@文章{info:doi/10.2196/37900，作者="Minian, Nadia和Lingam, Mathangee和Moineddin, Rahim和Thorpe, Kevin E和Veldhuizen, Scott和Dragonetti, Rosa和Zawertailo, Laurie和Taylor, Valerie H和Hahn, Margaret和deRuiter, Wayne K和Melamed, Osnat C和Selby, Peter"，标题="在戒烟治疗期间解决身体活动和健康饮食的临床决策支持系统的影响:混合I型随机对照试验”，期刊=“J Med Internet Res”，年=“2022”，月=“9”，日=“30”，卷=“24”，数=“9”，页=“e37900”，关键词=“戒烟;身体活动;健康饮食;临床决策支持系统;加拿大;饮食;干预;吸烟;初级保健; program; treatment; clinical decision support; health behavior", abstract="Background: People who smoke have other risk factors for chronic diseases, such as low levels of physical activity and poor diet. Clinical decision support systems (CDSSs) might help health care practitioners integrate interventions for diet and physical activity into their smoking cessation programming but could worsen quit rates. Objective: The aims of this study are to assess the effects of the addition of a CDSS for physical activity and diet on smoking cessation outcomes and to assess the implementation of the study. Methods: We conducted a pragmatic hybrid type I effectiveness-implementation trial with 232 team-based primary care practices in Ontario, Canada, from November 2019 to May 2021. We used a 2-arm randomized controlled trial comparing a CDSS addressing physical activity and diet to treatment as usual and used the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to measure implementation outcomes. The primary outcome was self-reported 7-day tobacco abstinence at 6 months. Results: We enrolled 5331 participants in the study. Of these, 2732 (51.2{\%}) were randomized to the intervention group and 2599 (48.8{\%}) to the control group. At the 6-month follow-up, 29.7{\%} (634/2137) of respondents in the intervention arm and 27.3{\%} (552/2020) in the control arm reported abstinence from tobacco. After multiple imputation, the absolute group difference was 2.1{\%} (95{\%} CI −0.5 to 4.6; F1,1000.42=2.43; P=.12). Mean exercise minutes changed from 32 (SD 44.7) to 110 (SD 196.1) in the intervention arm and from 32 (SD 45.1) to 113 (SD 195.1) in the control arm (group effect: B=−3.7 minutes; 95{\%} CI −17.8 to 10.4; P=.61). Servings of fruit and vegetables changed from 2.64 servings to 2.42 servings in the intervention group and from 2.52 servings to 2.45 servings in the control group (incidence rate ratio for intervention group=0.98; 95{\%} CI 0.93-1.02; P=.35). Conclusions: A CDSS for physical activity and diet may be added to a smoking cessation program without affecting the outcomes. Further research is needed to improve the impact of integrated health promotion interventions in primary care smoking cessation programs. Trial Registration: ClinicalTrials.gov NCT04223336https://www.clinicaltrials.gov/ct2/show/NCT04223336 International Registered Report Identifier (IRRID): RR2-10.2196/19157 ", issn="1438-8871", doi="10.2196/37900", url="//www.mybigtv.com/2022/9/e37900", url="https://doi.org/10.2196/37900", url="http://www.ncbi.nlm.nih.gov/pubmed/36178716" }