scholarly journals Mixed-Methods for Comparing Tobacco Cessation Interventions

2015 ◽  
Vol 12 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Behnoosh Momin ◽  
Antonio Neri ◽  
Lei Zhang ◽  
Jennifer Kahende ◽  
Jennifer Duke ◽  
...  

Introduction: The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions.Aims: This paper outlines the methodology used to conduct a comparative effectiveness research (CER) study of traditional and Web-based tobacco cessation and quitline promotion approaches.Methods: A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states.Results/Findings: The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates seven months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs.Conclusions: This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making.

Author(s):  
Bibhas Chakraborty ◽  
Raju Maiti ◽  
Victor J Strecher

BACKGROUND Project Quit was a randomized Web-based smoking cessation trial designed and conducted by researchers from the University of Michigan, where its primary outcome was the 7-day point prevalence. One drawback of such an outcome is that it only focuses on smoking behavior over a very short duration, rather than the quitting process over the entire study period. OBJECTIVE The aim of this study was to consider the number of quit attempts during the 6-month study period as an alternative outcome, which would better reflect the quitting process. We aimed to find out whether tailored interventions (high vs low) are better in reducing the number of quit attempts for specific subgroups of smokers. METHODS To identify interactions between intervention components of smoking cessation and individual smoker characteristics, we employed Poisson regression to analyze the number of quit attempts. This approach allowed us to construct data-driven, personalized interventions. RESULTS A negative effect of the number of cigarettes smoked per day (P=.03) and a positive effect of education (P=.03) on the number of quit attempts were detected from the baseline covariates (n=792). Thus, for every 10 extra cigarettes smoked per day, there was a 5.84% decrease in the expected number of quit attempts. Highly educated participants had a 15.49% increase in their expected number of quit attempts compared with their low-educated counterparts. A negative interaction between intervention component story and smoker’s education was also detected (P=.03), suggesting that a high-tailored story given to highly educated people results in 13.50% decrease in the number of quit attempts compared with a low-tailored story. CONCLUSIONS A highly individually tailored story is significantly more effective for smokers with a low level of education. This is consistent with prior findings from Project Quit based on the 7-day point prevalence.


2009 ◽  
Vol 95 (5) ◽  
pp. 637-645 ◽  
Author(s):  
Edward J Trapido ◽  
Josep Maria Borras ◽  
Robert Burton ◽  
Massoud Samiei ◽  
Mark Elwood ◽  
...  

Developing and maintaining a comprehensive cancer control program are two distinct entities. Key issues related to building and sustaining cancer control programs include how to integrate initiatives and efforts across multiple constituencies addressing components of the implementation of cancer control and non-communicable disease programs, the processes used in different resource settings to achieve effective drug budgeting, health technology assessment and health economics, and how countries can support public and societal engagement. There are promising examples in both resource-rich and resource-challenged countries of constituencies that have developed programs which can contribute to comprehensive cancer control. Some take advantage of newer technology and information services, while others are more people and patient focused. Critical issues and factors for establishing and maintaining population-based comprehensive cancer control programs are identified and reviewed.


2019 ◽  
Author(s):  
David Pócs ◽  
Tímea Óvári ◽  
Csaba Hamvai ◽  
Oguz Kelemen

BACKGROUND Smoking cessation support on Facebook (FB) is a cost-effective and extensible way to reduce tobacco use among young people. Motivational interviewing (MI) is a practical counselling style in face-to-face smoking cessation support and can be useful in web-based interventions as well. OBJECTIVE This study aimed at identifying which post creation strategies based on MI could achieve positive changes in FB post characteristics and FB users’ comments. METHODS We included MI-adherent posts (N=701) which were not boosted and were targeted at tobacco users. These FB posts have been categorized into five different groups according to specific MI strategies. The control group comprised entertaining and informative posts. Primary outcomes seem to highlight how the content has stimulated interactions (engagement rate), inhibited interactions (negative feedback) or appealed to the audience of the FB page (fan-total reach ratio). The first comments received on the FB posts were evaluated and used as secondary outcomes. We applied the classification of MI approach: change talk (CT), sustain talk (ST), desire, ability, reason, need (DARN), and commitment, activation, taking steps (CAT). RESULTS FB posts which used MI strategies were associated with significantly higher engagement rate (p=.010), higher fan-total reach ratio (p<.001), and more CT (p<.001), DARN (p=.005), or CAT comments (p=.003) compared to the control group. ‘Elaborating CT’ strategies elicited considerably more CT (p<.001) and DARN comments (p=.020). ‘Affirming CT’ strategies obtained higher fan-total reach ratio (p=.011) and generated significantly more CT (p=.006) and CAT comments (p<.001). ‘Reflecting CT’ strategies received significantly higher fan-total reach ratio (p<.001). Finally, ‘relational MI’ strategies achieved significantly higher engagement rate (p<.001) compared to the control group. It should be noted that we did not find significant difference in negative feedback and the number of ST comments. CONCLUSIONS Post creation strategies based on MI stimulated interactions with FB users and generated conversation about tobacco use cessation without relevant negative feedback. Our findings suggest that MI strategies may play a remarkable role in post creation within a web-based smoking cessation intervention. In the future, these strategies could be applicable to other online platforms, such as public health websites, health blogs, mobile applications or social networking groups.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029144 ◽  
Author(s):  
Yusra Elhidaia Elobaid ◽  
Andrea Leinberger Jabari ◽  
Aisha Al Hamiz ◽  
Abdul Rizzak Al Kaddour ◽  
Sherif Bakir ◽  
...  

ObjectivesTo explore: (A) the underlying motivators and barriers to smoking cessation among young Arabic speaking smokers and (B) to examine the suitability and preferences for tobacco cessation interventions (specifically text messages) and study the possibility of enrollment methods for a randomised controlled study using text messages as an intervention for tobacco cessation.DesignQualitative research using focus group discussions and content analysis.Setting(s)Two universities, one of them is the first and foremost comprehensive national university in the United Arab Emirates (UAE). The third setting is the largest hospital in the UAE and the flagship institution for the public health system in the emirate of Abu Dhabi.ParticipantsSix focus group discussions with a total of 57 participants. Forty-seven men and 10 women. Fifty-three of them were current smokers.ResultsThe analysis of six focus groups was carried out. Main themes arose from the data included: preferences for tobacco cessation interventions and acceptability and feasibility of text messaging as tobacco cessation intervention. Different motives and barriers for quitting smoking including shisha and dokha were explored.ConclusionInterventions using text messaging for smoking cessation have not been used in the Middle East and they could potentially be effective; however, tailoring and closely examining the content and acceptability of text messages to be used is important before the conduction of trials involving their use. Social media is perceived to be more effective and influential, with a higher level of penetration into communities of young smokers.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Mehta ◽  
R Botelho ◽  
F Fernandez ◽  
F Feres ◽  
A Abizaid ◽  
...  

Abstract Background The Latin America Telemedicine Infarct Network (LATIN) has exploited the remarkable competence of telemedicine for remote guidance. In doing so, LATIN created a mammoth population-based AMI network that employed experts located several hundred miles away to guide the reperfusion strategies for almost 800,000 screened patients. In this pioneering project, telemedicine was initially utilized to guide AMI management within national confines. We speculated whether LATIN telemedicine navigation could outstrip countrywide borders. Purpose To maximally harness the vast possibilities of telemedicine for improving AMI care. Methods During its pilot phase, LATIN began as a hub and spoke, AMI system in Colombia where 20 spokes (small community health centers and rural clinics) were configured with 3 hubs that could perform Primary PCI. These sites were linked through web-based connectivity. Expert cardiologists, located 50–250 miles away in Bogota, Colombia, used sophisticated telemedicine platforms for urgent EKG diagnosis and teleconsultation of the entire AMI process. Based upon the duration of chest pain and travel time to the hub, these experts guided patients through guideline-based strategies of thrombolysis, pharmaco invasive management or primary PCI. Efficiency of the telemedicine process was measured with the new metric of time to telemedicine diagnosis (TTD). Cloud computing, GPS navigation, and numerous business intelligent tools were gradually incorporated into LATIN telemedicine. As systems became more scalable, the program was expanded to Brazil, where LATIN flourished. Over the last 18 months, LATIN telemedicine capabilities have been pressed across national boundaries. Presently, all 82 LATIN centers in Mexico are guided by experts located in Bogota, Colombia and the 7 Argentina centers channeled through Santiago, Chile. Results 784,947 patients were screened for AMI at 350 LATIN centers (Brazil 143, Colombia 118, Mexico 82, Argentina 7). Navigation pathways are depicted in the attached figure. TTD remains extremely low in all four countries, and comparable efficiency and tele-accuracy have been achieved. With expanded geographic reach, 8,448 (1.08%) patients were diagnosed with STEMI and 3,911 (46.3%) urgently reperfused, including 3,049 (78%) with Primary PCI. Time to TTD ranged between 2.8 to 5.8 minutes, with a mean of 3.5 min. Tele-accuracy was 98.5%, D2B 51 min, and in-hospital mortality 5.2%. Various other comparative metrics for the 4 countries are being gathered and will be available at the time of presentation. Conclusions LATIN demonstrates the robust ability of telemedicine to transcend national boundaries to guide AMI management. This strategy can be adopted in under-developed countries in Asia and Africa to provide an umbrella of AMI care for the millions of disadvantaged patients.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jamie M. Zoellner ◽  
Kathleen J. Porter ◽  
Donna-Jean P. Brock ◽  
Emma Mc Kim Mitchell ◽  
Howard Chapman ◽  
...  

Abstract Background The objectives are to: 1) describe engagement processes used to prioritize and address regional comprehensive cancer control needs among a Community-Academic Advisory Board (CAB) in the medically-underserved, rural Appalachian region, and 2) detail longitudinal CAB evaluation findings. Methods This three-year case study (2017–2020) used a convergent parallel, mixed-methods design. The approach was guided by community-based participatory research (CBPR) principles, the Comprehensive Participatory Planning and Evaluation process, and Nine Habits of Successful Comprehensive Cancer Control Coalitions. Meeting artifacts were tracked and evaluated. CAB members completed quantitative surveys at three time points and semi-structured interviews at two time points. Quantitative data were analyzed using analysis of variance tests. Interviews were audio recorded, transcribed, and analyzed via an inductive-deductive process. Results Through 13 meetings, Prevention and Early Detection Action Teams created causal models and prioritized four cancer control needs: human papillomavirus vaccination, tobacco control, colorectal cancer screening, and lung cancer screening. These sub-groups also began advancing into planning and intervention proposal development phases. As rated by 49 involved CAB members, all habits significantly improved from Time 1 to Time 2 (i.e., communication, priority work plans, roles/accountability, shared decision making, value-added collaboration, empowered leadership, diversified funding, trust, satisfaction; all p < .05), and most remained significantly higher at Time 3. CAB members also identified specific challenges (e.g., fully utilizing member expertise), strengths (e.g., diverse membership), and recommendations across habits. Conclusion This project’s equity-based CBPR approach used a CPPE process in conjunction with internal evaluation of cancer coalition best practices to advance CAB efforts to address cancer disparities in rural Appalachia. This approach encouraged CAB buy-in and identified key strengths, weaknesses, and opportunities that will lay the foundation for continued involvement in cancer control projects. These engagement processes may serve as a template for similar coalitions in rural, underserved areas.


Author(s):  
Christopher J Cadham ◽  
Pianpian Cao ◽  
Jinani Jayasekera ◽  
Kathryn L Taylor ◽  
David T Levy ◽  
...  

Abstract Background Guidelines recommend offering cessation interventions to smokers eligible for lung cancer screening, but there is little data comparing specific cessation approaches in this setting. We compared the benefits and costs of different smoking cessation interventions to help screening programs select specific cessation approaches. Methods We conducted a societal-perspective cost-effectiveness analysis using a Cancer Intervention and Surveillance Modeling Network model simulating individuals born in 1960 over their lifetimes. Model inputs were derived from Medicare, national cancer registries, published studies, and micro-costing of cessation interventions. We modeled annual lung cancer screening following 2014 US Preventive Services Task Force guidelines plus cessation interventions offered to current smokers at first screen, including pharmacotherapy only or pharmacotherapy with electronic and/or web-based, telephone, individual, or group counseling. Outcomes included lung cancer cases and deaths, life-years saved, quality-adjusted life-years (QALYs) saved, costs, and incremental cost-effectiveness ratios. Results Compared with screening alone, all cessation interventions decreased cases of and deaths from lung cancer. Compared incrementally, efficient cessation strategies included pharmacotherapy with either web-based cessation ($555 per QALY), telephone counseling ($7562 per QALY), or individual counseling ($35 531 per QALY). Cessation interventions continued to have costs per QALY well below accepted willingness to pay thresholds even with the lowest intervention effects and was more cost-effective in cohorts with higher smoking prevalence. Conclusion All smoking cessation interventions delivered with lung cancer screening are likely to provide benefits at reasonable costs. Because the differences between approaches were small, the choice of intervention should be guided by practical concerns such as staff training and availability.


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