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Mondal T, Hernandez-Romero B, Wood N, Adler D, Abar B. Evaluating follow-up rates in cancer screening interventions among emergency department patients. Acad Emerg Med 2024. [PMID: 38742269 DOI: 10.1111/acem.14938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Trisha Mondal
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Brenda Hernandez-Romero
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Nancy Wood
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - David Adler
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Beau Abar
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
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Poole NL, Candel MJJM, Willemsen MC, van den Brand FA. Real-Life Effectiveness of Smoking Cessation Delivery Modes: A Comparison Against Telephone Counseling and the Role of Individual Characteristics and Health Conditions in Quit Success. Nicotine Tob Res 2024; 26:452-460. [PMID: 37930890 PMCID: PMC10959160 DOI: 10.1093/ntr/ntad195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/22/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Professional behavioral counseling for smoking cessation can be delivered in many forms, which may not work equally well for everyone. We aim to explore in a real-world setting whether different delivery modes yield different rates of quit success and whether quit success varies based on gender, age, educational level, and being treated for a health condition. AIMS AND METHODS We used monitoring data (n = 13 747) from a smoking cessation counseling provider in the Netherlands (September 2018 to August 2021) to compare differences in quit success immediately after the end of counseling and at 12-month follow-up between telephone and other modes of counseling. Participants chose which mode of counseling they received. At the 12-month follow-up, we also examined differences in quit success based on demographic characteristics and whether one is being treated for various health conditions. RESULTS Participants of in-person group counseling and online in-company group counseling were significantly more likely to have quit immediately after the counseling compared with telephone counseling (OR = 1.25, 95% CI = 1.08-1.44; OR = 1.63, 95% CI = 1.18-2.24). Analyses revealed no significant differences in quit success between telephone and other modes of counseling after 12 months. Those treated for a respiratory or psychological condition were less likely to have maintained quit success, as were women, and participants with a lower educational level. CONCLUSIONS When chosen by oneself, the mode of smoking cessation counseling received does not appear to be important for long-term quit success. However, certain groups warrant extra support to prevent excessive program attrition and unsuccessful quit attempts. IMPLICATIONS Our findings suggest that when chosen by oneself, the delivery mode of smoking cessation counseling does not appear to be important for long-term quit success. This finding is of particular relevance for those who are unable to attend in-person cessation counseling due to, for instance, reduced accessibility or mobility. We also found that women, lower educated, and younger participants were more likely to dropout of the cessation program or to not have maintained a quit attempt, signaling that disparities in smoking cessation persist when standardized counseling is given, and therefore more tailored counseling may be necessary for these groups.
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Affiliation(s)
- Nikita L Poole
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- IVO Research Institute, The Hague, The Netherlands
| | - Math J J M Candel
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Marc C Willemsen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Floor A van den Brand
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Brett EI, Feather AR, Lee Z, Fridberg DJ, Asvat Y, King AC. Courage to Quit® rolling group: Implementation in an urban medical center in primarily low-income Black smokers. HEALTHCARE (AMSTERDAM, NETHERLANDS) 2023; 11:100674. [PMID: 37028112 PMCID: PMC10330217 DOI: 10.1016/j.hjdsi.2023.100674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Continuous "rolling" tobacco group treatments may help reduce cessation disparities by increasing access among underserved people who smoke cigarettes. We evaluated the implementation of a rolling enrollment adaptation of an evidence-based tobacco treatment group intervention, Courage to Quit®-Rolling (CTQ®-R). METHODS The 4-session CTQ®-R incorporating psychoeducation, motivational enhancement, and cognitive behavioral skills was evaluated by examining feasibility and preliminary program outcomes with a pre-post design using the SQUIRE method in a sample of 289 primarily low-income, Black people who smoke. Feasibility was measured by examining program retention. Paired t-tests evaluated changes in behavioral intentions and knowledge about smoking cessation and differences in average daily cigarettes smoked from first to last session attended. RESULTS CTQ-R was feasible to implement in an urban medical center program enrolling primarily low-income Black people who smoke, with 52% attending at least 2 sessions and 24% completing the full program. Participants demonstrated improvements in knowledge of smoking cessation strategies and confidence in quitting (ps < .004). Preliminary effectiveness analyses showed a 30% reduction in average daily cigarette use, with group completers reporting greater reduction than non-completers. CONCLUSIONS CTQ®-R is feasible and showed preliminary effectiveness for increasing knowledge about stop smoking skills and reducing cigarette smoking. IMPLICATIONS A rolling enrollment smoking group treatment is feasible and may be effective among people who smoke who face historical and systemic barriers to tobacco treatment engagement. Evaluation in other settings and over longer periods of time is needed.
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Affiliation(s)
- Emma I Brett
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, USA
| | - Abigayle R Feather
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, USA
| | - Zoe Lee
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, USA
| | - Daniel J Fridberg
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, USA
| | - Yasmin Asvat
- Rush University Medical Center, Supportive Oncology, USA
| | - Andrea C King
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, USA.
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Motivation 2 Quit (M2Q): A cluster randomized controlled trial evaluating the effectiveness of Tobacco Cessation on Prescription in Swedish primary healthcare. PLoS One 2022; 17:e0278369. [PMID: 36454921 PMCID: PMC9714827 DOI: 10.1371/journal.pone.0278369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/17/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of Tobacco Cessation on Prescription (TCP) compared to standard treatment in socioeconomically disadvantaged areas in Swedish primary healthcare (PHC). STUDY DESIGN A pragmatic cluster randomized controlled trial, where randomization was conducted at the PHC center level using a computer-generated random allocation sequence. SETTING 18 PHC centers in socioeconomically disadvantaged areas in Stockholm. PARTICIPANTS 250 adult daily tobacco users (56% female, 41% foreign born) with Swedish social security numbers and permanent resident permits, fluent in Swedish or Arabic, of which 140 responded to the follow-up at 6 months and 139 to the follow-up at 12 months. No blinding was applied. INTERVENTIONS TCP (tobacco cessation counseling for ≥10 minutes, an individualized prescription for tobacco cessation treatment and follow-up on ≥1 occasion) compared to standard treatment. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was self-reported 7-day abstinence at 6 months and the secondary outcomes included self-reported 7-day abstinence at 12 months and 3-month continued abstinence at 6 and 12 months follow-up. RESULTS PHC centers were randomized to the intervention group (n = 8) and control group (n = 10). At the PHC centers, 250 patients (TCP n = 188, standard treatment n = 62) were recruited. There was a statistically significant effect of TCP compared to standard treatment for the outcomes 7-day abstinence at 6 months (OR adjusted 5.4, 95% CI 1.57 to 18.93) and 3-month continued abstinence at 6 (OR adjusted 6.4, 95% CI 1.30 to 31.27) and 12 months follow-up (OR adjusted 7.8, 95% CI 1.25 to 48.82). CONCLUSIONS TCP may be effective in achieving abstinence from tobacco use compared to standard treatment in the given setting but due to several limitations, resulting in high attrition rates and a low statistical power in the study, more research is needed to evaluate this. TRIAL REGISTRATION ISRCTN 11498135.
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Bustamante LA, Romo L. Validation of the French Smoking Cessation Motivation Scale with French Smokers Using a Mobile App for Smoking Cessation. Eur J Investig Health Psychol Educ 2022; 12:1179-1190. [PMID: 36005231 PMCID: PMC9407113 DOI: 10.3390/ejihpe12080082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/04/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
To tailor and predict the outcomes of smoking cessation treatment, it is essential to identify the nature of motivation, as it is the basis for long-term change in healthy behaviors according to self-determination theory (SDT). The purpose of this study is to examine the psychometric properties of the French Smoking Cessation Motivation Scale (F-SCMS). The factorial structure and the psychometric properties were assessed with French-speaking users who had started a 9-step preparation program through a mobile app for smoking cessation (n = 13,044). The results of the present study confirmed content validity (CFI = 0.905, SRMR = 0.045, RMSEA = 0.087) and good internal consistency (α = 0.86, ωh = 0.7, ωt = 0.89) with CFA. The convergent validity was very small, but there were highly significant positive correlations between the willingness and readiness to quit with integrated and intrinsic subscales (rs = 0.25−0.37, p < 0.001). The amotivation subscale significantly had no correlation with any degree of willingness (r = 0.01, p < 0.001), ability (r = 0.01, p < 0.001), and readiness to quit (r = 0.02, p < 0.001). This scale facilitates future research regarding the nature of motivation to quit smoking in the French-speaking population.
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Affiliation(s)
- Luz Adriana Bustamante
- Laboratoire EA 4430-CliPsyd, Department of Psychology, University of Paris Nanterre, 92000 Nanterre, France
- Research and Development Department, Kwit SAS, 67000 Strasbourg, France
- Correspondence:
| | - Lucia Romo
- Laboratoire EA 4430-CliPsyd, Department of Psychology, University of Paris Nanterre, 92000 Nanterre, France
- Hôpital Raymond-Poincaré, Assistance Publique Hôpitaux de Paris, 92380 Garches, France
- Inserm U1018 CESP, University of Paris Sanclay, 91190 Gif-sur-Yvette, France
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Bricca A, Swithenbank Z, Scott N, Treweek S, Johnston M, Black N, Hartmann-Boyce J, West R, Michie S, de Bruin M. Predictors of recruitment and retention in randomized controlled trials of behavioural smoking cessation interventions: a systematic review and meta-regression analysis. Addiction 2022; 117:299-311. [PMID: 34159677 DOI: 10.1111/add.15614] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/06/2021] [Accepted: 06/09/2021] [Indexed: 01/10/2023]
Abstract
AIM To investigate predictors of participant eligibility, recruitment and retention in behavioural randomized controlled trials (RCTs) for smoking cessation. METHOD Systematic review and pre-specified meta-regression analysis of behavioural RCTs for smoking cessation including adult (≥ 18-year-old) smokers. The pre-specified predictors were identified through a literature review and experts' consultation and included participant, trial and intervention characteristics and recruitment and retention strategies. Outcome measures included eligibility rates (proportion of people eligible for the trials), recruitment rates, retention rates and differential retention rates. RESULTS A total of 172 RCTs with 89 639 participants. Eligibility [median 57.6%; interquartile range (IQR) = 34.7-83.7], recruitment (median 66.4%; IQR = 42.7-85.2) and retention rates (median 80.5%; IQR = 68.5-89.5) varied considerably across studies. For eligibility rates, the recruitment strategy appeared not to be associated with eligibility rates. For recruitment rates, use of indirect recruitment strategies (e.g. public announcements) [odds ratio (OR) = 0.30, 95% confidence interval (CI) = 0.11-0.82] and self-help interventions (OR = 0.14, 95% CI = 0.03-0.67) were associated with lower recruitment rates. For retention rates, higher retention was seen if the sample had ongoing physical health condition/s (OR = 1.66, 95% CI = 1.04-2.63), whereas lower retention was seen amongst primarily female samples (OR = 0.83, 95% CI = 0.71-0.98) and those motivated to quit smoking (OR = 0.74, 95% CI = 0.55-0.99) when indirect recruitment methods were used (OR = 0.60, 95% CI = 0.38-0.97) and at longer follow-up assessments (OR = 0.83, 95% CI = 0.79-0.87). For differential retention, higher retention in the intervention group occurred when the intervention but not comparator group received financial incentives for smoking cessation (OR = 1.35, 95% CI = 1.02-1.77). CONCLUSIONS In randomized controlled trials of behavioural smoking cessation interventions, recruitment and retention rates appear to be higher for smoking cessation interventions that include a person-to-person rather than at-a-distance contact; male participants, smokers with chronic conditions, smokers not initially motivated to quit and shorter follow-up assessments seems to be associated with improved retention; financial incentive interventions improve retention in groups receiving them relative to comparison groups.
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Affiliation(s)
- Alessio Bricca
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark, Slagelse, Denmark
| | - Zoe Swithenbank
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Neil Scott
- Medical Statistics Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK
| | - Marie Johnston
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Nicola Black
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Technology Addiction Team, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences and National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Robert West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Marijn de Bruin
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, the Netherlands
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Felicione NJ, Ozga JE, Dino G, Berry JH, Sullivan CR, Blank MD. Timing of smoking cessation treatment integrated into outpatient treatment with medications for opioid use disorder: Feasibility trial. J Subst Abuse Treat 2022; 132:108579. [PMID: 34452780 PMCID: PMC8671242 DOI: 10.1016/j.jsat.2021.108579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/30/2021] [Accepted: 07/25/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Cigarette smoking rates among individuals with opioid use disorder (OUD) are notoriously high and may be improved by considering the timing of treatment integration for these two substances. The current study examined the feasibility of a method for assessing the timing of integrating smoking cessation pharmacotherapy within three different phases of outpatient treatment with medication for OUD (MOUD). METHODS Seventy-four buprenorphine-maintained smokers were enrolled in a quasi-experimental study across three MOUD treatment phases: 0-90 (Phase 1), 91-365 (Phase 2), and > 365 days of MOUD treatment (Phase 3). During a 12-week varenicline-based intervention, the study assessed outcomes daily via text messages (cigarette smoking, varenicline adherence, side effects) or monthly at in-person visits (quit motivation and carbon monoxide levels). RESULTS Thirty-five participants completed the study, with a lower retention rate in Phase 1 (37.5%) relative to Phases 2 (53.5%) or 3 (57.1%). A trend occurred for Phase 1 participants to report aversive side effects (e.g., abnormal dreams, gastrointestinal distress) on more study days. Among completers, adherence to text messaging and varenicline use was high and independent of MOUD treatment phase. Participants in all phases reported declines in cigarette smoking and increases in quit motivation over time; the study observed biochemically verified tobacco abstinence among only a few participants from Phases 2 or 3. CONCLUSIONS This feasibility study demonstrates a method to evaluate the timing of treatment integration for cigarette smoking and MOUD. Method strengths include a study schedule that coincided with the MOUD clinic schedule and use of text messaging to encourage varenicline adherence and evaluate outcomes regularly.
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Affiliation(s)
- Nicholas J. Felicione
- Psychology, West Virginia University, Morgantown, WV,Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Jenny E. Ozga
- Psychology, West Virginia University, Morgantown, WV,Behavioral Medicine & Psychiatry, West Virginia University School of Medicine, Morgantown, WV
| | - Geri Dino
- Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV,West Virginia Prevention Research Center, West Virginia University School of Public Health, Morgantown, WV
| | - James H. Berry
- Behavioral Medicine & Psychiatry, West Virginia University School of Medicine, Morgantown, WV
| | - C. Rolly Sullivan
- Behavioral Medicine & Psychiatry, West Virginia University School of Medicine, Morgantown, WV
| | - Melissa D. Blank
- Psychology, West Virginia University, Morgantown, WV,West Virginia Prevention Research Center, West Virginia University School of Public Health, Morgantown, WV
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Wen S, Wiers RW, Boffo M, Grasman RP, Pronk T, Larsen H. Subtypes of smokers in a randomized controlled trial of a web-based smoking cessation program and their role in predicting intervention non-usage attrition: Implications for the development of tailored interventions. Internet Interv 2021; 26:100473. [PMID: 34765460 PMCID: PMC8569479 DOI: 10.1016/j.invent.2021.100473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Web-based smoking interventions hold potential for smoking cessation; however, many of them report low intervention usage (i.e., high levels of non-usage attrition). One strategy to counter this issue is to tailor such interventions to user subtypes if these can be identified and related to non-usage attrition outcomes. The aim of this study was two-fold: (1) to identify and describe a smoker typology in participants of a web-based smoking cessation program and (2) to explore subtypes of smokers who are at a higher risk for non-usage attrition (i.e., early dropout times). METHODS We conducted secondary analyses of data from a large randomized controlled trial (RCT) that investigated effects of a web-based Cognitive Bias Modification intervention in adult smokers. First, we conducted a two-step cluster analysis to identify subtypes of smokers based on participants' baseline characteristics (including demographics, psychological and smoking-related variables, N = 749). Next, we conducted a discrete-time survival analysis to investigate the predictive value of the subtypes on time until dropout. RESULTS We found three distinct clusters of smokers: Cluster 1 (25.2%, n = 189) was characterized by participants being relatively young, highly educated, unmarried, light-to-moderate smokers, poly-substance users, and relatively high scores on sensation seeking and impulsivity; Cluster 2 (41.0%, n = 307) was characterized by participants being older, with a relatively high socio-economic status (SES), moderate-to-heavy smokers and regular drinkers; Cluster 3 (33.8%, n = 253) contained mostly females of older age, and participants were further characterized by a relatively low SES, heavy smoking, and relatively high scores on hopelessness, anxiety sensitivity, impulsivity, depression, and alcohol use. Additionally, Cluster 1 was more likely to drop out at the early stage of the intervention compared to Cluster 2 (adjusted Hazard Ratio (HR adjusted) = 1.51, 95% CI = [1.25, 1.83]) and Cluster 3 (HR adjusted = 1.52, 95% CI = [1.25, 1.86]). CONCLUSIONS We identified three clusters of smokers that differed on a broad range of characteristics and on intervention non-usage attrition patterns. This highlights the heterogeneity of participants in a web-based smoking cessation program. Also, it supports the idea that such interventions could be tailored to these subtypes to prevent non-usage attrition. The subtypes of smokers identified in this study need to be replicated in the field of e-health outside the context of RCT; based on the smoker subtypes identified in this study, we provided suggestions for developing tailored web-based smoking cessation intervention programs in future research.
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Affiliation(s)
- Si Wen
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Corresponding author at: Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology, University of Amsterdam, Postbus 15916, 1001 NK Amsterdam, the Netherlands.
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Center for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Marilisa Boffo
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Raoul P.P.P. Grasman
- Programme group Psychological Methods, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Thomas Pronk
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Open Science Tools (PsychoPy)-Lab, School of Psychology, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Helle Larsen
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Keijsers M, Vega-Corredor MC, Tomintz M, Hoermann S. Virtual Reality Technology Use in Cigarette Craving and Smoking Interventions (I "Virtually" Quit): Systematic Review. J Med Internet Res 2021; 23:e24307. [PMID: 34533471 PMCID: PMC8486991 DOI: 10.2196/24307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/22/2021] [Accepted: 06/21/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Over the last 2 decades, virtual reality technologies (VRTs) have been proposed as a way to enhance and improve smoking cessation therapy. OBJECTIVE This systematic review aims to evaluate and summarize the current knowledge on the application of VRT in various smoking cessation therapies, as well as to explore potential directions for future research and intervention development. METHODS A literature review of smoking interventions using VRT was conducted. RESULTS Not all intervention studies included an alternative therapy or a placebo condition against which the effectiveness of the intervention could be benchmarked, or a follow-up measure to ensure that the effects were lasting. Virtual reality (VR) cue exposure therapy was the most extensively studied intervention, but its effect on long-term smoking behavior was inconsistent. Behavioral therapies such as a VR approach-avoidance task or gamified interventions were less common but reported positive results. Notably, only 1 study combined Electronic Nicotine Delivery Devices with VRT. CONCLUSIONS The inclusion of a behavioral component, as is done in the VR approach-avoidance task and gamified interventions, may be an interesting avenue for future research on smoking interventions. As Electronic Nicotine Delivery Devices are still the subject of much controversy, their potential to support smoking cessation remains unclear. For future research, behavioral or multicomponent interventions are promising avenues of exploration. Future studies should improve their validity by comparing their intervention group with at least 1 alternative or placebo control group, as well as incorporating follow-up measures.
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Affiliation(s)
- Merel Keijsers
- School of Product Design, College of Engineering, University of Canterbury, Christchurch, New Zealand
- HIT Lab NZ, College of Engineering, University of Canterbury, Christchurch, New Zealand
- John Cabot University, Rome, Italy
| | | | - Melanie Tomintz
- Geospatial Research Institute, University of Canterbury, Christchurch, New Zealand
| | - Simon Hoermann
- School of Product Design, College of Engineering, University of Canterbury, Christchurch, New Zealand
- HIT Lab NZ, College of Engineering, University of Canterbury, Christchurch, New Zealand
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10
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Christofferson DE, Dennis PA, Hertzberg JS, Beckham JC, Knoeppel J, Hamlett-Berry K. Real-World Utilization and Outcomes of the Veterans Health Administration's Smoking Cessation Text Message Program. Nicotine Tob Res 2021; 23:931-938. [PMID: 32945887 DOI: 10.1093/ntr/ntaa183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 09/15/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Smoking cessation mobile health (mHealth) programs are effective and have been recommended for integration into health care services but have not been evaluated in real-world health care settings. The Veterans Health Administration, a safety net health care provider, provides health care for 9 million US military veterans. Veterans Health Administration implemented the SmokefreeVET text message program in 2013. METHODS A retrospective evaluation of 6153 SmokefreeVET subscribers was conducted. The primary outcome was 30-day self-reported abstinence at 6 months. Secondary outcomes included percentage of opt outs, program completers, and 30-day self-reported abstinence at 3 months. RESULTS SmokefreeVET subscribers were on average 47.5 years old and 71.4% male. Smoking cessation medication use was reported by 11.5% of subscribers at the start of their quit attempt and subscribers enrolled in the program for an average of 29 days. Subscribers who were younger, female, and heavier smokers were more likely to opt out of the six-week program early. The abstinence rate for the primary outcome, self-reported 30-day abstinence at 6 months among all subscribers was 3.7%. CONCLUSIONS SmokefreeVET enrolled a younger and more female population of subscribers than other studies of veterans interested in tobacco treatment. The mHealth program was generally acceptable to veterans, yet strategies to increase retention may improve completion rates and outcomes. In this real-world setting, nearly half of the mHealth program subscribers combined use of the text program with smoking cessation medication. Further study of the optimal combination of mHealth with smoking cessation treatments is needed. IMPLICATIONS mHealth smoking cessation programs can be effectively implemented within real-world health care settings, even in those serving disadvantaged populations. Further research to improve mHealth program efficacy and integration into clinical settings will increase the population-level impact of these effective smoking cessation programs.
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Affiliation(s)
- Dana E Christofferson
- Veterans Health Administration, Office of Mental Health and Suicide Prevention, Washington, DC
| | - Paul A Dennis
- Durham VA Medical Center, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - Jean C Beckham
- Durham VA Medical Center, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.,VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham, NC
| | - Jennifer Knoeppel
- Veterans Health Administration, Office of Mental Health and Suicide Prevention, Washington, DC
| | - Kim Hamlett-Berry
- Veterans Health Administration, Office of Mental Health and Suicide Prevention, Washington, DC
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11
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Walk or Run to Quit: a 3-year evaluation of a physical activity-based smoking cessation intervention. J Smok Cessat 2020. [DOI: 10.1017/jsc.2020.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AbstractIntroductionWalk or Run to Quit was a national program targeting smoking cessation through group-based running clinics. Increasing physical activity may facilitate smoking cessation as well as lead to additional health benefits beyond cessation.AimTo evaluate the impact of Walk or Run to Quit over 3 years.MethodsAdult male and female participants (N = 745) looking to quit smoking took part in 156 running-based cessation clinics in 79 locations across Canada. Using a pre-post design, participants completed questionnaires assessing physical activity, running frequency and smoking at the beginning and end of the 10-week program and at 6-months follow-up. Carbon monoxide testing pre- and post- provided an objective indicator of smoking status and coach logs assessed implementation.Results55.0% of program completers achieved 7-day point prevalence (intent-to-treat = 22.1%) and carbon monoxide significantly decreased from weeks 1 to 10 (P < 0.001). There was an increase in physical activity and running from baseline to end-of-program (P's<0.001). At 6-month follow-up, 28.9% of participants contacted self-reported prolonged 6-month abstinence (intent-to-treat = 11.4%) and 35.6% were still running regularly.ConclusionsAlthough attrition was a concern, Walk or Run to Quit demonstrated potential as a scalable behaviour change intervention that targets both cessation and physical activity.
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Camacho OM, Hedge A, Lowe F, Newland N, Gale N, McEwan M, Proctor C. Statistical analysis plan for "A randomised, controlled study to evaluate the effects of switching from cigarette smoking to using a tobacco heating product on health effect indicators in healthy subjects". Contemp Clin Trials Commun 2020; 17:100535. [PMID: 32072070 PMCID: PMC7013164 DOI: 10.1016/j.conctc.2020.100535] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/10/2020] [Accepted: 01/26/2020] [Indexed: 02/06/2023] Open
Abstract
Tobacco harm reduction strategies aim to substitute smoking with potentially reduced risk products (PRRPs) such as e-cigarettes and tobacco-heating products (THPs). The health benefits of switching from smoking to PRRPs is unknown. A randomised controlled trial is being conducted to increase understanding of the health effects of switching from smoking to a THP in a 12-month long ambulatory study (ISRCTN81075760). Here we describe the study endpoints and the statistical analysis plan. Endpoints are divided into biomarkers of exposure (BoE) to tobacco smoke constituents and health effect indicators related to risk of lung cancer, cardiovascular and obstructive lung disease. These have been selected on the basis of extensive literature evidence. Three primary endpoints, augmentation index (risk factor for cardiovascular disease), total NNAL (linked to lung cancer) and 8-Epi-PGF2α type III (indicator of oxidative stress linked to various diseases), and multiple secondary endpoints will be analysed at 90, 180, and 360 days. Changes from baseline will be compared between study arms by specific contrasts in mixed models. Study wise multiple comparisons adjustments will be performed to account for multiplicity of timepoints and comparisons within timepoints. Generalisability of outcomes will be tested by a sensitivity analysis adjusting for age and gender. Importantly, an ancillary analysis will be performed to assess product compliance during the study based on plasma levels of CEVal, a surrogate marker for acrylonitrile exposure. The rationale underlying the selection of BoEs and health effect indicators, coupled with the statistical analysis plan will be central to understanding the potential health effects of replacing smoking with THP use for one year.
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Affiliation(s)
- Oscar M. Camacho
- British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
| | - Andrew Hedge
- Covance Clinical Research Unit Ltd, Springfield House, Hyde Street, Leeds, Yorkshire, LS2 9LH, UK
| | - Frazer Lowe
- British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
| | - Nik Newland
- British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
| | - Nathan Gale
- British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
| | - Mike McEwan
- British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
| | - Christopher Proctor
- British American Tobacco Investments Ltd, Regents Park Road, Southampton, Hampshire, SO15 8TL, UK
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Bohadana A, Freier-Dror Y, Peles V, Babai P, Izbicki G. Extending varenicline preloading to 6 weeks facilitates smoking cessation: A single-site, randomised controlled trial. EClinicalMedicine 2020; 19:100228. [PMID: 32055787 PMCID: PMC7005428 DOI: 10.1016/j.eclinm.2019.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/21/2019] [Accepted: 11/28/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Initiating varenicline use 4 weeks before the target quit date (TQD) reduces smoking in the run-in phase and increases end-treatment cessation rates; however, the lack of a smoke intake plateau suggests longer preloading periods are required. This study assessed whether varenicline preloading for 6 weeks reduced pre-quit smoke intake and enhanced 6-month abstinence outcomes compared with the standard 1-week preloading. METHODS In this randomised single-centre controlled trial, (ClinicalTrials.gov identifier: NCT02634281), conducted between February 2016 and July 2018 in Israel, daily smokers (n = 242) aged ≥ 18 years were randomly assigned (1:1) to receive varenicline preloading for 6 weeks (n = 121) or a placebo for 5 weeks followed by varenicline for 1 week (n = 121) before the TQD. Participants and researchers were masked to both group assignment and treatment allocation. Both groups received standard 12-week post-TQD varenicline treatment. The primary outcome was the 24-week biochemically verified continuous abstinence rate (CAR) from weeks 6 (TQD)-30. Secondary outcomes included the 23-week CAR from 1-week post-TQD (week 7) to week 30, and the 7-day point-prevalence (PP) abstinence at week 30. Other measures included pre- and post-quit rewards, smoking urges, nausea, aversion, and markers of cigarette consumption. FINDINGS By intention-to-treat, the 24-week CAR, weeks 6-30 with extended preloading was significantly higher than with standard preloading (23·1% vs. 4·1%; risk reduction [RR]: -0·19 [95% confidence interval [CI]:-0·10-0·24]; p < 0·001). Extended preloading also showed better secondary outcomes. Extended preloading significantly decreased pre-quit rewards, urges, and smoke intake, including unsolicited smoking abstinence. Post-quit urges remained remarkably lower with extended preloading. Participants receiving extended preloading reported more nausea at week 4 (39.6% vs 11.5%) and abnormal dreams at week 6 (7.7% vs. 0%). Participants receiving standard preloading reported more constipation at week 7 (7.6% vs. 0%) and dizziness at weeks 7 (12.1% vs. 2.5%) and 12 (10.7% vs 1.4%). INTERPRETATION Extended preloading reduced ad lib smoking, enhanced cessation rates at 3 and 6 months, and decreased pre- and post-quit rewards and smoking drive in a pattern compatible with a reinforcement-reduction mechanism. These data substantiate extending the standard pre-treatment period, and suggest that targeting pre-quit smoking sensations should be a treatment priority, although confirmatory evidence is needed from larger clinical trials. FUNDING This study was funded by a 2013 Global Research Award for Nicotine Dependence (GRAND) supported by Pfizer, Inc. (#WI182915).
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Affiliation(s)
- Abraham Bohadana
- Respiratory Research Unit, Pulmonary Institute, Shaare Zedek Medical Center, Affiliated with the Hadassah School of Medicine, Hebrew University of Jerusalem, 12 Baiyt Street, Jerusalem 91031, Israel
- Corresponding author.
| | - Yossi Freier-Dror
- Mashav Applied Research, 5 Chail Nashim Street, Jerusalem 9332005, Israel
| | - Vardit Peles
- Respiratory Research Unit, Pulmonary Institute, Shaare Zedek Medical Center, Affiliated with the Hadassah School of Medicine, Hebrew University of Jerusalem, 12 Baiyt Street, Jerusalem 91031, Israel
| | - Polina Babai
- Mashav Applied Research, 5 Chail Nashim Street, Jerusalem 9332005, Israel
| | - Gabriel Izbicki
- Respiratory Research Unit, Pulmonary Institute, Shaare Zedek Medical Center, Affiliated with the Hadassah School of Medicine, Hebrew University of Jerusalem, 12 Baiyt Street, Jerusalem 91031, Israel
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Ozga-Hess JE, Felicione NJ, Ferguson SG, Dino G, Elswick D, Whitworth C, Turiano N, Blank MD. Piloting a clinical laboratory method to evaluate the influence of potential modified risk tobacco products on smokers' quit-related motivation, choice, and behavior. Addict Behav 2019; 99:106105. [PMID: 31470240 DOI: 10.1016/j.addbeh.2019.106105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 11/28/2022]
Abstract
Research methods are needed that can predict whether the availability of potential modified risk tobacco products (MRTPs) may influence smokers' quit-related motivation, choice, and behavior. This pilot study assessed the primary outcomes of feasibility and adherence to address this need using an electronic cigarette (ECIG) as a model MRTP. Cigarette smokers were randomly assigned to use only their own brand of cigarettes (OB-only) or a second-generation ECIG (18 ng/ml nicotine) plus their OB cigarettes (ECIG+OB) ad libitum for four weeks. Participants logged products using a mobile device, collected used cigarette filters, and provided saliva samples every day for analysis of cotinine. They returned to the lab once per week to provide a breath sample and accept or decline a choice to quit all tobacco products (i.e., cigarettes and/or ECIGs). They also returned for a one-month follow-up visit. Of those participants randomized (n = 60), 56.7% completed the 4-week intervention and 40.0% completed the follow-up visit. The primary reason for withdrawal was poor adherence with mobile device use. Comparable numbers of participants in each group chose to make a quit attempt, although more OB-only participants chose to quit during the first two weeks and more ECIG+OB participants during the last two weeks. With protocol modifications to reduce participation burden, the current method might ultimately be used by regulators to predict how smokers' quit-related motivation, choice, and behavior are influenced by current and future MRTPs.
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Affiliation(s)
- Jenny E Ozga-Hess
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | | | | | - Geri Dino
- WV Prevention Research Center, West Virginia University, Morgantown, WV, USA; Department of Social and Behavioral Sciences, West Virginia University, Morgantown, WV, USA
| | - Daniel Elswick
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
| | - Catherine Whitworth
- WV Prevention Research Center, West Virginia University, Morgantown, WV, USA
| | - Nicholas Turiano
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV, USA.
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Metse AP, Stockings E, Bailey J, Regan T, Bartlem K, Wolfenden L, Taylor G, Wiggers J, Bowman J. Rates of retention of persons with a mental health disorder in outpatient smoking cessation and reduction trials, and associated factors: protocol for a systematic review and meta-analysis. BMJ Open 2019; 9:e030646. [PMID: 31488491 PMCID: PMC6731776 DOI: 10.1136/bmjopen-2019-030646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/20/2019] [Accepted: 07/31/2019] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Smoking among persons with a mental health disorder is associated with inequitable health, social and economic burden. Randomised controlled trials (RCTs) are considered the gold standard design for the assessment of healthcare intervention efficacy/effectiveness. However, many RCTs of smoking interventions for persons with a mental health disorder lack rigour due to low participant retention. No systematic review has pooled retention rates in randomised trials of smoking interventions for persons with a mental health disorder or explored associated factors. The aims of the systematic review will therefore be to: (1) summarise overall rates of participant retention in smoking cessation and reduction trials involving persons with a mental health disorder (including for experimental and control groups separately) and (2) determine if retention rates vary according to participant, environmental, researcher and study factors. METHODS AND ANALYSIS PsycINFO, EMBASE, MEDLINE, CENTRAL and The Cochrane Tobacco Addiction Review Group Specialised Register will be searched for reports of RCTs of outpatient smoking cessation or reduction interventions for adults with a mental health disorder. The search terms will include MeSH terms and free text words, and there will be no language or date restrictions. All databases will be searched from inception to present. Data will be analysed using the Mantel-Haenszel fixed-effect model, and where substantial heterogeneity (I2 >50%) is detected, DerSimonian & Laird inverse-variance random effects model. Pooled estimates and 95% CIs will be calculated for overall participant retention rates and for intervention and control trial arms separately. Associations between participant retention and participant, environmental, researcher and study factors will be assessed via subgroup analyses and, where sufficient data are obtained, meta-regression. ETHICS AND DISSEMINATION This study does not require ethical approval. The findings of this review will be disseminated via publication in a peer-reviewed open access medical journal and presentations at international scientific meetings.
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Affiliation(s)
- Alexandra Patricia Metse
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
- Discipline of Psychology, Murdoch University, Murdoch, Western Australia, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Bailey
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Timothy Regan
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kate Bartlem
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Gemma Taylor
- Department of Psychology, University of Bath, Bath, BA2 7AY, United Kingdom
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Jenny Bowman
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
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Weiss-Gerlach E, McCarthy WJ, Wellmann J, Graunke M, Spies C, Neuner B. Secondary analysis of an RCT on Emergency Department-Initiated Tobacco Control: Repeatedly assessed point-prevalence abstinence up to 12 months and extension of results through a 10-year follow-up. Tob Induc Dis 2019; 17:26. [PMID: 31582937 PMCID: PMC6751984 DOI: 10.18332/tid/105579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/08/2019] [Accepted: 03/12/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Emergency departments (EDs) are opportune places for tobacco control interventions. The ‘Tobacco Control in an Urban Emergency Department’ (TED) study, ISRCTN41527831, originally evaluated the effect of motivational interviewing on-site plus up to four booster telephone calls on 12-month abstinence. This study’s aim was to evaluate the effect of the intervention on 7-day point-prevalence abstinence at 10 years follow-up (primary outcome) as well as on repeated point-prevalence abstinence at 1, 3, 6, 12 months and at 10 years (continual smoking abstinence, secondary outcome). METHODS At the 10 years follow-up and after informed consent, study participants responded to a mailed questionnaire. The primary outcome was analyzed in observed-only and in all-cases analyses. The secondary outcomes were analyzed using a multiple adjusted GLMM for binary outcomes. RESULTS Out of 1012 TED-study participants, 986 (97.4%) were alive and 231 (23.4% of 986) responded to the follow-up at 10 years. For observed-only and all-cases analyses, the effect of the baseline intervention on 7-day point-prevalence abstinence at the 10 years follow-up was statistically non-significant. However, when taking into account all repeated measures, the intervention significantly influenced continual abstinence with odds ratio 1.32 (95% CI: 1.01–1.73; p=0.042). Baseline motivation, perceived self-efficacy to stop smoking, and nicotine dependency were independently associated with long-term continual smoking abstinence (all p<0.05). CONCLUSIONS A conventional analysis failed to confirm a significant effect of the ED-initiated tobacco control intervention on the point-prevalence abstinence at 10 years. Results from a more integrative analysis nonetheless indicated an enduring intervention effect on continual abstinence among smokers first encountered in the emergency department setting 10 years earlier.
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Affiliation(s)
- Edith Weiss-Gerlach
- Department of Anesthesiology and Intensive Care Medicine, Charité- Universitätsmedizin Berlin, Berlin, Germany
| | - William J McCarthy
- Center for Cancer Prevention and Control Research, UCLA Fielding School of Public Health, Los Angeles, United States
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Marie Graunke
- Department of Anesthesiology and Intensive Care Medicine, Charité- Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care Medicine, Charité- Universitätsmedizin Berlin, Berlin, Germany
| | - Bruno Neuner
- Department of Anesthesiology and Intensive Care Medicine, Charité- Universitätsmedizin Berlin, Berlin, Germany
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Metse AP, Hizam NAN, Wiggers J, Wye P, Bowman JA. Factors associated with retention in a smoking cessation trial for persons with a mental illness: a descriptive study. BMC Med Res Methodol 2018; 18:177. [PMID: 30587149 PMCID: PMC6307187 DOI: 10.1186/s12874-018-0640-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/10/2018] [Indexed: 01/06/2023] Open
Abstract
Background Exploring factors associated with retention in randomised trials provides insight into potential threats to internal and external study validity, and may inform the development of interventions to increase retention in future trials. Given a paucity of existing research in the field, a study was conducted to explore factors associated with retention in a smoking intervention trial involving persons with a mental illness, considering demographic and smoking characteristics, treatment condition and engagement in prior follow-up assessments. Method A descriptive study was undertaken using data derived from a RCT of a smoking cessation intervention initiated in four adult psychiatric inpatient units in New South Wales (NSW), Australia. Retention assessment was undertaken at 1, 6 and 12-months post-discharge. A Generalised Linear Mixed Model was adopted to explore associations between retention at any follow up time point and demographic and smoking characteristics. Chi square analyses explored the association between retention at all follow up time points and treatment condition, and binary logistic regression analyses assessed for relationships between retention at 12-month follow up and engagement in prior follow up assessments. Results Retention rates were 63, 56 and 60% at the 1, 6 and 12-month assessments, respectively. No association was found between retention at any follow-up time point and 13 of 15 demographic and smoking characteristics. Younger participants and those who identified to be Aboriginal and/or Torres Strait Islander were more likely to be retained (both ps > 0.05). Retention rates did not vary according to treatment condition at any follow-up time point. Participants who completed a prior assessment were more likely to complete the 12 month assessment (both prior assessments: OR 10.7, p < 0.001; 6 month assessment: OR 6.01, p < 0.001; and 1 month assessment: OR 1.8, p = 0.002). Conclusion The underrepresentation of younger participants and those identifying to be Aboriginal and/or Torres Strait Islander may limit the generalisability of findings. Findings suggest that inclusion of multiple contacts during a trial follow up period may increase retention at the final assessment. Interventions to improve retention, overall and for those sub-groups less likely to be retained, in smoking trials involving persons with a mental illness are needed. Further assessment of sample characteristics, and also trial design factors, associated with retention in this field is warranted.
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Affiliation(s)
- Alexandra P Metse
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. .,Murdoch University, South Street, Murdoch, WA, 6150, Australia.
| | - Nur Ashikin Noor Hizam
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - John Wiggers
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Hunter New England Population Health, Longworth Ave, Wallsend, NSW, 2287, Australia
| | - Paula Wye
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Jenny A Bowman
- Psychology administration office, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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Courtney RJ, Clare P, Boland V, Martire KA, Bonevski B, Hall W, Siahpush M, Borland R, Doran CM, West R, Farrell M, Mattick RP. Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers. Addict Behav 2017; 64:13-20. [PMID: 27533077 DOI: 10.1016/j.addbeh.2016.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 07/20/2016] [Accepted: 07/30/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Little is known about the factors associated with retention in smoking cessation trials, especially for low-socioeconomic status (low-SES) smokers. This study examined the factors associated with retention of low-SES smokers in the Australian Financial Interventions for Smoking Cessation Among Low-Income Smokers (FISCALS) trial. DESIGN A two-group parallel block randomised open-label trial with allocation concealment. SETTING Australia. The study was conducted primarily by telephone-based interviews with nicotine replacement therapy delivered via mail. PARTICIPANTS 1047 low-SES smokers interested in quitting smoking were randomised. MEASUREMENTS Participants completed computer assisted telephone interviews (CATIs) at baseline, 2-month and 8-month follow-up. Smoking-related, substance use, mental or physical health, general psychological constructs, sociodemographic and recruitment sources association with retention at 8-month follow-up were examined using binary logistic regression. FINDINGS 946 participants (90%) completed the 2-month follow-up interview and 880 participants (84%) completed the 8-month follow-up interview. Retention at 8-months was associated with higher motivation to quit (OR: 1.15; 95% CI: 1.04, 1.27 p<0.01), more recent quit attempts (OR: 1.20; 95% CI: 1.04, 1.40 p<0.05), increasing age (OR: 1.05; 95% CI: 1.03, 1.07 p<0.01), and higher level of education (OR: 2.24; 95% CI: 1.45, 3.46 p<0.01). Lower retention at 8-months occurred for those participants recruited from posters placed in Department of Human Service Centrelink Offices (OR: 0.56; 95% CI: 0.35, 0.89, p<0.05) compared to participants recruited from Quitline services. No significant differences in retention were found for participants recruited via newspaper advertisements or word of mouth compared to Quitline services. No significant associations were found between health-related or behavioural factors and retention. CONCLUSIONS In the context of high overall retention rates from disadvantaged smokers in a randomised trial, retention was greater in those smokers with higher motivation to quit, more recent quit attempts, increased age, higher level of education and for those recruited through Quitline or newspaper advertisements.
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Affiliation(s)
- Ryan J Courtney
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia.
| | - Philip Clare
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Veronica Boland
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Kristy A Martire
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia; School of Psychology, UNSW, Australia. http://orcid.org/0000-0002-5324-0732
| | - Billie Bonevski
- School of Medicine & Public Health, Faculty of Health and Medicine, University of Newcastle, Australia
| | - Wayne Hall
- Centre for Clinical Research, University of Queensland, Australia
| | - Mohammad Siahpush
- College of Public Health, University of Nebraska Medical Center, United States
| | - Ron Borland
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Australia
| | - Christopher M Doran
- School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Australia
| | - Robert West
- UCL Department of Epidemiology & Public Health, University College London, UK
| | - Michael Farrell
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Australia
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