Cockburn J, Ruth D, Silagy C, Dobbin M, Reid Y, Scollo M, Naccarella L
Centre for Behavioural Research in Cancer, Carlton, Victoria, Australia.
BMJ. 1992 Mar 14;304(6828):691-4. doi: 10.1136/bmj.304.6828.691.
To compare three approaches for marketing a quit smoking intervention kit to general practitioners.
Randomised trial of (a) personal delivery and presentation by an educational facilitator with a follow up visit six weeks later; (b) delivery to the receptionist by a friendly volunteer courier with a follow up phone call six weeks later, or (c) postal delivery with a follow up letter six weeks later.
Melbourne, Australia.
264 randomly selected general practitioners.
A research assistant visited each doctor four months after delivery and measured use of components of the kit. A questionnaire measuring perceptions of aspects of the kit and its delivery was completed by doctors. Costs of each approach were calculated.
Doctors receiving the educational facilitator approach were significantly more likely than those receiving the other two approaches to have seen the kit, to rate the method of delivery as engendering motivation to try the kit, to have used one of the "intensive intervention" components from the kit, to report that they found the kit less complicated, and to report greater knowledge of how to use the kit. There were no significant differences in use of "minimal intervention" components of the kit, ratings of overall acceptability of delivery, perceptions of cultural and structural barriers to using the kit, and ratings of the overall acceptability of the kit. The cost of the educational facilitator approach ($A142/doctor) was 24 times that of the mailed approach. The volunteer courier approach ($A14) was twice the cost of the mailed approach.
Educational facilitators and volunteer couriers do not seem to be cost effective strategies for distributing smoking interventions.
比较向全科医生推广戒烟干预工具包的三种方法。
随机试验,方法包括:(a) 由教育协调员亲自送交并演示,六周后进行随访;(b) 由友善的志愿者信使送交接待员,六周后进行随访电话;(c) 邮寄,六周后寄发随访信。
澳大利亚墨尔本。
随机选取的264名全科医生。
研究助理在送交四个月后拜访每位医生,测量工具包各组件的使用情况。医生完成一份关于对工具包及其送交方式看法的问卷。计算每种方法的成本。
与接受其他两种方法的医生相比,接受教育协调员方法的医生更有可能看过工具包,认为送交方式能激发试用工具包的积极性,使用过工具包中的“强化干预”组件之一,报告称他们觉得工具包不那么复杂,并且对如何使用工具包了解更多。在工具包“最低限度干预”组件的使用、对送交总体可接受性的评分、对使用工具包的文化和结构障碍的看法以及对工具包总体可接受性的评分方面,没有显著差异。教育协调员方法的成本(每位医生142澳元)是邮寄方法的24倍。志愿者信使方法(14澳元)是邮寄方法成本的两倍。
教育协调员和志愿者信使似乎不是分发戒烟干预措施的具有成本效益的策略。