMS regions in Alabama; conduct stakeholder interviews and focus groups to aid in development of region and hospital specific prehospital and inter-facility stroke triage plans for patients with suspected LVO; implement a phased rollout of TCC Coordinated SBST across Alabama's six EMS regions; and conduct stakeholder surveys and interviews to assess context-specific perceptions of the intervention. The primary outcome is the change in proportion of prehospital stroke system patients with suspected LVO who are treated with MT before and after implementation of TCC Coordinated SBST. Secondary outcomes include change in broad public health impact before and after implementation and stakeholder perceptions of the intervention's feasibility, appropriateness, and acceptability using a mixed methods approach. With 1200 to 1300 total observations over 36 months, we have 80% power to detect a 15% improvement in the primary endpoint.Discussion: This project, if successful, can demonstrate how the trauma system infrastructure can serve as the basis for a more integrated and effective system of emergency stroke care.

scholarly journals Harnessing single-session interventions to improve adolescent mental health and well-being in India: Development, adaptation, and pilot testing of online single-session interventions in Indian secondary schools

2019 ◽  
Author(s):  
Akash Wasil ◽  
Suh Jung Park ◽  
Sarah Gillespie ◽  
Rebecca Shingleton ◽  
Sachin Shinde ◽  
...  
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Controlled Trial ◽  
Well Being ◽  
Evidence Based ◽  
Implementation Study ◽  
Single Session ◽  
Implementation Barriers ◽  
Hybrid Type

Background: Many evidence-based prevention and intervention approaches for youth mental health exist, but most are time-consuming and expensive to deliver. Innovative approaches are needed to develop and disseminate scalable mental health interventions, especially for youth in low- and middle-income countries. Computerized single-session interventions (SSIs) may be able to overcome many of these implementation barriers, especially if deployed in school settings. Methods: Guided by this logic, we designed three computerized SSIs (based on behavioral activation, gratitude, and growth mindset exercises) for delivery in Indian high schools. Then, we conducted focus groups with Indian adolescents and school officials to inform adaptations of the interventions. Finally, we designed a Hybrid Type 1 effectiveness-implementation study to evaluate the interventions. Results: In this paper, we present the rationale for selecting the interventions, the results of the focus groups, and the design of a Hybrid Type 1 effectiveness-implementation study. Our initial focus group data showed that the interventions were considered acceptable, feasible, and appropriate by both educators and students. We also describe feedback on the interventions which we incorporated to refine the interventions prior to our randomized controlled trial. Discussion: Computerized SSIs may offer innovative, scalable ways to disseminate evidence-based interventions. By identifying which interventions are most acceptable and effective in this highly scalable format, we may understand which SSIs are best suited for continued development, testing, and, ultimately, widespread dissemination.

Tobacco Use Disorder and Cardiovascular Health

Addiction ◽  
2021 ◽  
Author(s):  
Neal L. Benowitz ◽  
Evangelia Liakoni
Keyword(s):  
Tobacco Use ◽  
Cardiovascular Health ◽  
Tobacco Use Disorder

Assessing sex, gender identity, sexual orientation, race, ethnicity, socioeconomic status, and mental health concerns in tobacco use disorder treatment research: Measurement challenges and recommendations from a Society for Research on Nicotine and Tobacco (SRNT) pre-conference workshop

2021 ◽  
Author(s):  
Andrea H Weinberger ◽  
Marc L Steinberg ◽  
Sarah D Mills ◽  
Sarah S Dermody ◽  
Jaimee L Heffner ◽  
...  
Keyword(s):  
Mental Health ◽  
Socioeconomic Status ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Tobacco Use ◽  
Health Concerns ◽  
Tobacco Use Disorder ◽  
Lower Socioeconomic ◽  
Treatment Research ◽  
Mental Health Concerns

Abstract This paper reports on topics discussed at a Society for Research on Nicotine and Tobacco (SRNT) pre-conference workshop at the 2019 annual SRNT meeting. The goal of the preconference workshop was to help develop a shared understanding of the importance of several tobacco-related priority groups in tobacco use disorder treatment research and to highlight challenges in measurement related to these groups. The workshop focused on persons with minoritized sex, gender identity, and sexual orientation identities; persons with minoritized racial and ethnic backgrounds; persons with lower socioeconomic status (SES); and persons with mental health concerns. In addition to experiencing commercial tobacco-related health disparities, these groups are also underrepresented in tobacco research, including tobacco use disorder (TUD) treatment studies. Importantly, there is wide variation in how and whether researchers are identifying variation within these priority groups. Best practices for measuring and reporting sex, gender identity, sexual orientation, race, ethnicity, SES, and mental health concerns in TUD treatment research are needed. This paper provides information about measurement challenges when including these groups in TUD treatment research and specific recommendations about how to measure these groups and assess potential disparities in outcomes. The goal of this paper is to encourage TUD treatment researchers to use measurement best practices in these priority groups in an effort to conduct meaningful and equity-promoting research. Increasing the inclusion and visibility of these groups in TUD treatment research will help to move the field forward in decreasing tobacco-related health disparities. Implications Tobacco-related disparities exist for a number of priority groups including, among others, women, individuals with minoritized sexual and gender identities, individuals with minoritized racial and ethnic backgrounds, individuals with lower socioeconomic status, and individuals with mental health concerns. Research on tobacco use disorder (TUD) treatments for many of these subgroups is lacking. Accurate assessment and consideration of these subgroups will provide needed information about efficacious and effective TUD treatments, about potential mediators and moderators, and for accurately describing study samples, all critical elements for reducing tobacco-related disparities, and improving diversity, equity, and inclusion in TUD treatment research.

scholarly journals MECANISMOS DE DEPENDÊNCIA QUÍMICA NO TABAGISMO: REVISÃO DA LITERATURA

2015 ◽  
Vol 2 (2) ◽  
pp. 74 ◽  
Author(s):  
Alisson F. Pupulim ◽  
Andrey Biff Sarris ◽  
Luiz G. R. Fernandes ◽  
Maki C. Nakamura ◽  
Tatiane V. Camargo ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Use Disorder

Introdução: O tabagismo está associado à dependência química da nicotina, a qual leva o fumante a manifestar características de abstinência, tolerância e abandono de atividades sociais. O fumo é também influenciado por fatores bioquímicos, genéticos e ambientais. Objetivo: Abordar os principais mecanismos de dependência química relacionados ao tabagismo. Metodologia: Foi realizada consulta à literatura médica através de meios eletrônicos e físicos. A consulta por meios eletrônicos se desenvolveu através de pesquisas nas bases de dados MEDLINE, LILACS e SciELO. Nas bases MEDLINE e LILACS foi utilizado como descritor “transtorno por uso de tabaco” (“tobacco use disorder”). Discussão: O mecanismo de dependência se relaciona com o alto poder de difusão da nicotina pelos alvéolos pulmonares e sua interação com receptores colinérgicos nicotínicos (nAchR) centrais. Isso possibilita indução e propagação do impulso nervoso até o sistema de recompensa cerebral, contribuindo com efeitos momentâneos de euforia e prazer, principalmente através da secreção de dopamina. A falta de nicotina no organismo leva o indivíduo à síndrome de abstinência, condição clínica desencadeada por alterações do número e estado dos receptores nicotínicos. A genética mostrou ter influência no início, na manutenção do hábito e no tratamento da dependência nicotínica, condicionada, no entanto, por fatores ambientais. Estudos mostraram também relação entre genes dos receptores nicotínicos e câncer de pulmão. Conclusão: A nicotina é o principal fator desencadeante da dependência ao tabaco, pois altera a conformação dos receptores colinérgicos nicotínicos. Estes influenciam na propagação do impulso nervoso até o sistema de recompensa cerebral, criando mecanismos de reforço positivo.

Sign in / Sign up

Export Citation Format

Share Document