Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-30T17:30:25.807Z Has data issue: false hasContentIssue false

A Proactive Telephone-Delivered Risk Communication Intervention for Smokers Participating in Lung Cancer Screening: A Pilot Feasibility Trial

Published online by Cambridge University Press:  07 September 2017

Steven B. Zeliadt*
Affiliation:
Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington Department of Health Services, School of Public Health, University of Washington, Seattle, Washington
Preston A. Greene
Affiliation:
Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
Paul Krebs
Affiliation:
New York Harbor VA Health Care System, New York, New York School of Medicine, New York University, New York, New York
Deborah E. Klein
Affiliation:
Swedish Medical Group, Seattle, Washington
Laura C. Feemster
Affiliation:
Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington Division of Pulmonary and Critical Care Medicine, University of Washington, Washington, Seattle
David H. Au
Affiliation:
Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington Division of Pulmonary and Critical Care Medicine, University of Washington, Washington, Seattle
Christopher G. Slatore
Affiliation:
Center to Improve Veteran Involvement in Care, Health Services Research & Development, Portland VA Medical Center, Portland, Oregon Division of Pulmonary & Critical Care Medicine, Oregon Health & Science University, Portland, Oregon
Jaimee L. Heffner
Affiliation:
Tobacco & Health Behavior Science Research Group, Fred Hutchinson Cancer Research Center, Seattle, Washington
*
Address for correspondence: Steven Zeliadt, PhD, VA HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, 1660 S. Columbian Way (S-152), Seattle WA 98108. Email: szeliadt@uw.edu

Abstract

Introduction: Many barriers exist to integrating smoking cessation into delivery of lung cancer screening including limited provider time and patient misconceptions.

Aims: To demonstrate that proactive outreach from a telephone counsellor outside of the patient's usual care team is feasible and acceptable to patients.

Methods: Smokers undergoing lung cancer screening were approached for a telephone counselling study. Patients agreeing to participate in the intervention (n = 27) received two telephone counselling sessions. A 30-day follow-up evaluation was conducted, which also included screening participants receiving usual care (n = 56).

Results/Findings: Most (89%) intervention participants reported being satisfied with the proactive calls, and 81% reported the sessions were helpful. Use of behavioural cessation support programs in the intervention group was four times higher (44%) compared to the usual care group (11%); Relative Risk (RR) = 4.1; 95% CI: 1.7 to 9.9), and seven-day abstinence in the intervention group was double (19%) compared to the usual care group (7%); RR = 2.6; 95% CI: 0.8 to 8.9).

Conclusions: This practical telephone-based approach, which included risk messages clarifying continued risks of smoking in the context of screening results, suggests such messaging can boost utilisation of evidence-based tobacco treatment, self-efficacy, and potentially increase the likelihood of successful quitting.

Type
Original Articles
Copyright
Copyright © The Author(s) 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Biener, L., & Abrams, D. B. (1991). The Contemplation Ladder: Validation of a measure of readiness to consider smoking cessation. Health psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 10 (5), 360365.Google Scholar
Centers for Medicare and Medicaid Services. (2015). Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) (CAG-00439N) (No. CAG-00439N). Retrieved from: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274Google Scholar
Clark, M. M., Cox, L., Jett, J. R., Patten, C. A., Schroeder, D. R., Nirelli, L. M. et al. (2004). Effectiveness of smoking cessation self-help materials in a lung cancer screening population. Lung Cancer, 44 (1), 1321.Google Scholar
Etter, J. F., & Sutton, S. (2002). Assessing “stage of change” in current and former smokers. Addiction (Abingdon, England), 97 (9), 11711182.Google Scholar
Ferketich, A. K., Otterson, G. A., King, M., Hall, N., Browning, K. K., & Wewers, M. (2012). A pilot test of a combined tobacco dependence treatment and lung cancer screening program. Lung Cancer, 76 (2), 211215.Google Scholar
Ferketich, A., Khan, Y., & Wewers, M. (2006). Are physicians asking about tobacco use and assisting with cessation? Results from the 2001–2004 national ambulatory medical care survey (NAMCS). Preventive medicine, 43 (6), 472476.Google Scholar
Fucito, L. M., Czabafy, S., Hendricks, P. S., Kotsen, C., Richardson, D., & Toll, B. A. (2016). Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the association for the treatment of tobacco use and dependence and the society for research on nicotine and tobacco. Cancer, 122 (8), 11501159.Google Scholar
Gore, T. D., & Bracken, C. (2005). Testing the theoretical design of a health risk message: Reexamining the major tenets of the extended parallel process model. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 32 (1), 2741.Google Scholar
Hung, D. Y., Leidig, R., & Shelley, D. R. (2014). What's in a setting?: Influence of organizational culture on provider adherence to clinical guidelines for treating tobacco use. Health Care Management Review, 39 (2), 154.Google Scholar
Jamal, A., Dube, S. R., Malarcher, A. M., Shaw, L., & Engstrom, M. C. (2012). Tobacco use screening and counseling during physician office visits among adults–National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005–2009. MMWR Morbidity and Mortality Weekly Report Supplements, 61 (2), 3845.Google Scholar
Joyce, G. F., Niaura, R., Maglione, M., Mongoven, J., Larson-Rotter, C., Coan, J. et al. (2008). The effectiveness of covering smoking cessation services for Medicare beneficiaries. Health Services Research, 43 (6), 21062123.Google Scholar
Kinsinger, L., Anderson, C., Kim, J., Larson, M., Chan, S., King, H. et al. (2017). Implementation of lung cancer screening in the veterans health administration. JAMA Internal Medicine, 177 (3), 399406.Google Scholar
Kleinman, L. C., & Norton, E. C. (2009). What's the risk? A simple approach for estimating adjusted risk measures from nonlinear models including logistic regression. Health Services Research, 44 (1), 288302.Google Scholar
Marshall, H. M., Courtney, D. A., Passmore, L. H., McCaul, E. M., Yang, I. A., Bowman, R. V. et al. (2016). Brief tailored smoking cessation counseling in a lung cancer screening population is feasible: A pilot randomized controlled trial. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 18 (7), 16651669.Google Scholar
Miller, W. R., & Rollnick, S. (2002). Motivational Interviewing, Second Edition: Preparing People to Change. New York: The Guilford Press, pp. 111–139.Google Scholar
Moyer, A., Finney, J., Swearingen, C., & Vergun, P. (2002). Brief interventions for alcohol problems: A meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction (Abingdon, England), 97 (3), 279292.Google Scholar
Moyer, V., & Force, P. (2013). Screening for lung cancer: U.S. Preventive services task force recommendation statement. Annals of Internal Medicine, 160 (5), 330338.Google Scholar
Munafo, M. R., & Wileyto, E. P. (2015). Guidelines on statistical reporting at nicotine & tobacco research. Nicotine & Tobacco Research, 17 (11), 12951296.Google Scholar
Ostroff, J., Copeland, A., Borderud, S., Li, Y., Shelley, D., & Henschke, C. (2015). Readiness of lung cancer screening sites to deliver smoking cessation treatment: Current practices, organizational priority, and perceived barriers. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 18 (5), 10671075.Google Scholar
Park, E. R., Gareen, I. F., Japuntich, S., Lennes, I., Hyland, K., DeMello, S. et al. (2015). Primary care provider-delivered smoking cessation interventions and smoking cessation among participants in the national lung screening trial. JAMA Internal Medicine, 175 (9), 15091516.Google Scholar
Piñeiro, B., Simmons, V., Palmer, A., Correa, J., & Brandon, T. (2016). Smoking cessation interventions within the context of low-dose computed tomography lung cancer screening: A systematic review. Lung Cancer, 98, 9198.Google Scholar
Rounsaville, B. J., Carroll, K. M., & Onken, L. S. (2001). A stage model of behavioral therapies research: Getting started and moving on from stage 1. Clinical Psychology: Science and Practice, 8 (2), 142.Google Scholar
Slatore, C. G., Baumann, C., Pappas, M., & Humphrey, L. L. (2014). Smoking behaviors among patients receiving computed tomography for lung cancer screening. Systematic review in support of the U.S. Preventive Services Task Force. Annals of the American Thoracic Society, 11 (4), 619627.Google Scholar
Solberg, L., Maciosek, M., Edwards, N., Khanchandani, H., & Goodman, M. (2006). Repeated Tobacco-Use Screening and Intervention in Clinical Practice Health Impact and Cost Effectiveness. American Journal of Preventive Medicine, 31 (1), 6271.e3.Google Scholar
Taylor, K., Hagerman, C., Luta, G., Bellini, P., Stanton, C., Abrams, D. et al. (2017). Preliminary evaluation of a telephone-based smoking cessation intervention in the lung cancer screening setting: A randomized clinical trial. Lung Cancer, 108, 242246.Google Scholar
Van der Aalst, C. M., de Koning, H. J., van den Bergh, K., Willemsen, M. C., & van Klaveren, R. J. (2012). The effectiveness of a computer-tailored smoking cessation intervention for participants in lung cancer screening: A randomised controlled trial. Lung Cancer, 76 (2), 204210.Google Scholar
Volk, R. J., Linder, S. K., Leal, V. B., Rabius, V., Cinciripini, P. M., Kamath, G. R. et al. (2014). Feasibility of a patient decision aid about lung cancer screening with low-dose computed tomography. Preventive Medicine, 62, 6063.Google Scholar
Witte, K. (1994 [published online 2009]). Fear control and danger control: A test of the extended parallel process model (EPPM). Communications Monographs, 61 (2), 113134.Google Scholar
Zeliadt, S. B., Heffner, J. L., Sayre, G., Klein, D. E., Simons, C., Williams, J. et al. (2015). Attitudes and perceptions about smoking cessation in the context of lung cancer screening. JAMA Internal Medicine, 175 (9), 15301537.Google Scholar