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Identifying pathways to quitting smoking via telemedicine-delivered care.
Health Psychol. 2019 Jul; 38(7):638-647.HP

Abstract

OBJECTIVE

A randomized controlled trial of quitline-like phone counseling (QL) versus telemedicine integrated into primary care (ITM) compared the effectiveness of these modalities for smoking cessation. Study design and components were based on self-determination theory (SDT). The purpose of this study was to test our SDT-based model in which perceived health care provider autonomy support, working alliance, autonomous motivation, and perceived competence were hypothesized to mediate the effects of ITM on smoking cessation.

METHOD

Rural smokers (n = 560) were randomized to receive 4 sessions over a 3-month period of either QL or ITM. Follow-up assessments were conducted at Months 3, 6, and 12. The primary outcome was biochemically verified 7-day point prevalence at 12 -months. Structural equation modeling with latent change scores was used for the analysis.

RESULTS

Participants in the ITM condition reported greater increases in perceived health care provider autonomy support (PAS) at end of treatment, which in turn was associated with enhanced perceived competence to quit smoking (PC). Increased PC was associated with a higher likelihood of cessation at 12-months. Mediation analysis demonstrated significant indirect effects, including a path from ITM to increases in PAS to increases in PC to cessation at 12-months (indirect effect = 0.0183, 95% confidence interval [.003, .0434]).

CONCLUSIONS

When integrated into primary care, ITM may influence smoking cessation by enhancing the extent to which smokers feel supported by their providers and thereby increase their perceived ability to quit. Findings suggest that locating tobacco treatment services in health care provider offices imparts a motivational benefit for cessation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Authors+Show Affiliations

Department of Psychology.Department of Psychology & Human Development.Department of Public Health & Preventive Medicine.Cancer Prevention & Control Program.Children's Mercy Hospital.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31021123

Citation

Liebmann, Edward P., et al. "Identifying Pathways to Quitting Smoking Via Telemedicine-delivered Care." Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, vol. 38, no. 7, 2019, pp. 638-647.
Liebmann EP, Preacher KJ, Richter KP, et al. Identifying pathways to quitting smoking via telemedicine-delivered care. Health Psychol. 2019;38(7):638-647.
Liebmann, E. P., Preacher, K. J., Richter, K. P., Cupertino, A. P., & Catley, D. (2019). Identifying pathways to quitting smoking via telemedicine-delivered care. Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 38(7), 638-647. https://doi.org/10.1037/hea0000740
Liebmann EP, et al. Identifying Pathways to Quitting Smoking Via Telemedicine-delivered Care. Health Psychol. 2019;38(7):638-647. PubMed PMID: 31021123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identifying pathways to quitting smoking via telemedicine-delivered care. AU - Liebmann,Edward P, AU - Preacher,Kristopher J, AU - Richter,Kimber P, AU - Cupertino,A Paula, AU - Catley,Delwyn, Y1 - 2019/04/25/ PY - 2019/4/26/pubmed PY - 2019/8/27/medline PY - 2019/4/26/entrez SP - 638 EP - 647 JF - Health psychology : official journal of the Division of Health Psychology, American Psychological Association JO - Health Psychol VL - 38 IS - 7 N2 - OBJECTIVE: A randomized controlled trial of quitline-like phone counseling (QL) versus telemedicine integrated into primary care (ITM) compared the effectiveness of these modalities for smoking cessation. Study design and components were based on self-determination theory (SDT). The purpose of this study was to test our SDT-based model in which perceived health care provider autonomy support, working alliance, autonomous motivation, and perceived competence were hypothesized to mediate the effects of ITM on smoking cessation. METHOD: Rural smokers (n = 560) were randomized to receive 4 sessions over a 3-month period of either QL or ITM. Follow-up assessments were conducted at Months 3, 6, and 12. The primary outcome was biochemically verified 7-day point prevalence at 12 -months. Structural equation modeling with latent change scores was used for the analysis. RESULTS: Participants in the ITM condition reported greater increases in perceived health care provider autonomy support (PAS) at end of treatment, which in turn was associated with enhanced perceived competence to quit smoking (PC). Increased PC was associated with a higher likelihood of cessation at 12-months. Mediation analysis demonstrated significant indirect effects, including a path from ITM to increases in PAS to increases in PC to cessation at 12-months (indirect effect = 0.0183, 95% confidence interval [.003, .0434]). CONCLUSIONS: When integrated into primary care, ITM may influence smoking cessation by enhancing the extent to which smokers feel supported by their providers and thereby increase their perceived ability to quit. Findings suggest that locating tobacco treatment services in health care provider offices imparts a motivational benefit for cessation. (PsycINFO Database Record (c) 2019 APA, all rights reserved). SN - 1930-7810 UR - https://www.unboundmedicine.com/medline/citation/31021123/Identifying_pathways_to_quitting_smoking_via_telemedicine_delivered_care_ L2 - http://content.apa.org/journals/hea/38/7/638 DB - PRIME DP - Unbound Medicine ER -