Details:

Alternative Title:
Am J Prev Med
Personal Author:
Vidrine, Jennifer Irvin ; Shete, Sanjay ; Li, Yisheng ; Cao, Yumei ; Alford, Margo Hilliard ; ... More +
Vidrine, Jennifer Irvin ; Shete, Sanjay ; Li, Yisheng ; Cao, Yumei ; Alford, Margo Hilliard ; Galindo-Talton, Michelle ; Rabius, Vance ; Sharp, Barry ; Harmonson, Penny ; Zbikowski, Susan M. ; Miles, Lyndsay ; Wetter, David W. Less -
Description:
Background

Since smoking has a profound impact on socioeconomic disparities in illness and death, it is crucial that vulnerable populations of smokers be targeted with treatment. The US Public Health Service recommends that all patients be asked about their smoking at every visit, and that smokers be given brief advice to quit and referred to treatment.

Purpose

Initiatives to facilitate these practices include the 5 A’s (i.e., Ask, Advise, Assess, Assist, Arrange) and Ask Advise Refer (AAR). Unfortunately, primary care referrals are low, and most smokers referred fail to enroll. This study evaluated the efficacy of the Ask Advise Connect (AAC) approach to linking smokers with treatment in a large, safety-net public healthcare system.

Design

Pair-matched-two-treatment arm group-randomized trial.

Setting/participants

Ten safety-net clinics in Houston, TX.

Intervention

Clinics were randomized to AAC (n=5; intervention) or AAR (n=5; control). Licensed Vocational Nurses (LVNs) were trained to assess and record the smoking status of all patients at all visits in the electronic health record (EHR). Smokers were given brief advice to quit. In AAC, the names and phone numbers of smokers who agreed to be connected were sent electronically to the Texas Quitline daily, and patients were proactively called within 48 hours. In AAR, smokers were offered a Quitline referral card and encouraged to call on their own. Data were collected between June 2010 and March 2012 and analyzed in 2012.

Main Outcome Measure

The primary outcome – impact – was defined as the proportion of identified smokers that enrolled in treatment.

Results

The impact (proportion of identified smokers who enrolled in treatment) of AAC (14.7%) was significantly greater than the impact of AAR (0.5%), t (4) = 14.61, p = 0.0001, OR = 32.10 (95% CI 16.60–62.06).

Conclusions

AAC has tremendous potential to reduce tobacco-related health disparities.


Subject:
[+]
Article
Electronic Health Records
Health Status Disparities
Hotlines
Humans
Referral And Consultation
Safety-net Providers
Smoking
Smoking Cessation
Smoking Prevention
Socioeconomic Factors
Tobacco Use Disorder
Treatment Outcome

Source:
Am J Prev Med. 45(6):737-741.
Pubmed ID:
24237916
Pubmed Central ID:
PMC4023543
Document Type:
Journal Article
Funding:
P30 CA016672/CA/NCI NIH HHS/United States ; R18 DP001570/DP/NCCDPHP CDC HHS/United States ; CA016672/CA/NCI NIH HHS/United States ; R18DP001570/DP/NCCDPHP CDC HHS/United States
P30 CA016672/CA/NCI NIH HHS/United States ; R18 DP001570/DP/NCCDPHP CDC HHS/United States ; CA016672/CA/NCI NIH HHS/United States ; R18DP001570/DP/NCCDPHP CDC HHS/United States Less -
Place as Subject:
Texas
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ffdb25ef7ef44223ecd0e78681a9f888206271a574b73b7cc6f57f2f94fb877f
File Type:

Supporting Files

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