Mussulman Laura, Ellerbeck Edward F, Cupertino A Paula, Preacher Kristopher J, Spaulding Ryan, Catley Delwyn, Cox Lisa Sanderson, Lambart Leah, Hunt Jamie J, Nazir Niaman, Shireman Theresa, Richter Kimber P
(a)Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, United States.
(c)Peabody College of Education & Human Development, University of Vanderbilt, 230 Appleton Place, Nashville, TN 37203, United States.
Contemp Clin Trials. 2014 Jul;38(2):173-81. doi: 10.1016/j.cct.2014.04.008. Epub 2014 Apr 24.
In rural America cigarette smoking is prevalent, few cessation services are available, and healthcare providers lack the time and resources to help smokers quit. This paper describes the design and participant characteristics of Connect2Quit (C2Q), a randomized control trial (RCT) that tests the effectiveness and cost-effectiveness of integrated telemedicine counseling delivered by 2-way webcams mounted on desktop computers in participant's physician office examining rooms (ITM) versus quitline counseling delivered by telephone in participant's homes (Phone) for helping rural smokers quit.
METHODS/DESIGN: C2Q was implemented in twenty primary care and safety net clinics. Integrated telemedicine consisted of real-time video counseling, delivered to patients in their primary care physician's (PCP) office. Phone counseling, was delivered to patients in their homes. All participants received educational materials and guidance in selecting cessation medications.
The 566 participants were predominantly Caucasian (92%); 9% were Latino. Most (65%) earned <200% of Federal Poverty Level. One out of three lacked home internet access, 40% were not comfortable using computers, and only 4% had been seen by a doctor via telemedicine in the past. Hypertension, chronic lung disease, and diabetes were highly prevalent. Participants smoked nearly a pack a day and were highly motivated to quit.
C2Q is reaching a rural low-income population, with comorbid chronic diseases, that would benefit greatly from quitting smoking. ITM is a good delivery model, which integrates care by holding counseling sessions in the patient's PCP office and keeps the primary care team updated on patients' progress.
NCT00843505.
在美国农村地区，吸烟现象普遍存在，但戒烟服务却很少，医疗保健提供者也缺乏时间和资源来帮助吸烟者戒烟。本文描述了“连接戒烟”（Connect2Quit，C2Q）的设计及参与者特征，这是一项随机对照试验（RCT），旨在测试通过安装在参与者医生办公室检查室台式电脑上的双向网络摄像头提供的综合远程医疗咨询（ITM）与通过电话在参与者家中提供的戒烟热线咨询（电话咨询）相比，帮助农村吸烟者戒烟的有效性和成本效益。
方法/设计：C2Q在20家初级保健和安全网诊所实施。综合远程医疗包括实时视频咨询，在患者的初级保健医生（PCP）办公室提供给患者。电话咨询则在患者家中提供给患者。所有参与者都收到了教育材料以及关于选择戒烟药物的指导。
566名参与者主要为白种人（92%）；9%为拉丁裔。大多数（65%）的收入低于联邦贫困线的200%。三分之一的人家中没有网络接入，40%的人不习惯使用电脑，过去只有4%的人通过远程医疗看过医生。高血压、慢性肺病和糖尿病非常普遍。参与者每天吸烟近一包，并且有很强的戒烟意愿。
C2Q正在接触一个农村低收入人群，他们患有慢性合并症，戒烟将使他们受益匪浅。ITM是一种很好的提供模式，它通过在患者的初级保健医生办公室举行咨询会议来整合护理，并使初级保健团队随时了解患者的进展情况。
NCT00843505。
