Support Person Intervention to Promote Smoker Utilization of the QUITPLAN® Helpline

Mayo Clinic Cancer Center, Charlton 6-273, 200 First Street SW, Rochester, MN 55905, USA.
American journal of preventive medicine (Impact Factor: 4.28). 01/2009; 35(6 Suppl):S479-85. DOI: 10.1016/j.amepre.2008.09.003
Source: PubMed

ABSTRACT Effective cessation services are greatly underutilized by smokers. Only about 1.5% of smokers in Minnesota utilize the state-funded QUITPLAN Helpline. Substantial evidence exists on the role of social support in smoking cessation. In preparation for a large randomized trial, this study developed and piloted an intervention for an adult nonsmoking support person to motivate and encourage a smoker to call the QUITPLAN Helpline.
The support person intervention was developed based on Cohen's theory of social support. It consisted of written materials and three consecutive, weekly, 20-30 minute telephone sessions. Smoker calls to the QUITPLAN Helpline were documented by intake staff.
Participants were 30 support people (93% women, 97% Caucasian, mean age 49). High rates of treatment compliance were observed, with 28 (93%) completing all three telephone sessions. The intervention was ranked as somewhat or very helpful by 77% of the support people, and 97% would definitely or probably recommend the program. Five smokers linked to a support person called the QUITPLAN Helpline.
An intervention using natural support networks to promote smoker utilization of the QUITPLAN Helpline is both acceptable to a support person and feasible. A controlled randomized trial is under way to examine the efficacy of the intervention.


Available from: Christina M Smith, Apr 25, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: This qualitative study describes the process of providing a telephone intervention for adult non-smoking support persons to motivate and encourage a smoker to call the QUITPLAN Helpline. The intervention consisted of written materials and three consecutive, weekly, 15–30 min telephone sessions. Themes, issues, and concerns were summarized using content analysis. Participants were 212 support persons (94% female, 93% Caucasian) who completed at least one session. The intervention had a reported positive impact on participants’ understanding of the process of quitting smoking. The concept of readiness to quit including the Contemplation Ladder as a visual aid, education on nicotine dependence, and learning to recognize and reinforce small steps toward quitting or seeking help to quit were valuable tools to help participants understand their smoker's behavior, determine where the smoker was in the process of quitting and to use appropriate support strategies. Common issues and concerns raised are described along with strategies counselors used to address these during sessions. In addition, quantitative data on the types of goals and strategies used by support persons to motivate their smoker toward calling the Helpline and quitting are summarized. The themes of this study, along with counselor responses and suggestions, as well as goals and strategies used by support persons, could help providers to effectively guide and support non-smokers who want to help someone seek treatment to quit smoking.
    Addiction Research and Theory 11/2012; 20(6). DOI:10.3109/16066359.2012.665966
  • [Show abstract] [Hide abstract]
    ABSTRACT: Telephone services can provide information and support for smokers. Counselling may be provided proactively or offered reactively to callers to smoking cessation helplines. To evaluate the effect of proactive and reactive telephone support via helplines and in other settings to help smokers quit. We searched the Cochrane Tobacco Addiction Group Specialised Register for studies of telephone counselling, using search terms including 'hotlines' or 'quitline' or 'helpline'. Date of the most recent search: May 2013. randomized or quasi-randomised controlled trials in which proactive or reactive telephone counselling to assist smoking cessation was offered to smokers or recent quitters. One author identified and data extracted trials, and a second author checked them. The main outcome measure was the risk ratio for abstinence from smoking after at least six months follow-up. We selected the strictest measure of abstinence, using biochemically validated rates where available. We considered participants lost to follow-up to be continuing smokers. Where trials had more than one arm with a less intensive intervention we used only the most similar intervention without the telephone component as the control group in the primary analysis. We assessed statistical heterogeneity amongst subgroups of clinically comparable studies using the I² statistic. We considered trials recruiting callers to quitlines separately from studies recruiting in other settings. Where appropriate, we pooled studies using a fixed-effect model. We used a meta-regression to investigate the effect of differences in planned number of calls, selection for motivation, and the nature of the control condition (self help only, minimal intervention, pharmacotherapy) in the group of studies recruiting in non-quitline settings. Seventy-seven trials met the inclusion criteria. Some trials were judged to be at risk of bias in some domains but overall we did not judge the results to be at high risk of bias. Among smokers who contacted helplines, quit rates were higher for groups randomized to receive multiple sessions of proactive counselling (nine studies, > 24,000 participants, risk ratio (RR) for cessation at longest follow-up 1.37, 95% confidence interval (CI) 1.26 to 1.50). There was mixed evidence about whether increasing the number of calls altered quit rates but most trials used more than two calls. Three studies comparing different counselling approaches during a single quitline contact did not detect significant differences. Of three studies that tested the provision of access to a hotline two detected a significant benefit and one did not.Telephone counselling not initiated by calls to helplines also increased quitting (51 studies, > 30,000 participants, RR 1.27; 95% CI 1.20 to 1.36). In a meta-regression controlling for other factors the effect was estimated to be slightly larger if more calls were offered, and in trials that specifically recruited smokers motivated to try to quit. The relative extra benefit of counselling was smaller when it was provided in addition to pharmacotherapy (usually nicotine replacement therapy) than when the control group only received self-help material or a brief intervention.A further eight studies were too diverse to contribute to meta-analyses and are discussed separately. Two compared different intensities of counselling, both of which detected a dose response; one of these detected a benefit of multiple counselling sessions over a single call for people prescribed bupropion. The others tested a variety of interventions largely involving offering telephone counselling as part of a referral or systems change and none detected evidence of effect. Proactive telephone counselling aids smokers who seek help from quitlines. Telephone quitlines provide an important route of access to support for smokers, and call-back counselling enhances their usefulness. There is limited evidence about the optimal number of calls. Proactive telephone counselling also helps people who receive it in other settings. There is some evidence of a dose response; one or two brief calls are less likely to provide a measurable benefit. Three or more calls increase the chances of quitting compared to a minimal intervention such as providing standard self-help materials, or brief advice, or compared to pharmacotherapy alone.
    Cochrane database of systematic reviews (Online) 08/2013; 8(8):CD002850. DOI:10.1002/14651858.CD002850.pub3
  • [Show abstract] [Hide abstract]
    ABSTRACT: Smoking is the number one preventable cause of death in the United States. Effective Web-assisted tobacco interventions are often underutilized and require new and innovative engagement approaches. Web-based peer-driven chain referrals successfully used outside health care have the potential for increasing the reach of Internet interventions. The objective of our study was to describe the protocol for the development and testing of proactive Web-based chain-referral tools for increasing the access to, a Web-assisted tobacco intervention system. We will build and refine proactive chain-referral tools, including email and Facebook referrals. In addition, we will implement respondent-driven sampling (RDS), a controlled chain-referral sampling technique designed to remove inherent biases in chain referrals and obtain a representative sample. We will begin our chain referrals with an initial recruitment of former and current smokers as seeds (initial participants) who will be trained to refer current smokers from their social network using the developed tools. In turn, these newly referred smokers will also be provided the tools to refer other smokers from their social networks. We will model predictors of referral success using sample weights from the RDS to estimate the success of the system in the targeted population. This protocol describes the evaluation of proactive Web-based chain-referral tools, which can be used in tobacco interventions to increase the access to hard-to-reach populations, for promoting smoking cessation. Share2Quit represents an innovative advancement by capitalizing on naturally occurring technology trends to recruit smokers to Web-assisted tobacco interventions.
    09/2013; 2(2):e37. DOI:10.2196/resprot.2786