Tags

Type your tag names separated by a space and hit enter

The Equity Impact of Proactive Outreach to Smokers: Analysis of a Randomized Trial.
Am J Prev Med. 2018 10; 55(4):506-516.AJ

Abstract

INTRODUCTION

Population-based smoking-cessation services tend to preferentially benefit high-SES smokers, potentially exacerbating disparities. Interventions that include proactive outreach, telephone counseling, and free or low-cost cessation medications may be more likely to help low-SES smokers quit. This analysis evaluated the role of SES in smokers' response to a population-based proactive smoking-cessation intervention.

METHODS

This study, conducted in 2016 and 2017, was a secondary analysis of the Veterans Victory Over Tobacco Study, a multicenter pragmatic RCT of a proactive smoking-cessation intervention conducted from 2009 to 2011. Logistic regression modeling was used to test the effect of income or education level on 6-month prolonged abstinence at 1-year follow-up.

RESULTS

Of the 5,123 eligible, randomized participants, 2,565 (50%) reported their education level and 2,430 (47%) reported their income level. The interactions between education (p=0.07) or income (p=0.74) X treatment arm were not statistically significant at the 0.05 level. The largest effect sizes for the intervention were found among smokers in the lowest education category (≤11th grade), with a quit rate of 17.3% as compared with 5.7% in usual care (OR=3.5, 95% CI=1.4, 8.6) and in the lowest income range (<$10,000), with a quit rate of 18.7% as compared with 9.4% in usual care (OR=2.2, 95% CI=1.2, 4.0).

CONCLUSIONS

In a large, multicenter smoking-cessation trial, proactive outreach was associated with higher rates of prolonged abstinence among smokers at all SES levels. Proactive outreach interventions that integrate telephone-based care and facilitated cessation medication access have the potential to reduce socioeconomic disparities in quitting.

TRIAL REGISTRATION

This study is registered at www.clinicaltrials.gov NCT00608426.

Authors+Show Affiliations

Veterans Affairs Health Services Research & Development Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota. Electronic address: elizabeth.danan@va.gov.Veterans Affairs Health Services Research & Development Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.Veterans Affairs Health Services Research & Development Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.Veterans Affairs Health Services Research & Development Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.Veterans Affairs Health Services Research & Development Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota; Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, Minnesota.Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, Minnesota.Veterans Affairs Health Services Research & Development Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30139707

Citation

Danan, Elisheva R., et al. "The Equity Impact of Proactive Outreach to Smokers: Analysis of a Randomized Trial." American Journal of Preventive Medicine, vol. 55, no. 4, 2018, pp. 506-516.
Danan ER, Fu SS, Clothier BA, et al. The Equity Impact of Proactive Outreach to Smokers: Analysis of a Randomized Trial. Am J Prev Med. 2018;55(4):506-516.
Danan, E. R., Fu, S. S., Clothier, B. A., Noorbaloochi, S., Hammett, P. J., Widome, R., & Burgess, D. J. (2018). The Equity Impact of Proactive Outreach to Smokers: Analysis of a Randomized Trial. American Journal of Preventive Medicine, 55(4), 506-516. https://doi.org/10.1016/j.amepre.2018.05.023
Danan ER, et al. The Equity Impact of Proactive Outreach to Smokers: Analysis of a Randomized Trial. Am J Prev Med. 2018;55(4):506-516. PubMed PMID: 30139707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Equity Impact of Proactive Outreach to Smokers: Analysis of a Randomized Trial. AU - Danan,Elisheva R, AU - Fu,Steven S, AU - Clothier,Barbara A, AU - Noorbaloochi,Siamak, AU - Hammett,Patrick J, AU - Widome,Rachel, AU - Burgess,Diana J, Y1 - 2018/08/20/ PY - 2017/10/02/received PY - 2018/03/14/revised PY - 2018/05/16/accepted PY - 2018/8/25/pubmed PY - 2019/10/23/medline PY - 2018/8/25/entrez SP - 506 EP - 516 JF - American journal of preventive medicine JO - Am J Prev Med VL - 55 IS - 4 N2 - INTRODUCTION: Population-based smoking-cessation services tend to preferentially benefit high-SES smokers, potentially exacerbating disparities. Interventions that include proactive outreach, telephone counseling, and free or low-cost cessation medications may be more likely to help low-SES smokers quit. This analysis evaluated the role of SES in smokers' response to a population-based proactive smoking-cessation intervention. METHODS: This study, conducted in 2016 and 2017, was a secondary analysis of the Veterans Victory Over Tobacco Study, a multicenter pragmatic RCT of a proactive smoking-cessation intervention conducted from 2009 to 2011. Logistic regression modeling was used to test the effect of income or education level on 6-month prolonged abstinence at 1-year follow-up. RESULTS: Of the 5,123 eligible, randomized participants, 2,565 (50%) reported their education level and 2,430 (47%) reported their income level. The interactions between education (p=0.07) or income (p=0.74) X treatment arm were not statistically significant at the 0.05 level. The largest effect sizes for the intervention were found among smokers in the lowest education category (≤11th grade), with a quit rate of 17.3% as compared with 5.7% in usual care (OR=3.5, 95% CI=1.4, 8.6) and in the lowest income range (<$10,000), with a quit rate of 18.7% as compared with 9.4% in usual care (OR=2.2, 95% CI=1.2, 4.0). CONCLUSIONS: In a large, multicenter smoking-cessation trial, proactive outreach was associated with higher rates of prolonged abstinence among smokers at all SES levels. Proactive outreach interventions that integrate telephone-based care and facilitated cessation medication access have the potential to reduce socioeconomic disparities in quitting. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT00608426. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/30139707/The_Equity_Impact_of_Proactive_Outreach_to_Smokers:_Analysis_of_a_Randomized_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(18)31934-2 DB - PRIME DP - Unbound Medicine ER -