Department of Internal Medicine, University of California, Davis, Sacramento, California.
Department of Public Health Sciences, University of California, Davis, Sacramento, California.
Am J Prev Med. 2018 Dec;55(6 Suppl 2):S159-S169. doi: 10.1016/j.amepre.2018.07.031.
Little is known about how incentives may encourage low income smokers to call for quitline services. This study evaluates the impact of outreach through health channels on California Medicaid (Medi-Cal) quitline caller characteristics, trends, and reach.
Longitudinal study.
SETTING/PARTICIPANTS: Medi-Cal quitline callers.
Statewide outreach was conducted with health providers, Medi-Cal plans (all-household mailings with tracking codes), and public health organizations (March 2012-July 2015). For incentives, Medi-Cal callers could ask for a $20 gift card; in September 2013, callers were offered free nicotine patches.
Caller characteristics were compared with chi-square analyses, joinpoint analysis of call trends was performed accounting for Medi-Cal population growth, referral source among Medi-Cal and non-Medi-Cal callers was documented, and the annual percentage of the population reached who called the Helpline was calculated. Analyses were conducted 2016-2018.
Total Medi-Cal callers were 92,900, a 70% increase from prior annual averages: 12.4% asked for the financial incentive, 17.3% reported the mailing code, and 73.3% received nicotine patches while offered. Among the two thirds of callers who completed counseling, 15.5% asked for the financial incentive, and 13.6% reported the mailing code. A joinpoint analysis showed call trends increased 23% above expected for the Medi-Cal population growth after mailings to providers and members began, and decreased after outreach ended. Annual reach increased from 2.3% (95% CI=2.1, 2.6) in 2011 to peak at 4.5% (95% CI=3.6, 5.3) in 2014. Among subgroups with higher reach rates, some also had higher rates of asking for the financial incentive (African Americans, American Indian), reporting the tracking code (whites), or both (aged 45-64 years). Medi-Cal callers were more likely than non-Medi-Cal callers to report providers (32.3% vs 23.8%) and plans (19.7% vs 1.4%) as their referral source, and less likely to cite media (20.2% vs 44.4%, p<0.001).
Statewide outreach through health channels incentivizing Medi-Cal members increased the utilization and reach of quitline services.
This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.
关于激励措施如何鼓励低收入吸烟者拨打戒烟热线，人们知之甚少。本研究评估了通过健康渠道进行外展对加利福尼亚医疗补助（Medi-Cal）戒烟热线呼叫者特征、趋势和覆盖范围的影响。
纵向研究。
设置/参与者：Medi-Cal 戒烟热线呼叫者。
向医疗服务提供者、Medi-Cal 计划（所有家庭邮件，并附有跟踪码）和公共卫生组织（2012 年 3 月至 2015 年 7 月）进行了全州范围的外展。对于激励措施，Medi-Cal 呼叫者可以要求获得 20 美元的礼品卡；2013 年 9 月，呼叫者可获得免费尼古丁贴片。
通过卡方分析比较呼叫者特征，对 Medi-Cal 人口增长进行呼叫趋势的联合点分析，记录 Medi-Cal 和非 Medi-Cal 呼叫者的转介来源，并计算每年拨打 Helpline 的人口比例。分析于 2016-2018 年进行。
Medi-Cal 呼叫者总数为 92900 人，比之前每年的平均水平增长了 70%：12.4%的人要求获得经济激励，17.3%的人报告了邮件代码，73.3%的人在提供时获得了尼古丁贴片。在完成咨询的三分之二的呼叫者中，15.5%的人要求获得经济激励，13.6%的人报告了邮件代码。联合点分析显示，自向提供者和成员发送邮件后，呼叫趋势比 Medi-Cal 人口增长高出 23%，而在外展结束后，呼叫趋势下降。年覆盖率从 2011 年的 2.3%（95%CI=2.1，2.6）增加到 2014 年的峰值 4.5%（95%CI=3.6，5.3）。在覆盖率较高的亚组中，一些人也有更高的要求获得经济激励（非裔美国人、美国印第安人）、报告跟踪代码（白人）或两者兼有的比例（45-64 岁）。与非 Medi-Cal 呼叫者相比，Medi-Cal 呼叫者更有可能报告提供者（32.3%对 23.8%）和计划（19.7%对 1.4%）是他们的转介来源，而不太可能引用媒体（20.2%对 44.4%，p<0.001）。
通过健康渠道进行全州范围的外展，激励 Medi-Cal 成员，增加了戒烟热线服务的利用率和覆盖范围。
本文是题为“推进加利福尼亚医疗补助计划中的戒烟工作”的增刊的一部分，该增刊由加利福尼亚州公共卫生部赞助。
