住院部出院的退伍军人吸烟者志愿者电话戒烟后续咨询的评估与成本：一项准实验性混合方法研究
Evaluation and costs of volunteer telephone cessation follow-up counseling for Veteran smokers discharged from inpatient units: a quasi-experimental, mixed methods study.
作者信息
Duffy Sonia A, Ewing Lee A, Louzon Samantha A, Ronis David L, Jordan Neil, Harrod Molly
机构信息
Ohio State University, College of Nursing, Columbus, USA ; Ann Arbor VA Center for Clinical Management Research, Health Services Research and Development, P.O. Box 130170, Ann Arbor, MI 48113-0170 USA ; University of Michigan, Department of Psychiatry, Ann Arbor, USA.
Ann Arbor VA Center for Clinical Management Research, Health Services Research and Development, P.O. Box 130170, Ann Arbor, MI 48113-0170 USA.
出版信息
Tob Induc Dis. 2015 Feb 5;13(1):4. doi: 10.1186/s12971-015-0028-9. eCollection 2015.
BACKGROUND
The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to evaluate the volunteer telephone smoking cessation counseling follow-up program implemented as part of the inpatient Tobacco Tactics intervention in a Veterans Affairs (VA) hospital.
METHODS
This was a quasi-experimental, mixed methods design that collected data through electronic medical records (EMR), observations of telephone smoking cessation counseling calls, interviews with staff and Veterans involved in the program, and intervention costs.
RESULTS
Reach: Of the 131 Veterans referred to the smoking cessation telephone follow-up program, 19% were reached 0-1 times, while 81% were reached 2-4 times. Effectiveness: Seven-day point-prevalence 60-day quit rates (abstracted from the EMR) for those who were reached 2-4 times were 26%, compared to 8% among those who were reached 0-1 times (p = 0.06). Sixty-day 24-hour point-prevalence quit rates were 33% for those reached 2-4 times, compared to 4% of those reached 0-1 times (p < 0.01). Adoption and Implementation: The volunteers correctly followed protocol and were enthusiastic about performing the calls. Veterans who were interviewed reported positive comments about the calls. The cost to the hospital was $21 per participating Veteran, and the cost per quit was $92. Maintenance: There was short-term maintenance (about 1 year), but the program was not sustainable long term.
CONCLUSIONS
Quit rates were higher among those Veterans that had greater participation in the calls. Joint Commission standards for inpatient smoking with follow-up calls are voluntary, but should these standards become mandatory, there may be more motivation for VA administration to institute a hospital-based, volunteer telephone smoking cessation follow-up program.
TRIAL REGISTRATION
ClinicalTrials.Gov NCT01359371.
背景
采用覆盖范围、有效性、采用情况、实施情况及维持情况（RE-AIM）框架，对作为退伍军人事务部（VA）医院住院烟草策略干预措施一部分实施的志愿者电话戒烟咨询随访项目进行评估。
方法
这是一项准实验性混合方法设计，通过电子病历（EMR）、电话戒烟咨询通话观察记录、对参与该项目的工作人员及退伍军人的访谈以及干预成本收集数据。
结果
覆盖范围：在被转介至戒烟电话随访项目的131名退伍军人中，19%被联系0 - 1次，而81%被联系2 - 4次。有效性：被联系2 - 4次者的7天点患病率60天戒烟率（从电子病历中提取）为26%，相比之下，被联系0 - 1次者为8%（p = 0.06）。被联系2 - 4次者的60天24小时点患病率戒烟率为33%，而被联系0 - 1次者为4%（p < 0.01）。采用及实施情况：志愿者正确遵循方案，且对进行通话充满热情。接受访谈的退伍军人对通话给予了积极评价。医院为每位参与的退伍军人花费21美元，每例戒烟花费92美元。维持情况：有短期维持（约1年），但该项目无法长期持续。
结论
参与通话次数较多的退伍军人戒烟率更高。联合委员会关于住院患者吸烟及随访电话的标准是自愿性的，但如果这些标准变为强制性，退伍军人事务部管理部门可能会更有动力设立一个基于医院的志愿者电话戒烟随访项目。
试验注册
ClinicalTrials.Gov NCT01359371
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