TY - JOUR
T1 - Quitline treatment dose predicts cessation outcomes among safety net patients linked with treatment via Ask-Advise-Connect
AU - Piñeiro, Bárbara
AU - Wetter, David W.
AU - Vidrine, Damon J.
AU - Hoover, Diana S.
AU - Frank-Pearce, Summer G.
AU - Nguyen, Nga
AU - Zbikowski, Susan M.
AU - Williams, Mary B.
AU - Vidrine, Jennifer I.
N1 - Funding Information:
This work was supported by the Cancer Prevention Research Institute of Texas ( PP120191 ; PI: JI Vidrine), the Oklahoma Tobacco Settlement Endowment Trust ( 092-016-0002 ; PI: JI Vidrine), United States, the National Institute on Drug Abuse ( K23DA040933 ; PI: DS Hoover), The University of Texas MD Anderson Cancer Center 's Cancer Center Support Grant ( P30CA016672 ; PI: P. Pisters), and the Stephenson Cancer Center 's Cancer Center Support Grant ( P30CA225520 ; PI: R. Mannel), United States.
Publisher Copyright:
© 2019 The Author(s)
PY - 2019/3
Y1 - 2019/3
N2 - The efficacy of tobacco treatment delivered by state quitlines in diverse populations is well-supported, yet little is known about associations between treatment dose and cessation outcomes following the implementation of Ask-Advise-Connect (AAC), an electronic health record-based systematic referral process that generates a high volume of proactive calls from the state quitline to smokers. The current study is a secondary analysis of a 34-month implementation trial evaluating ACC in 13 safety-net clinics in Houston, TX. Treatment was delivered by a quitline and comprised up to five proactive, telephone-delivered multi-component cognitive-behavioral treatment sessions. Associations between treatment dose and abstinence were examined. Abstinence was assessed by phone six months after treatment enrollment, and biochemically confirmed via mailed saliva cotinine. Among smokers who enrolled in treatment and agreed to follow-up (n = 3704), 29.2% completed no treatment sessions, 35.5% completed one session, 16.4% completed two sessions, and 19.0% completed ≥three sessions. Those who completed one (vs. no) sessions were no more likely to report abstinence (OR: 0.98). Those who completed two (vs. no) sessions were nearly twice as likely to report abstinence (OR: 1.83). Those who completed ≥three (vs. no) sessions were nearly four times as likely to report abstinence (OR: 3.70). Biochemically-confirmed cessation outcomes were similar. Most smokers received minimal or no treatment, and treatment dose had a large impact on abstinence. Results highlight the importance of improving engagement in evidence-based treatment protocols following enrollment. Given that motivation to quit fluctuates, systematically offering enrollment to all smokers at all visits is important.
AB - The efficacy of tobacco treatment delivered by state quitlines in diverse populations is well-supported, yet little is known about associations between treatment dose and cessation outcomes following the implementation of Ask-Advise-Connect (AAC), an electronic health record-based systematic referral process that generates a high volume of proactive calls from the state quitline to smokers. The current study is a secondary analysis of a 34-month implementation trial evaluating ACC in 13 safety-net clinics in Houston, TX. Treatment was delivered by a quitline and comprised up to five proactive, telephone-delivered multi-component cognitive-behavioral treatment sessions. Associations between treatment dose and abstinence were examined. Abstinence was assessed by phone six months after treatment enrollment, and biochemically confirmed via mailed saliva cotinine. Among smokers who enrolled in treatment and agreed to follow-up (n = 3704), 29.2% completed no treatment sessions, 35.5% completed one session, 16.4% completed two sessions, and 19.0% completed ≥three sessions. Those who completed one (vs. no) sessions were no more likely to report abstinence (OR: 0.98). Those who completed two (vs. no) sessions were nearly twice as likely to report abstinence (OR: 1.83). Those who completed ≥three (vs. no) sessions were nearly four times as likely to report abstinence (OR: 3.70). Biochemically-confirmed cessation outcomes were similar. Most smokers received minimal or no treatment, and treatment dose had a large impact on abstinence. Results highlight the importance of improving engagement in evidence-based treatment protocols following enrollment. Given that motivation to quit fluctuates, systematically offering enrollment to all smokers at all visits is important.
KW - Ask-Advise-Connect
KW - Electronic health record
KW - Quitline
KW - Smoking cessation
KW - Telephone counseling
KW - Tobacco
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U2 - 10.1016/j.pmedr.2019.01.009
DO - 10.1016/j.pmedr.2019.01.009
M3 - Article
C2 - 30723660
AN - SCOPUS:85060349219
SN - 2211-3355
VL - 13
SP - 262
EP - 267
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
ER -