Reaching out, inviting back

Using Interactive voice response (IVR) technology to recycle relapsed smokers back to Quitline treatment - A randomized controlled trial

Beatriz H. Carlini, Anna M. McDaniel, Michael T. Weaver, Ross M. Kauffman, Barbara Cerutti, Renée M. Stratton, Susan M. Zbikowski

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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.

Original languageEnglish
Article number507
JournalBMC Public Health
Volume12
Issue number1
DOIs
StatePublished - 2012

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Randomized Controlled Trials
Technology
Recycling
Self Efficacy
Therapeutics
Control Groups
Smoking
Tobacco Use Disorder
Tobacco
Logistic Models
Education

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Reaching out, inviting back : Using Interactive voice response (IVR) technology to recycle relapsed smokers back to Quitline treatment - A randomized controlled trial. / Carlini, Beatriz H.; McDaniel, Anna M.; Weaver, Michael T.; Kauffman, Ross M.; Cerutti, Barbara; Stratton, Renée M.; Zbikowski, Susan M.

In: BMC Public Health, Vol. 12, No. 1, 507, 2012.

Research output: Contribution to journalArticle

Carlini, Beatriz H. ; McDaniel, Anna M. ; Weaver, Michael T. ; Kauffman, Ross M. ; Cerutti, Barbara ; Stratton, Renée M. ; Zbikowski, Susan M. / Reaching out, inviting back : Using Interactive voice response (IVR) technology to recycle relapsed smokers back to Quitline treatment - A randomized controlled trial. In: BMC Public Health. 2012 ; Vol. 12, No. 1.
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abstract = "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.",
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AU - Stratton, Renée M.

AU - Zbikowski, Susan M.

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