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经济激励和主动呼吁减少社会经济劣势女性的烟草治疗障碍:一项析因随机试验。

Financial incentives and proactive calling for reducing barriers to tobacco treatment among socioeconomically disadvantaged women: A factorial randomized trial.

机构信息

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.

出版信息

Prev Med. 2019 Dec;129:105867. doi: 10.1016/j.ypmed.2019.105867. Epub 2019 Oct 18.

Abstract

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).

摘要

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)。

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