University of Minnesota, 1100 S. Washington Ave., Minneapolis, MN 55415, USA; Minnesota Department of Health, 85 East 7th Place, St. Paul, MN 55164, USA.
Minnesota Department of Health, 85 East 7th Place, St. Paul, MN 55164, USA.
Prev Med. 2019 Dec;129:105867. doi: 10.1016/j.ypmed.2019.105867. Epub 2019 Oct 18.
Improved strategies and scalable interventions to engage low-socioeconomic status (SES) smokers in tobacco treatment are needed. We tested an intervention designed to connect low-SES smokers to treatment services, implemented through Minnesota's National Breast and Cervical Cancer Early Detection Program (Sage) in 2017; the trial was designed to last 3 months (July through October). Participants were female smokers who were 250% below the federal poverty level (randomized N = 3723; analyzed N = 3365). Using a factorial design, participants were randomized to six intervention groups consisting of a proactive call (no call vs call) and/or a financial incentive offered for being connected to treatment services ($0 vs $10 vs $20). Simple randomization was conducted using Stata v.13. All individuals received direct mail. Participants and staff were blinded to allocation. The outcome was connection via phone to QUITPLAN Services®, Minnesota's population-based cessation services. Groups that received $10 or $20 incentives had higher odds of treatment engagement compared to the no incentive group [respectively, OR = 1.94; 95% CI (1.19-3.14); OR = 2.18; 95% CI (1.36-3.51)]. Individuals that received proactive calls had higher odds of treatment engagement compared to individuals not called [OR = 1.59; 95% CI (1.11-2.29)]. Economic evaluation revealed that the $10 incentive, no call group had the best cost-benefit ratio compared to the no incentive, no call group. Direct mail with moderate incentives or proactive calling can successfully encourage connections to population-based tobacco treatment services among low-SES smokers. The intervention could be disseminated to similar programs serving low-SES populations. This trial is registered at ClinicalTrials.gov (NCT03760107).
需要改进策略和可扩展的干预措施,以吸引社会经济地位较低(SES)的吸烟者接受烟草治疗。我们测试了一种干预措施,旨在通过明尼苏达州的全国乳腺癌和宫颈癌早期检测计划(Sage)将 SES 较低的吸烟者与治疗服务联系起来,该计划于 2017 年实施;该试验旨在持续 3 个月(7 月至 10 月)。参与者为女性吸烟者,其收入低于联邦贫困线 250%(随机分组 N=3723;分析 N=3365)。采用析因设计,参与者随机分为六组干预组,包括主动电话联系(不联系与联系)和/或提供与治疗服务联系的经济奖励(无奖励、10 美元奖励、20 美元奖励)。使用 Stata v.13 进行简单随机分组。所有个体均收到直邮。参与者和工作人员对分组情况不知情。结局是通过电话与 QUITPLAN Services®(明尼苏达州基于人群的戒烟服务)建立联系。与无奖励组相比,获得 10 美元或 20 美元奖励的组更有可能接受治疗[分别为,OR=1.94;95%CI(1.19-3.14);OR=2.18;95%CI(1.36-3.51)]。与未接到电话的个体相比,接到电话的个体更有可能接受治疗[OR=1.59;95%CI(1.11-2.29)]。经济评估显示,与无奖励、不打电话组相比,10 美元奖励、不打电话组具有最佳的成本效益比。带有适度奖励或主动电话联系的直邮可以成功鼓励 SES 较低的吸烟者与基于人群的烟草治疗服务建立联系。该干预措施可推广到为 SES 较低人群服务的类似项目中。该试验在 ClinicalTrials.gov 注册(NCT03760107)。