Empowering Primary Care Nurse Practitioners: A Multilevel Approach to Combating the Opioid Crisis.

Aims: We offer a literature-driven, empirically informed, and highly warranted recommendation for a multilevel approach tailored to nurse practitioners. This approach aimed to drive change at the individual level (nurse practitioner), dyadic level (nurse-patient therapeutic relationship), and systems level (organisational culture, education, and policy) to strengthen nurse practitioners' capacity to deliver optimal opioid use disorder care.

Background: The opioid overdose epidemic is a global public health crisis, with the United States facing the most severe impact.

Predictors of Enrollment and Adherence in a Randomized Tobacco Cessation Clinical Trial.

Background: New therapeutic cessation approaches are being tested in clinical trials to engage and retain people who smoke. Our team is conducting a pragmatic randomized clinical trial (RCT) to evaluate a new treatment for tobacco dependence, but enrolling participants and ensuring adherence has been more challenging than in previous trials.

Objective: To determine the predictors of enrollment and adherence in the RCT.

The Impact of Nonpharmacological Interventions on Opioid Use for Chronic Noncancer Pain: A Scoping Review.

Despite the lack of evidence, opioids are still routinely used as a solution to long-term management for chronic noncancer pain (CNCP). Given the significant risks associated with long-term opioid use, including the increased number of unregulated opioid pills at large in the opioid ecosystem, opioid cessation or reduction may be the desired goal of the patient and clinician. Viable nonpharmacological interventions (NPIs) to complement and/or replace opioids for CNCP are needed.

#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial.

Background: Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas.

Assessing the Pragmatic Effectiveness and Implementation of Click City: Tobacco: A School-Based Prevention Program Targeting Youth Cigarette and E-cigarette Use.

Introduction: Given the rapid increase in the prevalence of e-cigarette use among youth, we updated Click City: Tobacco, an existing, efficacious, online tobacco prevention program for 5th graders with a 6th-grade booster, to also target e-cigarette use.

Methods: To evaluate the effectiveness of the updated 5th-grade program within a "real world" setting, we conducted a pragmatic randomized trial with 5th-grade students in 43 schools across Arizona and Oregon, assessing change in intentions and willingness to use e-cigarettes/cigarettes, from baseline to one-week post-intervention. Students in intervention schools (n = 1327) received the updated version of Click City: Tobacco; students in control schools (n = 1346) received their usual tobacco prevention curriculum.

Testing the Efficacy of a Scalable Telephone-Delivered Guided Imagery Tobacco Cessation Treatment: Protocol for a Randomized Clinical Trial.

Background: Tobacco use continues to be a leading preventable cause of death and disease in the United States, accounting for >480,000 deaths each year. Although treatments for tobacco use are effective for many, there is substantial variability in outcomes, and these approaches are not effective for all individuals seeking to quit smoking cigarettes. New, effective therapeutic approaches are needed to meet the preferences of people who want to stop smoking.

A Scoping Review and Meta-analysis of the Use of Remote Biochemical Verification Methods of Smoking Status in Tobacco Research.

Introduction: Increasing digital delivery of smoking cessation interventions has resulted in the need to employ novel strategies for remote biochemical verification.

Aims And Methods: This scoping review and meta-analysis aimed to investigate best practices for remote biochemical verification of smoking status. The scientific literature was searched for studies that reported remotely obtained (not in-person) biochemical confirmation of smoking status (ie, combustible tobacco).

Barriers to implementation of pediatric emergency department interventions for parental tobacco use and dependence: a qualitative study using the theoretical domains framework.

Background: Pediatric emergency department (PED) and urgent care (UC) professionals can play a key role in delivering evidence-based guidelines to address parental tobacco use and child tobacco smoke exposure (TSE). Understanding PED/UC professionals' perceptions regarding these guidelines is the first step in developing and implementing a TSE screening and counseling intervention in these settings. This study aimed to use the theoretical domains framework (TDF) to identify current screening and counseling behaviors of PED/UC professionals related to parental tobacco use and child TSE, and determine barriers and enablers that influence these behaviors.

Clinical decision support for tobacco screening and counseling parents of pediatric patients: A qualitative analysis of pediatric emergency department and urgent care professionals.

Background: Clinical Decision Support Systems (CDSS) embedded into electronic medical records is a best practices approach. However, information is needed on how to incorporate a CDSS to facilitate parental tobacco cessation counseling and reduce child tobacco smoke exposure (TSE) in Pediatric Emergency Department (PED) and Urgent Care (UC) settings. The objective was to explore the barriers and enablers of CDSS use to facilitate child TSE screening and parental tobacco cessation counseling by PED/UC nurses and physicians.

Use of a Guided Imagery Mobile App (See Me Serene) to Reduce COVID-19-Related Stress: Pilot Feasibility Study.

Background: The SARS-CoV-2 pandemic has led to concerns about mental health resulting from regional and national lockdowns, social isolation, job loss, and concern about disease exposure.

Objective: We describe results of the pilot feasibility study of the See Me Serene mHealth app. The app provides users with immersive, vivid, nature experiences to reduce stress and anxiety related to COVID-19 and other isolation.

Evaluation of tobacco screening and counseling in a large, midwestern pediatric emergency department.

Introduction: The study objective was to assess tobacco screening and cessation counseling practices of pediatric emergency department (PED) and urgent care (UC) nurses and physicians, and factors associated with these practices. Secondarily, we assessed factors associated with performing tobacco smoke exposure reduction and tobacco cessation counseling.

Methods: We conducted a cross-sectional survey of 30 PED/UC nurses and physicians working at one large, urban, Midwestern children's hospital.

Examination of the '5-2-1-0' Recommendations in Racially Diverse Young Children Exposed to Tobacco Smoke.

Purpose: The '5-2-1-0' guidelines recommend that children: eat ≥5 servings of fruits/vegetables ('5'), have ≤2 hours of screen-time ('2'), have ≥1 hour of activity ('1'), and drink 0 sugar-sweetened beverages ('0') daily. The pediatric emergency department (PED) treats children at risk for obesity and tobacco smoke exposure (TSE). We examined body mass index (BMI), overweight, obesity, TSE, and '5-2-1-0' rates in children with TSE in the PED.

Healthcare resources attributable to child tobacco smoke exposure.

Background: Tobacco smoke exposure (TSE) places an economic toll on the U.S. healthcare system.

A Parental Smoking Cessation Intervention in the Pediatric Emergency Setting: A Randomized Trial.

We examined the efficacy of a pediatric emergency visit-based screening, brief intervention, and referral to treatment (SBIRT) condition compared to a control condition (Healthy Habits Control, HHC) to help parental smokers quit smoking. We enrolled 750 parental smokers who presented to the pediatric emergency setting with their child into a two-group randomized controlled clinical trial. SBIRT participants received brief cessation coaching, quitting resources, and up to 12-weeks of nicotine replacement therapy (NRT).

Developing a Guided Imagery Telephone-Based Tobacco Cessation Program for a Randomized Controlled Trial.

Background/aims: Guided imagery is an evidence-based, multi-sensory, cognitive process that can be used to increase motivation and achieve a desired behavior. Quitlines are effective, standard care approaches for tobacco cessation; however, utilization of quitlines is low. Using guided imagery-based interventions for smoking cessation may appeal to smokers who do not utilize traditional quitline services.

A telephone-based guided imagery tobacco cessation intervention: results of a randomized feasibility trial.

Background: Evidence supports the use of guided imagery for smoking cessation; however, scalable delivery methods are needed to make it a viable approach. Telephone-based tobacco quitlines are a standard of care, but reach is limited. Adding guided imagery to quitline services might increase reach by offering an alternative approach.

Child tobacco smoke exposure and healthcare resource utilization patterns.

Background: The objective was to examine the relationship between healthcare resource utilization patterns in tobacco smoke-exposed children (TSE group) compared with unexposed children (non-TSE group).

Methods: We matched 380 children in the TSE group with 1140 children in the non-TSE group based on child age, sex, race, and ethnicity using propensity scores. Healthcare resource utilization variables included respiratory-related procedures, diagnostic testing, disposition, and medications.

Testing the feasibility of a guided imagery tobacco cessation intervention delivered by a telephone quitline: Study protocol for a randomized controlled feasibility trial.

Background: Guided imagery (GI) is an evidence-based method that uses the imagination to practice and achieve a desired outcome. Little research has focused on how GI can be delivered to smokers using remote or virtual methods, such as a telephone-based intervention. Telephone-based services for tobacco cessation (quitlines) have emerged as standard of care for tobacco cessation.

Electronic Health Record Classification of Tobacco Smoke Exposure and Cotinine Levels in Hospitalized Pediatric Patients.

Objectives: Documentation of children's tobacco smoke exposure (TSE) in the electronic health record (EHR) can have important implications for clinical care. However, it may not be accurate if it is not based on biochemical assessment, the most reliable method of verifying TSE. Our objectives were to compare the accuracy of EHR classification of TSE with cotinine verification and to explore parent and child variables associated with biochemically verified TSE.

Tobacco Use Behaviors and Perceptions of Parental Smokers in the Emergency Department Setting.

Background: More information is needed about modifiable child tobacco smoke exposure (TSE) patterns in racially diverse parental smokers to tailor interventions designed to help parents quit smoking and reduce their child's TSE. Our objectives were to determine whether there were differences in smoking and TSE patterns based on parental race and child age and whether these patterns differed based on child age within black and white parental smokers. Secondary objectives were to assess the relationship between parental perceptions about the effects of smoking and the benefits of quitting on their child based on child age, race, and reported TSE patterns and to examine biochemically verified TSE levels by child age, race, and parent-reported TSE patterns.

Effect of a Responsiveness-Based Support Intervention on Smokeless Tobacco Cessation: The UCare-ChewFree Randomized Clinical Trial.

Introduction: Partner behaviors and attitudes can motivate or undermine a tobacco user's cessation efforts. We developed a multimedia intervention, UCare (Understanding-CAring-REspect) for women who wanted their male partner to quit smokeless tobacco (ST), based on perceived partner responsiveness-the empirically based theory that support is best received when the supporter conveys respect, understanding, and caring.

Methods: One thousand one hundred three women were randomized to receive either immediate access to the UCare website and printed booklet (Intervention; N = 552), or a Delayed Treatment control (N = 551).

A Multimedia Support Skills Intervention for Female Partners of Male Smokeless Tobacco Users: Use and Perceived Acceptability.

Background: UCare is a new multimedia (website+booklet) intervention for women who want their male partner to quit their use of smokeless tobacco. The intervention is based on research showing that perceived partner responsiveness to social support is highest when the supporter conveys respect, understanding, and caring in their actions. The website included both didactic and interactive features, with optional video components, and special activities to help women develop empathy for nicotine addiction.

Using Facebook for Large-Scale Online Randomized Clinical Trial Recruitment: Effective Advertising Strategies.

Targeted Facebook advertising can be an effective strategy to recruit participants for a large-scale online study. Facebook advertising is useful for reaching people in a wide geographic area, matching a specific demographic profile. It can also target people who would be unlikely to search for the information and would thus not be accessible via Google AdWords.

Utilization of a Clinical Decision Support Tool to Reduce Child Tobacco Smoke Exposure in the Urgent Care Setting.

Background: Clinical decision support systems (CDSS) may facilitate caregiver tobacco screening and counseling by pediatric urgent care (UC) nurses.

Objective: This study aimed to assess the feasibility of a CDSS to address caregivers' tobacco use and child tobacco smoke exposure (TSE).

Methods: We conducted a 3-month prospective study on caregivers screened using a CDSS.