Multi-level Approaches to Reducing Tobacco-related Disparities in Rural Michigan

Why is reduction tobacco-related disparities the focus of this study?

  • Tobacco use is one of the leading causes of death in the United States
  • Tobacco use rates tend to be higher in rural areas compared the general population
  • Evidence-based treatments for tobacco cessation are available but underutilized when individuals attempt to quit
  • Lung cancer screening is an evidence-based practice that reduces death from lung cancer among current and former smokers
  • There are no comprehensive programs that address the multi-level challenges of providing evidence-based tobacco cessation and lung cancer screening services in rural communities.

This study aims to assess the best ways to encourage tobacco cessation and/or lung cancer screening in rural clinics and communities in Michigan.

  • This is an observational study that will collect data across 50 rural primary care practices
  • We will interview 10 medical directors, recruit four focus groups of primary care providers (6-10 members each).
  • We will recruit four focus groups of adults (two groups of current smokers, two groups of former smokers) age greater than 18.
  • We will send surveys to current and former smokers across 50 primary care practices to assess smoking history (including living with another smoker), experience and attitudes toward smoking cessation (including particular barriers faced by smokers living in rural communities), and knowledge and attitudes toward lung cancer screening. 

What are the criteria for including in the study?

Health care professionals will include:

  1. Medical Director (organizational leaders) of a participating clinic
  2. MD and DO physicians and Advance Practice Providers (e.g. Nurse Practitioners, Physicians Assistants) in family and general medicine, internal medicine, and obstetrics and gynecology.
  3. Practice in a rural county of Michigan

Patients will be eligible to participate if they:

  1. Are the patient of one of the eligible PCPs in rural counties in Michigan
  2. Age greater than 18
  3. Current or former cigarette smokers
  4. Speak English
  5. Consent to participate

What is the long-term goal of the study?

The long-term goal of this study is to reduce disease and death from tobacco use and increase cessation among rural residents who use tobacco. In order to accomplish these aims we wish to understand and address particular challenges that may be faced by tobacco users who live in rural counties when they attempt to quit using tobacco. We also wish to understand and address knowledge, attitudes, and barriers to participation in lung cancer screening (a leading cause of cancer death).