TeaMOUT: Teachable Moment to Opt-out of Tobacco: Interactive Voice Response Quit Line for Veteran Active Smokers With Lung Nodules
Study Details
Study Description
Brief Summary
The purpose of this study is to evaluate the effectiveness of a smoking cessation outreach intervention (TeaM OUT) on increasing use of smoking cessation resources in Veterans. The hypotheses are 1) patients included in the TeaM OUT group will have higher accession of cessation services, such as counseling and medication therapies, compared to patients in enhanced usual care and 2) more patients in the TeaM OUT group will have quit smoking at one year after the intervention.
Veterans with a recently diagnosed lung nodule who currently smoke will receive the TeaM OUT intervention or Enhanced Usual Care. The TeaM OUT intervention has 2 parts: 1) a letter that
- describes the nodule and the importance of cessation related to the pulmonary nodule (i.e. teachable moment) and b) notification that a Proactive IVR Quit Line will initiate contact and 2) call(s) from the Proactive IVR Quit Line which a) offers smoking cessation resources and b) helps connect the patient to those resources. The enhanced usual care group will receive a letter that provides information about how to contact the IVR Quit Line.
The IVR system will track referrals to cessation services. Additional information about smoking status and use of cessation resources will be collected from the electronic health record and surveys.
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Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: TeaM OUT Intervention The TeaM OUT Intervention has 2 elements: 1) a letter that a) describes the nodule and the importance of cessation related to the pulmonary nodule (i.e. teachable moment) and b) notification that a Proactive IVR Quit line will initiate contact and 2) call(s) from the Proactive IVR Quit Line which a) offers smoking cessation resources and b) helps connect the patient to those resources. |
Behavioral: TeaM OUT Intervention
The TeaM OUT Intervention has 2 elements: 1) a letter that a) describes the nodule and the importance of cessation related to the pulmonary nodule (i.e. teachable moment) and b) notification that a Proactive IVR Quit line will initiate contact and 2) call(s) from the Proactive IVR Quit Line which a) offers smoking cessation resources and b) helps connect the patient to those resources.
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Other: Enhanced Usual Care The Enhanced Usual Care arm also has two elements: 1) a letter that a) describes the nodule without linking it to smoking cessation (i.e. no teachable moment) with b) wording to contact an Optional IVR Quit line if desired and 2) the Optional IVR Quit line which a) offers smoking cessation resources and b) helps connect the patient to those resources. |
Behavioral: Enhanced Usual Care
The Enhanced Usual Care arm also has two elements: 1) a letter that a) describes the nodule without linking it to smoking cessation (i.e. no teachable moment) with b) wording to contact an Optional IVR Quit line if desired and 2) the Optional IVR Quit line which a) offers smoking cessation resources and b) helps connect the patient to those resources.
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Outcome Measures
Primary Outcome Measures
- IVR connection to smoking cessation service [56 weeks after nodule identification]
A positive (yes) response is a completed call to a patient who then indicates (by pressing the number keypad) to be connected to one or more smoking cessation resources. In the control group, if the patient calls the Optional IVR Quitline and then requests to be connected to smoking cessation resources it is counted as a positive response. Each patient will be categorized as a "yes" after her/his first positive response to the system, regardless of how many times he/she actually engages with the system.
- 7-day point prevalence nicotine abstinence [56 weeks after exposure to TeaM OUT Intervention or Enhanced Usual Care]
Aim 2: Participants will be considered to have quit smoking (including non-combustible) if they respond "no" to the question, "Have you smoked a cigarette (regular or e-cigarette), even a puff, in the past 7 days?"
Secondary Outcome Measures
- Utilization of cessation resources [72 weeks after nodule identification]
Aim 1: Utilization includes new prescriptions and refills for nicotine-replacement therapies, anti-smoking medications, referrals to smoking cessation counseling, and attendance of smoking cessation counseling session, as recorded in the electronic health record.
- Incremental Behavior Change Toward Smoking Cessation (IBC-S) [56 weeks after exposure to TeaM OUT Intervention or Enhanced Usual Care]
Aim 2: Measure is the summed score of the Incremental Behavior Change toward Smoking cessation (IBC-S) scale.
Other Outcome Measures
- Qualitative analysis of IVR intervention [Patients--56 weeks after exposure to TeaM OUT Intervention or Enhanced Usual Care; Clinical Stakeholders--at least 6 months after clinic randomization]
Aim 3: Interviews with patients and clinical stakeholders will collect feedback about the IVR intervention. Interview content will be analyzed using qualitative description. Interview transcripts will be reviewed and coded by the qualitative analysts. Development of the codes will occur in the context of the qualitative data. The analysts will discuss the codes, achieve consensus, resolve differences, and modify the codes if necessary.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Newly diagnosed pulmonary nodule with plan for surveillance
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Active smoker
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Receiving care at the Portland VA Health Care System, the Minneapolis VA Health Care System, or the Ralph H. Johnson Medical Center (Charleston, SC VA)
Exclusion Criteria:
-No exclusion criteria
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Minneapolis VA Health Care System, Minneapolis, MN | Minneapolis | Minnesota | United States | 55417 |
2 | VA Portland Health Care System, Portland, OR | Portland | Oregon | United States | 97239 |
3 | Ralph H. Johnson VA Medical Center, Charleston, SC | Charleston | South Carolina | United States | 29401-5799 |
Sponsors and Collaborators
- VA Office of Research and Development
- Minneapolis Veterans Affairs Medical Center
- Ralph H. Johnson VA Medical Center
Investigators
- Principal Investigator: Christopher G. Slatore, MD MS, VA Portland Health Care System, Portland, OR
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IIR 19-425