{
  "abstract": "Introduction Tobacco use is a major contributor to the burden of chronic obstructive pulmonary disease (COPD) and other non-communicable diseases in China. People at high risk for COPD who smoke, particularly those with pre-existing chronic conditions, often remain underserved by conventional smoking cessation programmes. Population medicine offers a promising framework for proactively identifying high-burden diseases, managing multimorbidity and prioritising interventions for vulnerable populations.Methods and analysis This protocol describes a stratified, two-arm cluster randomised controlled trial (Population Medicine Multimorbidity Intervention in Xishui County-Smoking) being conducted in Xishui County, a rural area of Guizhou Province, China. A total of 26 townships were stratified by population size and randomly assigned in a 1:1 ratio to receive either a multicomponent intervention or usual care. Eligible participants were individuals aged 35 years or older who smoked and were at high risk for COPD as identified by the COPD Screening Questionnaire. The intervention package integrates multiple components, including a digital smoking cessation programme, digital mental health support, community-based spirometry, tailored chronic disease management, health education and a performance-linked ‘pay-for-population’ scheme that aligns healthcare worker reimbursement with population health outcomes. Primary outcomes are smoking amount and nicotine dependence and secondary outcomes include COPD-related health outcomes, hypertension, diabetes, health risk behaviours, quality of life, healthcare utilisation and productivity loss. Follow-up occurs at 3, 6 and 12 months.Ethics and dissemination Ethical approval has been granted by the Peking Union Medical College Ethics Committee (CAMS&PUMC-IEC-2024-042). Informed consent was obtained from all participants prior to enrolment. Results will be shared through peer-reviewed publication and (inter)national conference presentations.Trial registration number NCT06458205.",
  "authors": [
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China",
        "Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany",
        "State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China"
      ],
      "name": "Simiao Chen"
    },
    {
      "affiliations": [
        "State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China",
        "Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China",
        "National Center for Respiratory Medicine, Beijing, China"
      ],
      "name": "Ke Huang"
    },
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China"
      ],
      "name": "Zhoutao Zheng"
    },
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China"
      ],
      "name": "Yuhao Liu"
    },
    {
      "affiliations": [
        "School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China"
      ],
      "name": "Shiyu Zhang"
    },
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China"
      ],
      "name": "Wenjin Chen"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China",
        "National Center for Respiratory Medicine, Beijing, China"
      ],
      "name": "Xingyao Tang"
    },
    {
      "affiliations": [
        "Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany"
      ],
      "name": "Zhong Cao"
    },
    {
      "affiliations": [
        "Guizhou Medical University, Guiyang, Guizhou, China"
      ],
      "name": "Lei Tang"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, National Center of Gerontology, Beijing Hospital, Chinese Academy of Medical Sciences Institute of Geriatric Medicine, Beijing, China"
      ],
      "name": "Xunliang Tong"
    },
    {
      "affiliations": [
        "Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany"
      ],
      "name": "Jinghan Zhao"
    },
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China"
      ],
      "name": "Liu He"
    },
    {
      "affiliations": [
        "Department of Health Policy and Management, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"
      ],
      "name": "Lirui Jiao"
    },
    {
      "affiliations": [
        "Center for Disease Control and Prevention of Xishui County, Zunyi, Guizhou, China"
      ],
      "name": "Yingping Wang"
    },
    {
      "affiliations": [
        "Center for Disease Control and Prevention of Xishui County, Zunyi, Guizhou, China"
      ],
      "name": "Tianying Zhao"
    },
    {
      "affiliations": [
        "Center for Disease Control and Prevention of Xishui County, Zunyi, Guizhou, China"
      ],
      "name": "Yingchi Luo"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, People’s Hospital of Xishui County, Zunyi, Guizhou, China"
      ],
      "name": "Qiande Lai"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, People’s Hospital of Xishui County, Zunyi, Guizhou, China"
      ],
      "name": "Xiangqin Lyu"
    },
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China"
      ],
      "name": "Ruopeng Dou"
    },
    {
      "affiliations": [
        "The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, Pennsylvania State University University Park, University Park, Pennsylvania, USA"
      ],
      "name": "Qiushi Chen"
    },
    {
      "affiliations": [
        "Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany"
      ],
      "name": "Aditi Bunker"
    },
    {
      "affiliations": [
        "Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany"
      ],
      "name": "Sebastian Vollmer"
    },
    {
      "affiliations": [
        "Division of Primary Care and Population Health, Stanford University Department of Medicine, Stanford, California, USA",
        "Chan Zuckerberg Biohub San Francisco, San Francisco, California, USA"
      ],
      "name": "Pascal Geldsetzer"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics and Institute for Global Health Sciences, University of California, San Francisco, California, USA"
      ],
      "name": "Dean Jamison"
    },
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China",
        "Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany",
        "Department of Global and Population Health, Harvard University, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA"
      ],
      "name": "Till Bärnighausen"
    },
    {
      "affiliations": [
        "State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China",
        "Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China",
        "National Center for Respiratory Medicine, Beijing, China"
      ],
      "name": "Ting Yang"
    },
    {
      "affiliations": [
        "School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China",
        "State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China",
        "Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China",
        "National Center for Respiratory Medicine, Beijing, China"
      ],
      "name": "Chen Wang"
    },
    {
      "affiliations": [],
      "name": "on behalf of the POPMIX study investigators"
    }
  ],
  "title": "Impact of the POPulation Medicine Multimorbidity Intervention in Xishui County (POPMIX) on people at high risk for COPD who smoke: protocol for the POPMIX-Smoking cluster randomised controlled trial",
  "uid": "fd3acfef-74e5-5d66-ad0e-8bb8f7c3ef0f"
}