Implementing Tobacco Use Guidelines in Community Health Centers in Vietnam Public Health System
Condition: Tobacco Use Cessation
Study type: Interventional

Summary: 
      Vietnam has a smoking prevalence that is the second highest among South East Asian countries
      (SEACs). With a population of approximately 90 million, Vietnam also has the second largest
      total number of adult smokers (over 16 million) in SEA. According to the World Health
      Organization (WHO), most reductions in mortality from tobacco use in the near future will be
      achieved through helping current users quit. Tobacco use treatment, as defined by the U.S.
      Preventive Health Service Guideline (Guideline) on Treating Tobacco use and Dependence, is
      evidence-based and highly cost-effective. Yet, in the U.S. and globally, adoption of
      recommended care is suboptimal. The objective of this proposal is to fill the current
      research-to-practice gap by conducting a randomized controlled trial that compares the
      effectiveness and cost effectiveness of two practical and highly replicable strategies for
      implementing evidence-based guidelines for the treatment of tobacco use in public health
      clinics in Vietnam. The proposed implementation strategies draw on evidence-based approaches,
      and the WHO's recently released guidelines for implementing Article 14 of the Framework
      Convention on Tobacco Control (FCTC). The FCTC is an evidence-based treaty that was developed
      by the WHO in response to the globalization of the tobacco epidemic. Vietnam ratified the
      FCTC in 2004; however, they have not taken steps to implement Article 14 which specifies the
      need to integrate best practices for treating tobacco use and dependence into routine
      preventive care. The proposed implementation strategies also build on the growing literature
      that supports the effectiveness of integrating community health workers as members of the
      health care team to improve access to preventive services.
    

Detailed description: 
      The long-term goal of the project is to develop a generalizable model for implementing
      evidence-based tobacco use treatment within existing health systems locally and globally. The
      objective of this proposal is to fill the current research-to-practice gap by conducting a
      randomized controlled trial that compares the effectiveness and cost of two practical and
      highly replicable strategies for implementing evidence-based guidelines for the treatment of
      tobacco use in public health clinics and community based settings in Vietnam. The proposed
      implementation strategies draw on evidence-based approaches and the WHO's recently released
      guidelines for implementing Article 14 of the Framework Convention on Tobacco Control (FCTC).
      The FCTC is an evidence-based treaty that was developed by the WHO in response to the
      globalization of the tobacco epidemic Article 14specifies the need to integrate clinical best
      practices for treating tobacco use and dependence into routine preventive care. The proposed
      implementation strategies also build on the growing literature that supports the
      effectiveness of integrating community health workers as members of the health care team to
      improve access to preventive services.
    

Intervention name(s): Technical Assistance, training and clinical reminders; TTC+Referral to Community Health Worker
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Technical Assistance, training and clinical reminders (TTC); TTC+ referral to a VHW for additional counseling and follow-up
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment