Optimizing Smoking Cessation Treatment for Patients with Bladder Cancer

Sloan-Kettering Inst Can Research, New York NY

Investigators

Linked publications & trials

Abstract

PROJECT SUMMARY / ABSTRACT- Smoking is the leading risk factor for bladder cancer and is estimated to account for half of the 80,000 new cases each year in the United States. Smoking cessation after a diagnosis of bladder cancer can profoundly improve patient and treatment outcomes. Bladder cancer patients rely principally on their urologist for medical information and guidance and are highly motivated to quit smoking. However, urologists do not frequently provide the necessary support by offering evidence-based smoking cessation treatment, for unclear reasons. The proposed research plan will investigate and optimize how urologists use evidence-based practices (EBPs) for smoking cessation for patients with bladder cancer. Specific Aim #1 will quantify and describe the variation in urologist prescription of evidence-based pharmacotherapy as an operationalized means of understanding how smoking cessation treatment is delivered. Specific Aim #2 will explore determinants of smoking cessation treatment given by urology providers to veterans with bladder cancer using qualitative methods that will help better understand barriers and facilitators to care delivery. Specific Aim #3 will adapt an implementation strategy that has previously facilitated use of smoking cessation EBPs in the primary care setting to the urology clinic using theory-based implementation science methods informed by our mixed- methods explanatory phase (Aims #1 and #2). The proposed research plan represents a significant step towards understanding and improving how urologists use EBPs for smoking cessation. This study will also pilot a strategy that can be widely disseminated, implemented, and studied during future independent hybrid implementation-effectiveness investigations. The proposed research project is accompanied by a training plan that will provide the candidate with new expertise in mixed-methods research and implementation science. This will be accomplished through a detailed plan that involves coursework, collaboration, and experiential learning. Advanced work at the institution in biostatistics and modeling, qualitative methodology and implementation science that correspond to each specific aim will give the candidate a set of skills unique among urologists. The research and training plan will be guided by a world-class group of mentors and collaborators at a premier academic medical center. The members of this multidisciplinary team will each contribute unique expertise to the candidate’s novel career development plan and research proposal. This proposed career development award will position him to make a significant contributions in the future as an independent investigator in health services research and urologic oncology.