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Carlini B.H.,University of Washington | Safioti L.,University of Washington | Rue T.C.,University of Washington | Miles L.,Alere Wellbeing
Journal of Immigrant and Minority Health | Year: 2014

Limited English proficient (LEP) individuals face disparities in accessing substance abuse treatment, but little is known on how to reach this population. This study aimed to test online recruitment methods for tobacco and alcohol screening among LEP Portuguese speakers. The study was advertised in Portuguese using Facebook, Google, online newsletters and E-mail. Participants clicked ads to consent and access a screening for tobacco and alcohol dependence. Ads yielded 690 screening responses in 90 days. Respondents had a mean age of 42.7 (SD 12), with a higher proportion of women than men, 95 % born in Brazil with high levels of LEP and low levels of acculturation. Facebook ads yielded 41.4 % of responses, and were the lowest cost recruitment channel ($8.9, $31.10 and $20.40 per respondent, hazardous drinker and smoker, respectively). Online recruitment of LEP populations is feasible. Future studies should test similar strategies in other LEP groups. © 2014 Springer Science+Business Media New York.


Vickerman K.A.,Training and Evaluation Services | Zhang L.,Centers for Disease Control and Prevention | Malarcher A.,Centers for Disease Control and Prevention | Mowery P.,Biostatistics Inc | Nash C.,Alere Wellbeing
Preventing Chronic Disease | Year: 2015

Introduction: Antismoking mass media campaigns, such as the Centers for Disease Control and Prevention's Tips from Former Smokers (Tips) campaign, increase the number of tobacco users calling tobacco quitlines. Few studies have investigated long-term tobacco use cessation for callers during antismoking media campaigns. Studies have suggested that callers during campaigns may be less committed to quitting and have lower quit rates. This study examines tobacco user cessation outcomes 7 months after quitline enrollment during the 2012 Tips campaign (March 19 through June 10, 2012). Methods: We analyzed data for 715 tobacco users who enrolled in the Nebraska, North Carolina, or Texas state quitline multiple-call programs during the 2012 Tips campaign and responded to a 7-month postenrollment survey (38.5% survey response rate). We used multivariable logistic regression analyses to determine whether 7- day and 30-day point prevalence abstinence rates 7 months after enrollment were related to level of exposure to the campaign. Results: In multivariable models, only lower nicotine dependence and higher call completion were associated with higher odds of 7-day and 30-day abstinence 7 months after enrollment. Tips campaign exposure was not associated with abstinence. Conclusion: Once enrolled in quitline counseling, quitline callers achieved similar outcomes regardless of Tips campaign exposure levels. While the campaign did not appear to directly affect odds of tobacco abstinence through quitlines, antismoking mass media campaigns such as Tips are valuable in increasing tobacco users' exposure to quitlines and thus increasing their likelihood of making a quit attempt and eventually achieving tobacco abstinence.


Carlini B.H.,Alere Wellbeing | Carlini B.H.,University of Washington | McDaniel A.M.,Indiana University | Weaver M.T.,Indiana University | And 4 more authors.
BMC Public Health | Year: 2012

Background: Tobacco dependence is a chronic, relapsing condition that typically requires multiple quit attempts and extended treatment. When offered the opportunity, relapsed smokers are interested in recycling back into treatment for a new, assisted quit attempt. This manuscript presents the results of a randomized controlled trial testing the efficacy of interactive voice response (IVR) in recycling low income smokers who had previously used quitline (QL) support back to QL support for a new quit attempt. Methods: A sample of 2985 previous QL callers were randomized to either receive IVR screening for current smoking (control group) or IVR screening plus an IVR intervention. The IVR intervention consists of automated questions to identify and address barriers to re-cycling in QL support, followed by an offer to be transferred to the QL and reinitiate treatment. Re-enrollment in QL services for both groups was documented. Results: The IVR system successfully reached 715 (23.9%) former QL participants. Of those, 27% (194/715) reported to the IVR system that they had quit smoking and were therefore excluded from the study and analysis. The trials final sample was composed of 521 current smokers. The re-enrollment rate was 3.3% for the control group and 28.2% for the intervention group (p≤.001). Logistic regression results indicated an 11.2 times higher odds for re-enrollment of the intervention group than the control group (p≤.001). Results did not vary by gender, race, ethnicity, or level of education, however recycled smokers were older (Mean =45.2; SD = 11.7) than smokers who declined a new treatment cycle (Mean = 41.8; SD = 13.2); (p = 0.013). The main barriers reported for not engaging in a new treatment cycle were low self-efficacy and lack of interest in quitting. After delivering IVR messages targeting these reported barriers, 32% of the smokers reporting low self-efficacy and 4.8% of those reporting lack of interest in quitting re-engaged in a new QL treatment cycle. Conclusion: Proactive IVR outreach is a promising tool to engage low income, relapsed smokers back into a new cycle of treatment. Integration of IVR intervention for recycling smokers with previous QL treatment has the potential to decrease tobacco-related disparities. Trial registration: ClinicalTrials.gov Identifier: NCT01260597. © 2012 Carlini et al.; licensee BioMed Central Ltd.


Zbikowski S.M.,Alere Wellbeing | Magnusson B.,Alere Wellbeing | Pockey J.R.,Medical Center Blvd | Tindle H.A.,University of Pittsburgh | Weaver K.E.,Medical Center Blvd
Maturitas | Year: 2012

Objectives: Cigarette smoking poses substantial health risks at any age, but is particularly dangerous for older smokers, who are already at heightened risk for various health conditions. Studies suggest that older smokers are motivated to quit and succeed, but few of these have been randomized controlled trials. There is a need to systematically evaluate the research on effective interventions in older smokers. Methods: We followed PRISMA guidelines in the development of this systematic review, which included randomized controlled trials of cessation interventions with smokers aged 50 or older. Results: We found 740 unique titles matching specified search criteria; 13 met final eligibility criteria. Nearly all the cessation treatments combined counseling with other strategies. Eight studies provided smoking cessation medications. None of the studies used newer forms of technology such as web- or text-based interventions. Nine of the 13 studies reported a significant intervention effect at one or more time points, with three studies reporting sustained treatment effects at 12 mos or longer. In general, more intensive interventions and those with combined approaches including medications and follow-up counseling achieved the best outcomes. Conclusion: The quit rates from these studies and the relative effectiveness of different intervention approaches are consistent with the general smoking cessation literature. However, in most studies, treatment effects were of short duration, and absolute quit rates were low, leaving the vast majority of older smokers at high risk for smoking-related health conditions. This systematic review suggests a need for additional research to design and test future interventions specifically tailored for older smokers. © 2011 Elsevier Ireland Ltd.


Bush T.,Alere Wellbeing | Levine M.D.,University of Pittsburgh | Beebe L.A.,University of Oklahoma | Cerutti B.,Alere Wellbeing | And 5 more authors.
American Journal of Health Promotion | Year: 2012

Purpose. To evaluate the effectiveness of a cognitive behavioral treatment (CBT) addressing cessation-related weight concerns delivered via a tobacco quitline that does not address weight concerns. Design. Randomized controlled trial, blinded 6-month follow-up. Setting. The Oklahoma Tobacco Helpline (OKHL). Subjects. All 7998 smokers who called the OKHL were screened; 4240 were eligible; 2000 were randomized to the standard quitline (STD) or the brief version of the CBT weight concerns program (WCP). Intervention. Telephone counseling to help people quit smoking and address concerns about cessation-related weight gain. Measures. Demographics, weight, tobacco status, weight concerns, self-efficacy in quitting, and quitting without weight gain. Analysis. Descriptive statistics and logistic regression. Results. Of those randomized, 1002 participants completed the 6-month survey (response rates = 53.2% for STD, 47% for WCP). Compared with STD, WCP led to reduced weight concerns (p < .01) and less weight gain among quitters (1.8 vs. 23.4 pounds; p = .01). Although not significant, participants in the WCP were more likely to report 30-day abstinence (33.3% vs. 36.8%, p = .24; intent to treat = 17.7 vs. 17.3). Conclusion. The WCP was successfully delivered via a quitline and resulted in improved attitudes about weight and decreased cessation-related weight gain without harming quit rates. Promotion of a quitline focused on addressing weight in conjunction with quitline treatment for smoking cessation may improve cessation and weight outcomes. Study limitations include use of self-report and survey response. Copyright © 2012 by American Journal of Health Promotion, Inc.

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