POST: Proactive Outreach for Smoking Treatment
Study Details
Study Description
Brief Summary
Tobacco use disorder is a chronic disease. This is particularly true for people living with mental illness, who are more likely to smoke and make more unsuccessful quit attempts than those without. The current study is designed to test a package of two chronic disease management strategies to treatment tobacco in community mental health centers: regular provider interventions during routine mental healthcare visits, and proactive outreach by community mental health center staff to offer connections to tobacco cessation treatment. 50 patients at a community mental health center will receive provider intervention at their regular visits as well as 3 outreach calls over 9 months from trained staff to offer to connect them with stop smoking treatment. The investigators will measure the effect of these interventions on tobacco use over the next year.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 3 |
Detailed Description
BACKGROUND: The US Public Health Service (USPHS) designated tobacco dependence as a chronic disease. This is especially true for smokers with serious mental illness (SMI) who make more cessation attempts and are less successful sustaining long-term abstinence than the general population. There is a significant health disparity wherein individuals with SMI have a higher tobacco use prevalence and a greater risk for tobacco-related mortality than the general population. Chronic care models suggest chronic disease management requires a multidisciplinary care team to assess tobacco use, administer treatment, support patient self-management, and monitor progress. Proactive telephone outreach to smokers and brief provider interventions are two effective chronic disease management strategies. Community based mental health centers (CMHCs) are a primary treatment access point for many smokers with SMI. However, rates of intervention with smoking by CMHC providers are low. In order to implement the chronic care model for tobacco dependence for CMHCs, comprehensive implementation strategies are needed. OBJECTIVE: to conduct a feasibility pilot trial to adapt an implementation strategy developed by the SAMHSA-funded network of Addiction Technology Transfer Centers (ATTCs) to integrate a proactive, chronic care model of tobacco cessation treatment into CMHCs. AIM: To conduct a pilot trial to assess the feasibility, acceptability and initial effectiveness of the implementation strategy. DESIGN: The investigators will conduct a pilot hybrid type 2 implementation-effectiveness trial in 3 CMHCs (N=50 patients; 96-130 providers). The investigators will conduct 2 baseline assessments (3 months apart) and outcomes will be assessed at 3, 6, and 12-months post implementation.
Outcomes include feasibility, acceptability, effectiveness of the implementation strategy on tobacco cessation treatment utilization (counseling and medication) and patient effectiveness on tobacco cessation (CO confirmed 7-day point prevalence abstinence). SIGNIFICANCE: An effective implementation strategy for tobacco cessation treatment in CMHCs, a widespread model of care delivery, would have enormous public health impact.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Chronic care for tobacco use Quarterly brief provider interventions about tobacco and 3 quarterly proactive outreach calls to connect patients to telephone cessation counseling and facilitate obtaining cessation medication. |
Behavioral: Chronic care management
Quarterly brief provider intervention (the 5As) and 3 quarterly outreach calls over 3 months.
|
Outcome Measures
Primary Outcome Measures
- Smoking abstinence [12-months post baseline]
CO validated 7-day point prevalence smoking abstinence
Secondary Outcome Measures
- Smoking abstinence [12 months post-baseline]
30 day prolonged abstinence
- Quit attempts [12 months post-baseline]
Number of 24 hour intentional quit attempts
- Cigarettes per day [12 months post baseline]
number of cigarettes smoked per day
Eligibility Criteria
Criteria
Inclusion Criteria:
-
daily cigarettes smokers (smoking >25 days/month)
-
English speaking
-
patient in one of the two community mental health center study sites.
Exclusion Criteria:
-
cognitive impairment
-
judged by community mental health center staff as unable to participate in research
-
no access to a telephone
-
no mailing address.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Hennepin Healthcare Research Institute | Minneapolis | Minnesota | United States | 55415 |
Sponsors and Collaborators
- Hennepin Healthcare Research Institute
- Brown University
- University of Minnesota
Investigators
None specified.Study Documents (Full-Text)
More Information
Publications
None provided.- 19-4723