Text messaging to engage and retain Veterans in smoking cessation counseling

通过短信吸引和留住退伍军人进行戒烟咨询

• 批准号: 9927904
• 负责人: PAUL KREBS
• 金额: --
• 依托单位: VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9927904
• 关键词: Abstinence; Address; Adherence; Adult; Appointment; Behavioral; Biochemical; Car Phone; Caring; Cessation of life; Cotinine; Counseling; Data; Decision Making; Disease; Education; Effectiveness; Electronic Health Record; Enrollment; Ensure; Goals; Health; Health Care Costs; Health Services; Impairment; Institutes; Intervention; Medical Records; Methods; Modeling; Modification; Morbidity - disease rate; Patients; Pharmacotherapy; Preventive service; Problem Solving; Protocols documentation; Provider; Public Health Informatics; Quality of life; Randomized; Registries; Reporting; Research; Resources; Self Management; Services; Site; Smoke; Smoker; Smoking; System; Telephone; Testing; Text; Text Messaging; Text Telephone; Tobacco; Tobacco Use Cessation; Tobacco use; United States; Veterans; base; care systems; cigarette smoking; cost effective; design; evidence base; experience; improved; improved outcome; innovation; mHealth; novel; outreach; population based; population health; premature; primary outcome; programs; quitline; randomized trial; recruit; smoking cessation; standard care; tobacco screening

ABSTRACT Tobacco use remains the number one cause of premature death and morbidity in the United States, and tobacco-related diseases account for 24% of all VA healthcare costs. The VA has been a leader in addressing tobacco use, having implemented annual tobacco screening and made pharmacotherapy readily available. However, one of the most cost-effective services - telephone quit lines - remain highly underused. Few Veterans enroll in telephone counseling to help them quit smoking, and among Veterans who begin telephone counseling, few complete a full course. The advent of electronic health records (EHRs) has enabled new strategies for ensuring that patients receive preventive services. These methods can reduce provider burden and close gaps in systems of care. Our research team has conducted numerous studies using EHRs to identify smokers and proactively reach out to coordinate telephone tobacco treatment. While we have successfully implemented this approach, the overall enrollment rates for counseling remain low and the majority of smokers complete only one counseling session. Therefore, we propose to test novel mHealth strategies for promoting enrollment in and adherence to telephone counseling. The Specific Aims are to: 1) Conduct a sequentially randomized trail to estimate the effectiveness of text messaging for increasing enrollment in and adherence to telephone tobacco treatment, 2) Compare rates of tobacco cessation between patients who received and did not receive text messaging during treatment, and 3) Evaluate patient experiences with these interventions. Using the VA EHR, we will identify N=3,600 smokers at three VA sites. All identified smokers will be mailed an introductory packet with information about the study. Patients who do not opt out will first be randomized to standard telephone outreach for counseling or to receive 8 educational texts to counter barriers of participating in counseling prior to telephone outreach. Patients who enroll in tobacco treatment will then be randomized to receive standard telephone counseling or to also receive appointment reminders and supportive texts throughout the 8-week counseling period. We hypothesize that these approaches will increase the rate of enrollment in telephone tobacco cessation and 12-month biochemically validated abstinence (primary outcomes) over standard telephone counseling approaches. We will also assess patient experiences with each texting protocol. Our overarching goal is to investigative innovative mHealth strategies for increasing Veteran use of telephone-based tobacco cessation counseling and to improve quit rates. This research, exploring both population-based outreach and text messaging, advances multiple goals set forth by the VA’s Blueprint for Excellence. Results will have direct implications to inform decision-making and population-based care models for tobacco treatment.

摘要 烟草使用仍然是美国过早死亡和发病的头号原因， 与烟草有关的疾病占所有VA医疗保健费用的24%。退伍军人事务部一直是解决 烟草使用，实施了年度烟草筛查，并随时提供药物治疗。 然而，最具成本效益的服务之一----电话退出热线----仍然没有得到充分利用。几 退伍军人参加电话咨询，以帮助他们戒烟，并在退伍军人谁开始电话 咨询，很少有人完成完整的课程。电子健康记录（EHR）的出现使新 确保患者获得预防服务的战略。这些方法可以减轻提供商的负担 并填补护理系统中的空白。我们的研究团队已经进行了大量的研究，使用电子病历，以确定 吸烟者和主动接触，以协调电话烟草治疗。虽然我们成功地 实施这种方法，咨询的总体登记率仍然很低，大多数吸烟者 只完成一次咨询课程。因此，我们建议测试新的mHealth策略，以促进 参加并坚持电话咨询。具体目标是：1）按顺序进行 一项随机试验，以评估短信对增加患者入组和依从性的有效性 电话烟草治疗，2）比较接受和不接受电话烟草治疗的患者之间的戒烟率 在治疗期间不接收短信，以及3）评估患者对这些干预的体验。 使用VA EHR，我们将在三个VA站点识别N= 3，600名吸烟者。所有被确认的吸烟者将被邮寄一份 介绍性数据包，包含有关研究的信息。未选择退出的患者将首先随机分配至 标准的电话咨询服务，或接收8个教育文本，以消除参与障碍 在电话咨询之前。参加烟草治疗的患者随后将被随机分配至 接受标准的电话咨询，或同时收到预约提醒和支持短信 在为期8周的咨询期间。我们假设这些方法会增加 电话戒烟和12个月经生化验证的戒烟（初级） （二）电话咨询方式。我们还将评估患者的经验， 短信协议我们的首要目标是调查创新的移动健康战略，以增加退伍军人 使用电话戒烟咨询，提高戒烟率。这项研究探索了 以人口为基础的外展和短信，推进了退伍军人事务部蓝图提出的多个目标， 卓越研究结果将直接影响决策和基于人口的护理模式 烟草治疗。