An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial
Year: 2022
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: This study tested the preliminary effectiveness of an electronic health record (EHR)-automated population health management (PHM) intervention for smoking cessation among adult patients of a federally qualified health center in Chicago. Participants (N = 190; 64.7% women, 82.1% African American/Black, 8.4% Hispanic/Latino) were self-identified as smokers, as documented in the EHR, who completed the baseline survey of a longitudinal "needs assessment of health behaviors to strengthen health programs and services." Four weeks later, participants were randomly assigned to the PHM intervention (N = 97) or enhanced usual care (EUC; N = 93). PHM participants were mailed a single-page self-determination theory (SDT)-informed letter that encouraged smoking cessation or reduction as an initial step. The letter also addressed low health literacy and low income. PHM participants also received automated text messages on days 1, 5, 8, 11, and 20 after the mailed letter. Two weeks after mailing, participants were called by the Illinois Tobacco Quitline. EUC participants were e-referred following a usual practice. Participants reached by the quitline were offered behavioral counseling and nicotine replacement therapy. Outcome assessments were conducted at weeks 6, 14, and 28 after the mailed letter. Primary outcomes were treatment engagement, utilization, and self-reported smoking cessation. In the PHM arm, 25.8% of participants engaged in treatment, 21.6% used treatment, and 16.3% were abstinent at 28 weeks. This contrasts with no quitline engagement among EUC participants, and a 6.4% abstinence rate. A PHM approach that can reach all patients who smoke and address unique barriers for low-income individuals may be a critical supplement to clinic-based care.
DOI: 10.1093/tbm/ibac026
Authors: Brian Hitsman, Phoenix A Matthews, George D Papandonatos, Kenzie A Cameron, Sarah S Rittner, Nivedita Mohanty, Timothy Long, Ronald T Ackermann, Edgardo Ramirez, Jeremy Carr, Emmanuel Cordova, Cherylee Bridges, Crystal Flowers-Carson, Aida Luz Giachello, Andrew Hamilton, Christina C Ciecierski, Melissa A Simon
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: National Institutes of Health, Agency for Healthcare Research and Quality, University of Illinois at Chicago, Robert H. Lurie Comprehensive Cancer Center, National Cancer Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences
Awards: G2639496168, G2786289396, 1/3: The Chicago Cancer Health Equity Collaborative (ChicagoCHEC), G3830332521, Northwestern University Clinical and Translational Science Institute (NUCATS), G7065848802, G815100389, CENTER FOR ADVANCING EQUITY IN CLINICAL PREVENTIVE SERVICES, G9000060301, G9000106374, Chicago Center for Diabetes Translation Research
OpenAlex ID: W4303418608