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Mersha AG, Bryant J, Booth K, Watson L, Kennedy M. The effectiveness of internet-based group behavioural interventions on lifestyle modifications: A systematic review. Prev Med 2024; 186:108099. [PMID: 39134180 DOI: 10.1016/j.ypmed.2024.108099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES To examine the effectiveness of internet-based group interventions incorporating social support elements in addressing behaviours related to smoking, nutrition, alcohol consumption, physical activity, and obesity. METHODS A literature search was undertaken in six databases from inception to April 2024. Articles were eligible if they reported on group-based online interventions targeting smoking, nutrition, alcohol consumption, physical activity, and obesity, and included interactive features aimed at promoting social engagement and support. Two reviewers independently screened and assessed the quality of articles using Joanna Briggs Institute Critical Appraisal tools. A narrative analysis was used to synthesize and interpret the data to understand the effects of online interventions on lifestyle modifications. RESULTS A total of 4063 citations underwent screening, resulting in 32 articles being deemed eligible and included in this review. Most studies examined physical activity (n = 14), followed by obesity (n = 7) and smoking (n = 6), Most studies were conducted in the USA (n = 14) and Australia (n = 11). Websites were the most utilised mode of intervention delivery (n = 11), followed by Facebook (n = 7) and mobile apps (n = 5). Group-based internet interventions were effective in improving smoking cessation, increasing physical activity and addressing obesity. However, there is insufficient data to determine their effect on promoting healthy nutrition and reducing alcohol intake. CONCLUSION Group-based interventions delivered on the internet are effective in changing various health behaviours. This approach can offer large scale and cost-effective means to deliver behavioural interventions. However, the long-term effects and strategies for maintaining the behaviour changes are lacking, underscoring the need for further research.
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Affiliation(s)
- Amanual Getnet Mersha
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia.
| | - Jamie Bryant
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia
| | - Kade Booth
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia
| | - Levi Watson
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Michelle Kennedy
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia
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2
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Mersha AG, Bryant J, Rahman T, McGuffog R, Maddox R, Kennedy M. What Are the Effective Components of Group-Based Treatment Programs For Smoking Cessation? A Systematic Review and Meta-Analysis. Nicotine Tob Res 2023; 25:1525-1537. [PMID: 37104053 PMCID: PMC10439487 DOI: 10.1093/ntr/ntad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/12/2023] [Accepted: 04/26/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION There is significant variation in the format and delivery of group-based smoking cessation programs. To guide research and healthcare program implementation, it is important to understand the active components of interventions. AIMS AND METHODS This review aimed to (1) identify behavior change techniques (BCTs) used in effective group-based smoking cessation interventions, (2) determine the effectiveness of group-based smoking cessation interventions on smoking cessation at 6-month follow-up, and (3) identify the behavior change techniques (BCTs) related to effective group-based smoking cessation. The following databases were searched in January 2000 and March 2022: MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Library, and Web of Science. BCTs used in each study were extracted using the BCT Taxonomy. Studies that included identified BCTs were computed, and meta-analyses were conducted to evaluate smoking cessation at 6-month follow-up. RESULTS A total of 28 BCTs were identified from 19 randomized controlled trials. Studies included an average of 5.42 ± 2.0 BCTs. The most frequent BCTs were "information about health consequences" and "problem solving." The pooled 6-month smoking cessation was higher in the group-based intervention group (OR = 1.75, 95% CI = 1.12 to 2.72, p <.001). Inclusion of the following four BCTs: "Problem solving," "Information about health Consequences," "Information about social and environmental consequences," and "Reward (outcome)" were found to be significantly associated with increased rate of 6-month smoking cessation. CONCLUSIONS Group-based smoking cessation interventions doubles the rate of smoking cessation at 6-month follow-up. Implementing group-based smoking cessation programs, that incorporate multiple BCTs, is recommended for an effective smoking cessation care. IMPLICATIONS Group-based smoking cessation programs improves smoking cessation outcomes in clinical trials. There is a need to incorporate effective individual BCTs techniques to enhance smoking cessation treatment outcomes. A robust evaluation is required to assess the effectiveness of group-based cessation programs in real world settings. There is also a need to consider the differential effectiveness of group-based programs and BCT impacts on populations, for example, indigenous peoples.
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Affiliation(s)
- Amanual Getnet Mersha
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tabassum Rahman
- Centre for Epidemiology and Biostatistics, University of Melbourne, VIC, Australia
| | - Romany McGuffog
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Raglan Maddox
- National Centre for Epidemiology and Public Health, Australian National University, Canberra, ACT, Australia
| | - Michelle Kennedy
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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3
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Olando Y, Mathai M, Kuria M, Njiri F, Huffman M. Effect of a group tobacco cessation behavioral intervention
among patients with mental illness in Kenya: Results from a
controlled clinical trial. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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4
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Kennedy M, Heris C, Barrett E, Bennett J, Maidment S, Chamberlain C, Hussein P, Longbottom H, Bacon S, Field BG, Field B, Ralph F, Maddox R. Smoking cessation support strategies for Aboriginal and Torres Strait Islander women of reproductive age: findings from the Which Way? study. Med J Aust 2022; 217 Suppl 2:S19-S26. [PMID: 35842910 PMCID: PMC9544708 DOI: 10.5694/mja2.51631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify smoking cessation support strategies that resonate with Aboriginal and Torres Strait Islander women. DESIGN, SETTING AND PARTICIPANTS A national cross-sectional survey of Aboriginal and Torres Strait Islander women aged 16-49 years who were smokers or ex-smokers was conducted online during the period July to October 2020. MAIN OUTCOME MEASURES Preferred strategies, providers and locations for smoking cessation support. RESULTS Among a total of 428 women who participated in the survey, group-based support and holistic support were the most preferred strategies (preferred by 31.8% and 22.2% of women, respectively). Use of an Aboriginal health service was positively associated with choosing holistic support programs (prevalence ratio, 1.14 [95% CI, ≥ 1.00-1.28]). Women with high or moderate nicotine dependency were more likely to consider group-based support to be helpful (prevalence ratio, 1.13 [95% CI, ≥ 1.00-1.27]) than those with low nicotine dependency. The most preferred providers for smoking cessation support were Aboriginal health workers (64.3%). Most women (73.4%) preferred face-to-face support at an Aboriginal health service, 38.8% preferred online support and 34.8% preferred phone support. A higher percentage of older women (≥ 35 years) preferred online or phone support (prevalence ratio, 1.70 [95% CI, 1.03-2.80]) compared with younger women (16-20 years). Use of an Aboriginal health service was positively associated with preference for an Aboriginal health worker (prevalence ratio, 1.35 [95% CI, 1.12-1.62]), and receiving face-to-face support at an Aboriginal health service (prevalence ratio, 1.28 [95% CI, 1.10-1.49]). CONCLUSION Aboriginal and Torres Strait Islander women prefer a range of cessation supports, with most women preferring group support and holistic approaches. Cessation supports that resonated with women varied by age, remoteness, nicotine dependence, and whether participants used an Aboriginal health service. Women want support to quit smoking from the Aboriginal health workers at their Aboriginal health service, at their health care providers and in their community. Comprehensive, multifaceted supports are required. Online support and phone-based support are also preferred by some women, which helps to increase accessibility. Appropriate models of care - including sufficient funding for Aboriginal health services and Aboriginal health workers - are required and should be developed in partnership with communities to implement meaningful and culturally safe cessation care. This research demonstrates the need for and importance of multifaceted, comprehensive cessation support strategies.
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Affiliation(s)
- Michelle Kennedy
- University of NewcastleNewcastleNSW
- Hunter Medical Research InstituteUniversity of NewcastleNewcastleNSW
| | - Christina Heris
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraACT
| | - Eden Barrett
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraACT
| | | | | | - Catherine Chamberlain
- Centre for Health EquityUniversity of MelbourneMelbourneVIC
- Judith Lumley CentreLa Trobe UniversityMelbourneVIC
| | - Paul Hussein
- Yerin Eleanor Duncan Aboriginal Health CentreWyongNSW
| | - Hayley Longbottom
- Waminda South Coast Women’s Health and Welfare Aboriginal CorporationNowraNSW
| | - Shanell Bacon
- Nunyara Aboriginal Health Clinics, Central Coast Local Health DistrictGosfordNSW
| | | | | | - Frances Ralph
- Yerin Eleanor Duncan Aboriginal Health CentreWyongNSW
| | - Raglan Maddox
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraACT
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5
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Kennedy M, Maddox R. Ngaaminya
(find, be able to see): summary of key findings from the Which Way? project. Med J Aust 2022; 217 Suppl 2:S27-S29. [PMID: 35842911 PMCID: PMC9539978 DOI: 10.5694/mja2.51622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/21/2022]
Affiliation(s)
| | - Raglan Maddox
- National Centre for Epidemiology and Population Health Australian National University Canberra ACT
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6
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Acuna N, Malarkey S, Plaha J, Smith N, Valera P. Examining Attitudes, Expectations, and Tobacco Cessation Treatment Outcomes Among Incarcerated Tobacco Smokers. JOURNAL OF CORRECTIONAL HEALTH CARE 2022; 28:252-259. [PMID: 35704917 PMCID: PMC9529363 DOI: 10.1089/jchc.20.08.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
People who are incarcerated have limited resources to help them quit tobacco smoking. This study assessed the association between baseline attitudes and expectations of the program with final smoking status as the outcome. A 6-week group-based counseling with nicotine patches was provided to incarcerated individuals to quit smoking. A cross-sectional survey was given at the first session. Questions surrounding attitudes such as interest, confidence, motivation, and expectations were used to assess associations with smoking cessation. Exhaled carbon monoxide (CO) levels were taken at each sessions. Participants were categorized as nonsmoking or continued smoking at a 6.0 parts per million (ppm) CO at their final session attended. Overall, 123 participants had a CO higher than 6.0 ppm or missed more than two sessions at their final session, and 54 had a CO under 6.0 ppm. A total of 102 participants completed the 6-week program. Differences among the two groups in exhaled CO began at Session 3 and continued throughout the study.
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Affiliation(s)
- Nicholas Acuna
- Department of Population & Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, California, USA.,Community Health Justice Lab, Newark, New Jersey, USA
| | - Sarah Malarkey
- Community Health Justice Lab, Newark, New Jersey, USA.,Department of Epidemiology and Biostatistics, Rutgers University School of Public Health, Piscataway, New Jersey, USA
| | - Jessica Plaha
- Community Health Justice Lab, Newark, New Jersey, USA.,Rutgers University, School of Graduate Studies, Newark, New Jersey, USA
| | - Nadia Smith
- Community Health Justice Lab, Newark, New Jersey, USA.,Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, New Jersey, USA
| | - Pamela Valera
- Community Health Justice Lab, Newark, New Jersey, USA.,Department of Urban-Global Public Health, Rutgers University School of Public Health, Newark, New Jersey, USA
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7
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Vinci C, Hemenway M, Baban SS, Yang MJ, Brandon KO, Witkiewitz K, Unrod M, Brandon TH, Wetter DW, Sutton SK. Transition to telehealth: Challenges and benefits of conducting group-based smoking and alcohol treatment virtually. Contemp Clin Trials 2022; 114:106689. [PMID: 35085833 PMCID: PMC8785408 DOI: 10.1016/j.cct.2022.106689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/13/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
In the midst of the COVID-19 pandemic, many research and clinical teams have transitioned their projects to a remote-based format, weighing the pros and cons of making such a potentially disruptive decision. One key aspect of this decision is related to the patient population, with underserved populations possibly benefiting from the increased reach of telehealth, while also encountering technology barriers that may limit accessibility. Early in the pandemic, our team shifted a group-based, smoking cessation and alcohol modification treatment trial to a remote-based format. Our population included individuals who concurrently wanted to quit smoking and modify their alcohol use. This paper describes technical and logistical considerations of transitioning from in-person to remote-based delivery for group-based treatment, including the impact upon study staff, group facilitators, participants, and the institution. Remotely-delivered group treatment may be valuable not only in response to pandemic-related restrictions, but it may also offer an alternative treatment-delivery modality with independent benefits in terms of population reach, costs, and pragmatics for clients, staff, and institutions.
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Affiliation(s)
- Christine Vinci
- Moffitt Cancer Center, Tampa, FL, United States of America; University of South Florida, Tampa, FL, United States of America.
| | | | - Sana S Baban
- Moffitt Cancer Center, Tampa, FL, United States of America
| | - Min-Jeong Yang
- Moffitt Cancer Center, Tampa, FL, United States of America
| | - Karen O Brandon
- Moffitt Cancer Center, Tampa, FL, United States of America; University of South Florida, Tampa, FL, United States of America
| | - Katie Witkiewitz
- University of New Mexico, Albuquerque, NM, United States of America
| | - Marina Unrod
- Moffitt Cancer Center, Tampa, FL, United States of America
| | - Thomas H Brandon
- Moffitt Cancer Center, Tampa, FL, United States of America; University of South Florida, Tampa, FL, United States of America
| | - David W Wetter
- University of Utah and Huntsman Cancer Institute, Salt Lake City, UT, United States of America
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8
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Katz DA, Mott SL, Utech JA, Bahlmann AC, Dukes KA, Seaman AT, Laux DE, Furqan M, Pollock ZJ, Vander Weg MW. Time to put it out - nurse-facilitated tobacco treatment in a comprehensive cancer center. Transl Behav Med 2021; 11:1726-1738. [PMID: 34347876 PMCID: PMC8529899 DOI: 10.1093/tbm/ibab073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Few cancer patients receive guideline-concordant care for treatment of tobacco dependence. The purpose of this pilot trial was to obtain preliminary estimates of effectiveness of an evidence-based practice intervention on the delivery of tobacco treatment and cessation outcomes in cancer patients. We conducted a pragmatic implementation trial with a before-after design in 119 current or recently quit adult smokers with cancer who met with a clinician at a single National Cancer Institute designated comprehensive cancer center (CCC) (n = 61 pre-implementation, n = 58 post-implementation). We used a multi-component strategy based on the Chronic Care Model to implement National Comprehensive Cancer Network (NCCN) guidelines for smoking cessation. Smoking cessation counseling during the index visit was assessed by exit interview and patients were interviewed by phone to assess cessation outcomes at 3-month follow-up. Performance of cessation counseling and 7-day point prevalence abstinence (PPA) were compared across the pre- and post-implementation periods using log-logistic regression, accounting for clustering by nursing staff. More patients had received assistance in quitting at the index visit during the post-implementation period compared to the pre-implementation period (30 vs. 10%, p < .01). At 3-month follow-up, 38 and 14% of participants had discussed smoking cessation medication with a CCC healthcare professional and 57 and 27% of participants had used pharmacotherapy, respectively (p < .01 for both comparisons). Seven-day PPA at 3-month follow-up was similar in both periods, however (14 vs. 12%, respectively). A multi-component tobacco treatment intervention increased the proportion of smokers who received assistance in quitting smoking during usual cancer care but did not improve cessation outcomes.
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Affiliation(s)
- David A Katz
- Department of Medicine, University of Iowa,
Iowa City, IA, USA
- Department of Epidemiology, University of Iowa,
Iowa City, IA, USA
| | - Sarah L Mott
- The Holden Comprehensive Cancer Center, University of Iowa Hospitals
& Clinics, Iowa City, IA, USA
| | - Jane A Utech
- The Holden Comprehensive Cancer Center, University of Iowa Hospitals
& Clinics, Iowa City, IA, USA
| | - Autumn C Bahlmann
- The Holden Comprehensive Cancer Center, University of Iowa Hospitals
& Clinics, Iowa City, IA, USA
| | | | - Aaron T Seaman
- Department of Medicine, University of Iowa,
Iowa City, IA, USA
- The Holden Comprehensive Cancer Center, University of Iowa Hospitals
& Clinics, Iowa City, IA, USA
- Department of Community and Behavioral Health, University of
Iowa, Iowa City, IA, USA
| | - Douglas E Laux
- Department of Medicine, University of Iowa,
Iowa City, IA, USA
- The Holden Comprehensive Cancer Center, University of Iowa Hospitals
& Clinics, Iowa City, IA, USA
| | - Muhammad Furqan
- Department of Medicine, University of Iowa,
Iowa City, IA, USA
- The Holden Comprehensive Cancer Center, University of Iowa Hospitals
& Clinics, Iowa City, IA, USA
| | - Zachary J Pollock
- The Holden Comprehensive Cancer Center, University of Iowa Hospitals
& Clinics, Iowa City, IA, USA
| | - Mark W Vander Weg
- Department of Medicine, University of Iowa,
Iowa City, IA, USA
- Department of Community and Behavioral Health, University of
Iowa, Iowa City, IA, USA
- Department of Psychological and Brain Sciences, University of
Iowa, Iowa City, IA, USA
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9
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Martin-Lujan F, Basora-Gallisa J, Villalobos F, Martin-Vergara N, Aparicio-Llopis E, Pascual-Palacios I, Santigosa-Ayala A, Catalin RE, Rey-Reñones C, Solà R. Effectiveness of a motivational intervention based on spirometry results to achieve smoking cessation in primary healthcare patients: randomised, parallel, controlled multicentre study. J Epidemiol Community Health 2021; 75:1001-1009. [PMID: 33883199 PMCID: PMC8458052 DOI: 10.1136/jech-2020-216219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/10/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
Objective This 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results. Design Randomised, parallel, controlled, multicentre clinical trial. Setting This study involved 12 primary healthcare centres (Tarragona, Spain). Participants Active smokers aged 35–70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters. Main outcome Prolonged abstinence (12 months) validated by expired-CO testing. Results Spirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD ±7.78) years and mean cumulative smoking exposure was 29.2 (±18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04). Conclusions In active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare. Trial registration number NCT01194596.
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Affiliation(s)
- Francisco Martin-Lujan
- Direcció d'Atenció Primària, Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain .,Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain
| | - Josep Basora-Gallisa
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain
| | - Felipe Villalobos
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain
| | - Nuria Martin-Vergara
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain
| | | | | | - Antoni Santigosa-Ayala
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain.,Institut Català de la Salut, Sant Salvador Primary Health-Care Centre, Tarragona, Spain
| | - Roxana-Elena Catalin
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,Institut Català de la Salut, Bonavista-La Canonja Primary Health-Care Centre, Tarragona, Spain
| | - Cristina Rey-Reñones
- Unitat de Suport a la Recerca Tarragona-Reus, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Reus, Spain.,School of Medicine and Health Sciences, Universitat Rovira i Virgili, Reus, Spain
| | - Rosa Solà
- Hospital Universitari Sant Joan de Reus, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Functional Nutrition, Oxidation and Cardiovascular Disease (NFOC-SALUT) group, Universitat Rovira i Virgili, Reus, Spain
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10
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Kotsen C, Dilip D, Carter-Harris L, O'Brien M, Whitlock CW, de Leon-Sanchez S, Ostroff JS. Rapid Scaling Up of Telehealth Treatment for Tobacco-Dependent Cancer Patients During the COVID-19 Outbreak in New York City. Telemed J E Health 2020; 27:20-29. [PMID: 32649266 DOI: 10.1089/tmj.2020.0194] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The (COVID-19) pandemic resulted in sudden disruption of routine clinical care necessitating rapid transformation to maintain clinical care while safely reducing virus contagion. Introduction: Memorial Sloan Kettering (MSK) experienced a rapid evolution from delivery of in-person cessation counseling services to virtual telehealth treatments for our tobacco-dependent cancer patients. Aim: To examine the effect of rapid scaling of tobacco treatment telehealth on patient engagement, as measured by attendance rates for in-person counseling visits versus remote telehealth counseling visits. We also describe the patient, clinician, and health care system challenges encountered in rapid expansion of individual and group tobacco telehealth services. Methods: Data collected from the electronic medical record during the first 4 months of the COVID-19 pandemic were examined for tobacco treatment counseling. Results: From January 1, 2020 to March 30, 2020, markedly improved patient engagement was observed in ambulatory tobacco treatment services with greater attendance at scheduled telehealth visits than in-person visits, 75% versus 60.3%, odds ratio 1.84 (confidence interval: 1.26-2.71; p < 0.001). In addition, bedside hospital counseling visits were transformed into inpatient telephone visits with high levels of sustained patient engagement. Lastly, group telehealth services were launched rapidly to increase capacity and provide greater psychosocial support for cancer patients struggling with tobacco dependence. Discussion: Clinical, Information Technology (IT), and hospital system barriers were successfully addressed for most cancer patients seeking individual telehealth treatment. Group telehealth services were found to be feasible and acceptable. Conclusions: MSK's rapid leap into virtual care delivery mitigated disruption of tobacco treatment services and demonstrated strong feasibility and acceptance for managing complex tobacco-dependent patients.
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Affiliation(s)
- Chris Kotsen
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Deepika Dilip
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lisa Carter-Harris
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Maureen O'Brien
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Charles W Whitlock
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Suhana de Leon-Sanchez
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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11
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Valera P, Acuna N, Vento I. The Preliminary Efficacy and Feasibility of Group-Based Smoking Cessation Treatment Program for Incarcerated Smokers. Am J Mens Health 2020; 14:1557988320943357. [PMID: 32705965 PMCID: PMC7383630 DOI: 10.1177/1557988320943357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Group-based tobacco dependence treatment has been known to help smokers to quit in general adult populations, but the feasibility and efficacy of this type of smoking cessation treatment in correctional settings remain uncertain. A 6-week group-based smoking cessation treatment with nicotine replacement therapy (NRT) in the form of nicotine patches was implemented in seven male prison facilities, in the Northeast, among smokers who were born biologically as male. Exhaled breath carbon monoxide (CO) levels were collected from participants at each session to confirm smoking status. Participants were evaluated at the 1-month post-group treatment follow-up to determine abstinence. Those who were lost to follow-up were recorded as continued smoking and not using NRT nicotine patches. The goal of the study was to explore the feasibility and preliminary efficacy of conducting a smoking cessation treatment program for incarcerated smokers. A total of 350 inmates were screened, 177 inmates were enrolled across the prison sites for the 6-week program, and 102 inmates completed the program. A majority of those enrolled reported that they began smoking when they were between 15 and 19 years of age (44.9%) and were smoking on average for 26 years. Less than half (21.3%) reported ever using electronic cigarettes at baseline and in Session 1,116 individuals who attended reported a median CO level of 18.0 parts per million (ppm). At a 1-month follow-up, 43 individuals reported a median CO level of 5.00 ppm. The study demonstrated preliminary efficacy and feasibility of group-based smoking cessation treatment with NRT nicotine patches in incarcerated smokers.
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Affiliation(s)
- Pamela Valera
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Nicholas Acuna
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
| | - Ismary Vento
- School of Public Health, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Cancer Health Justice Lab, Rutgers University School of Public Health, Newark, NJ, USA
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12
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Predictors of participant ‘no-shows’ for intensive behavioral tobacco cessation treatment: recruitment, demographics, and distance. J Smok Cessat 2020. [DOI: 10.1017/jsc.2020.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AbstractIntroductionCognitive-behavioral therapy (CBT) for tobacco cessation is an evidence-based, yet underutilized intervention. More research is needed to understand why some treatment-seekers are ‘no-shows’ for the initial visit.AimExamine factors associated with participant no-shows among smokers scheduled for group CBT.MethodsTobacco smokers (N = 115) were recruited from the community, screened, and if eligible, scheduled to begin group-based CBT plus nicotine replacement therapy. At the screening, participants reported their recruitment source, demographics, smoking history, and contact information. We computed the distance to the study site using the address provided. Regression analyses tested predictors of participant no-shows for the initial visit.ResultsEligible participants were mostly recruited via flyers (56%), female (58%), African American (61%), middle-aged (Mage = 49 years), averaged 16 cigarettes per day, and resided 8 miles away from the study site. The overall initial visit no-show rate was 56%. Bivariate analyses indicated that respondents who were recruited online, younger, and lived further away from the site were more likely to be no-shows. Younger age significantly predicted failure to attend in the multivariable model.ConclusionsFindings highlight potential barriers to participation in a group-based intervention, and have implications for pre-intervention engagement strategies and modifications that may increase reach and uptake.
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13
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Hughes JR. Transdisciplinary: Nicotine and Tobacco Research Walks the Walk. Nicotine Tob Res 2019; 21:1579. [PMID: 31398250 DOI: 10.1093/ntr/ntz140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- John R Hughes
- Vermont Center for Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, Burlington, VT
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14
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Payne TJ, Sheffer CE, Gaughf NW, Sutton MJ, Peeples HH, Elci OU, Ma JZ, Penman A, Crews KM. Enrollee Characteristics in an Intensive Tobacco Dependence Treatment Program: The Relationship of Race and Sex to Demographic Factors and Tobacco Use Patterns. Front Psychiatry 2019; 10:112. [PMID: 30949071 PMCID: PMC6437063 DOI: 10.3389/fpsyt.2019.00112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 02/14/2019] [Indexed: 11/20/2022] Open
Abstract
Intensive tobacco treatment programs offer many advantages relative to other treatment options, particularly for more complex patients, e.g., highly nicotine dependent, or those with medical and psychiatric symptoms and disorders. Efforts to better understand those who choose to enroll in these programs, particularly regarding the characteristics they possess known to mediate outcomes, are important considerations in tailoring available services. In this study, we examined how participants differed on key descriptive and tobacco use variables within race (i.e., African-American, Caucasian) and sex subgroups. Baseline characteristics from a large group of consecutive program enrollees were examined across targeted subgroups. Strong racial effects and some sex effects were noted for marital status, education, employment and health insurance status, alcohol consumption, presence of medical and psychiatric disorders, as well as participant tobacco use patterns and tobacco use rates of family, friends and coworkers. The differences in participant tobacco use measures across race and sex factors remained significant after adjusting for the confounding effects of all other covariates. These findings have implications for characterizing key patient subgroups who present at tobacco treatment clinics. Such information may contribute to options for tailoring treatment regimens.
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Affiliation(s)
- Thomas J Payne
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, United States
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, United States
| | - Natalie W Gaughf
- Academic Counseling, University of Mississippi Medical Center, Jackson, MS, United States
| | - Monica J Sutton
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, United States
| | - Holly H Peeples
- Department of Family Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Okan U Elci
- Center for Biostatistics, University of Mississippi Medical Center, Jackson, MS, United States
| | - Jennie Z Ma
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Alan Penman
- Center for Biostatistics, University of Mississippi Medical Center, Jackson, MS, United States
| | - Karen M Crews
- Professor Emeritus, University of Mississippi Medical Center, Jackson, MS, United States
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15
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Van den Brand FA, Dohmen LME, Van Schayck OCP, Nagelhout GE. 'Secretly, it's a competition': a qualitative study investigating what helped employees quit smoking during a workplace smoking cessation group training programme with incentives. BMJ Open 2018; 8:e023917. [PMID: 30478122 PMCID: PMC6254401 DOI: 10.1136/bmjopen-2018-023917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Smoking cessation programmes in combination with financial incentives have shown to increase quit rates in smokers, but it is not clear which elements of this intervention help smokers to succeed in their quit attempt. The aim of this study was to explore the view of successful and unsuccessful quitters about which factors had affected their ability to quit smoking. DESIGN Semistructured qualitative interviews were conducted and analysed using the Framework method. SETTING Interviews were conducted in 2017 with employees from nine different Dutch companies. PARTICIPANTS 24 successful and unsuccessful quitters from the intervention group of a cluster randomised controlled trial (RCT) who participated in a workplace smoking cessation group training programme in which smoking abstinence was rewarded with financial incentives. RESULTS Themes that emerged were the workplace setting, quitting with colleagues, motivation, family support, strategies and the financial incentives. The interviewees reported that the smoking cessation programme was appreciated in general, was convenient, lowered the threshold to sign up, stimulated peer support and competition and provided strategies to resist smoking. Personal motivation and a mind set to never smoke again were regarded as important factors for quit success. The financial incentives were not considered as a main motivator to quit smoking, which contradicts the results from the RCT. The financial incentives were considered as more attractive to smokers with a low income. CONCLUSIONS According to participants, contributors to quitting smoking were the workplace cessation programme, personal motivation and peer support, but not the incentives. More research is needed on the contradiction between the perceived effects of financial incentives on quit success and the actual difference in quit rates. TRIAL REGISTRATION NUMBER NTR5657.
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Affiliation(s)
- Floor A Van den Brand
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Lisa M E Dohmen
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Onno C P Van Schayck
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Gera E Nagelhout
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
- IVO Addiction Research Institute, The Hague, The Netherlands
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