Tobacco Quit Line Re-enrollments for the Underserved
| Status: | Completed |
|---|---|
| Conditions: | Smoking Cessation |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | September 2010 |
| End Date: | July 2011 |
Re-engagement in Evidence-based Quit Line Treatment for Low Income Smokers
The purpose of this proposed study is to develop, refine and test the use of Interactive
Voice Response (IVR) technology as a means of increasing re-engagement of low income smokers
in telephone support for tobacco cessation (quit lines). If this strategy proves to be
acceptable and feasible, it may offer a technological solution to increase access to and
utilization of a widely available evidence-based form of behavioral treatment for low income
smokers.
The primary aims of this research are to:
1. Develop an IVR system that delivers tailored audio messages to increase low income
smokers' re-engagement in treatment offered by two state quit lines (Washington and
Indiana). The investigators will develop: a) a menu of audio messages that can be
delivered by an IVR system; b) an IVR algorithm (i.e., a set of decision rules) to make
proactive automated calls to deliver brief, tailored messages for re-engaging low
income smokers who previously used the quit line.
2. Evaluate the feasibility and efficacy of an IVR system as a tool to re-engage low
income smokers into quit line treatment measured by number of IVR calls answered,
number of smokers who re-engage in treatment and satisfaction with IVR calls.
Hypothesis 2.1 - It is hypothesized that the rates of re-engagement into treatment
among those receiving the IVR intervention will be higher than smokers not proactively
invited to re-engage in quit line services.
Voice Response (IVR) technology as a means of increasing re-engagement of low income smokers
in telephone support for tobacco cessation (quit lines). If this strategy proves to be
acceptable and feasible, it may offer a technological solution to increase access to and
utilization of a widely available evidence-based form of behavioral treatment for low income
smokers.
The primary aims of this research are to:
1. Develop an IVR system that delivers tailored audio messages to increase low income
smokers' re-engagement in treatment offered by two state quit lines (Washington and
Indiana). The investigators will develop: a) a menu of audio messages that can be
delivered by an IVR system; b) an IVR algorithm (i.e., a set of decision rules) to make
proactive automated calls to deliver brief, tailored messages for re-engaging low
income smokers who previously used the quit line.
2. Evaluate the feasibility and efficacy of an IVR system as a tool to re-engage low
income smokers into quit line treatment measured by number of IVR calls answered,
number of smokers who re-engage in treatment and satisfaction with IVR calls.
Hypothesis 2.1 - It is hypothesized that the rates of re-engagement into treatment
among those receiving the IVR intervention will be higher than smokers not proactively
invited to re-engage in quit line services.
We propose a randomized controlled trial to compare re-engagement into quit line treatment
between low income smokers receiving IVR intervention to re-engage into treatment through
quit line services and those receiving usual care (no intervention to re-engage). Subjects
will be recruited from two state quit lines (Washington (WA) and Indiana (IN)). WA and IN
were selected because they both contract with Free & Clear for quit line services and have
supported research collaborations in the past. Both states have agreed to participate in
this study. Three thousand subjects will be randomized to the intervention or usual care
prior to entry into the IVR calling database. This sampling frame was defined based in our
past research experience in using similar method to re-engage low income smokers from ethnic
populations and assumed a high proportion of invalid phone numbers and difficulties on
successfully reaching individuals even after several call attempts. In our previous
re-engagement study, 29% of the phone numbers provided by quit line users were invalid 12
months later and 38% of the subjects were never reached after five attempted calls.
Therefore, in this study we are anticipating successfully reaching 30% of the sample.
This is a feasibility study and the main outcome is re-engagement into treatment, measured
by re-enrollment into quit line support after receiving the IVR intervention. Process
measures are IVR calls answered and satisfaction with IVR calls. Thirty-day point prevalence
abstinence at 6 months after intervention will be also measured, as a way to preliminarily
evaluate the efficacy of this intervention.
The target population of this study is low income smokers, defined as being a Medicaid
recipient or uninsured by the time of their first enrollment into quit line treatment. This
working definition for eligibility criterion was chosen because health insurance status is
routinely assessed in the provision of quit line services and it is a good proxy indicator
of income.
between low income smokers receiving IVR intervention to re-engage into treatment through
quit line services and those receiving usual care (no intervention to re-engage). Subjects
will be recruited from two state quit lines (Washington (WA) and Indiana (IN)). WA and IN
were selected because they both contract with Free & Clear for quit line services and have
supported research collaborations in the past. Both states have agreed to participate in
this study. Three thousand subjects will be randomized to the intervention or usual care
prior to entry into the IVR calling database. This sampling frame was defined based in our
past research experience in using similar method to re-engage low income smokers from ethnic
populations and assumed a high proportion of invalid phone numbers and difficulties on
successfully reaching individuals even after several call attempts. In our previous
re-engagement study, 29% of the phone numbers provided by quit line users were invalid 12
months later and 38% of the subjects were never reached after five attempted calls.
Therefore, in this study we are anticipating successfully reaching 30% of the sample.
This is a feasibility study and the main outcome is re-engagement into treatment, measured
by re-enrollment into quit line support after receiving the IVR intervention. Process
measures are IVR calls answered and satisfaction with IVR calls. Thirty-day point prevalence
abstinence at 6 months after intervention will be also measured, as a way to preliminarily
evaluate the efficacy of this intervention.
The target population of this study is low income smokers, defined as being a Medicaid
recipient or uninsured by the time of their first enrollment into quit line treatment. This
working definition for eligibility criterion was chosen because health insurance status is
routinely assessed in the provision of quit line services and it is a good proxy indicator
of income.
Inclusion Criteria:
- Enrolled in Medicaid or uninsured, 18 years or older, able to read and speak English,
provided verbal consent to be contacted by quit line to follow-up, sought quit line
services for being primarily a smoker
Exclusion Criteria:
- Primary use of other forms of tobacco such as smokeless tobacco, not understanding
English
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