Tobacco Use Clinical Trial
Official title:
Enhancing Smoker Utilization of the Minnesota Quitline Through Support Persons
This study will develop an intervention for adults who want to support a smoker. The goal of the intervention is for the support person to motivate & encourage their smoker to call the state Quitline funded by Minnesota ClearWay. The study will examine the efficacy of a telephone based intervention for support persons compared to a self-help intervention (written materials only).
To have the greatest impact on the public health, interventions need to reach as large a
proportion of the smoking population as possible. A significant science base now exists that
demonstrates the effectiveness of tobacco quitlines. While the provision of telephone
counseling has improved the reach of treatment services to smokers, research is needed to
enhance their utilization or reach. In 2001, ClearWay Minnesota (formerly known as MPAAT
[Minnesota Partnership for Action Against Tobacco) funded the QUITPLAN Helpline, a
telephone-based tobacco cessation counseling service for Minnesotans. Consistent with
findings from other quitlines, the QUITPLAN Helpline has reached only 1.5% of smokers in
Minnesota. Nonsmokers have a substantial potential role in tobacco control efforts. They
represent 82% of the adult population of Minnesota. A novel approach to increasing smoker
utilization of effective cessation services is by focusing on nonsmokers who want to help a
smoker, i.e., support persons or proxies. Numerous studies provide evidence for the role of
extra-treatment social support in smoking cessation. The current study builds on our
previous work which indicated the feasibility and potential efficacy of directly recruiting
and providing intervention for support persons. Cohen?s theory of social support and health
is the conceptual basis for the proposed intervention.
In the first phase of this study, we will pilot the intervention to obtain support person
feedback in refining the telephone counseling and other study procedures. We will recruit 30
nonsmoking adult support persons for the pilot to complete the 3-session telephone
counseling intervention. Assessments will be completed by mail at baseline and week 4. In
phase 2, after refining the intervention, we will use a randomized, two-group design to
examine the effect of a 3-session telephone-based intervention versus a self-help
intervention (written materials) for nonsmoking adult support persons on increasing their
smokers? utilization of the ClearWay Minnesota funded QUITPLAN Helpline. Repeated mailed
assessments will be completed by support persons at baseline (week 0) and follow-up at weeks
4 and 26. This study, funded by ClearWay Minnesota, addresses their funding priority area to
?Increase the Availability and Use of Individual Cessation Services.? The Primary Aims of
phase 2 are (1) To determine if providing the telephone-based intervention for nonsmoking
adult support persons results in a greater proportion of their smokers who call the QUITPLAN
Helpline compared to the self-help intervention over the 26 week study period; and (2) To
compare treatment groups on change in supportive behaviors provided (Support Provided
Measure score) from baseline to week 4. Secondary Aims are to compare the smoker's readiness
to quit and utilization of cessation service in the two groups.
We will recruit 564 (30 phase 1, 534 phase 2) nonsmoking adult support persons throughout
the entire state of Minnesota using mass media and outreach approaches. They must be
interested in supporting a current cigarette smoker who is 18 years of age or older and a
resident of Minnesota. In phase 2, support persons will be randomly assigned to receive
written self-help materials only (N=237; control group) or to receive the same written
materials plus three, 15-20minute telephone-based sessions (N=237; experimental group)
stratified according to whether or not the support person lives in the same residence as
their smoker. The written materials will be mailed to the support person?s home. These
materials will include a QUITPLAN Helpline toll-free number developed specifically for this
study and a study reference code that reflects the support person's group assignment and
includes the support person?s study ID number (e.g., BLUE 012) that the smoker should
provide to the QUITPLAN Helpline intake staff if and when he/she decides to call. The
primary dependent variable will be the proportion of support persons? smokers who call the
QUITPLAN Helpline anytime during the interval from randomization through week 26, documented
by the QUITPLAN Helpline intake staff. (using the study reference code).
The chi-square test will be used to examine treatment differences on the proportion of
support persons whose smokers called the QUITPLAN Helpline at least once between
randomization into the study and week 26 (Primary Aim 1). Additionally, the two groups will
be compared on the time of the smoker?s first call using the Kaplan-Meier method with a log
rank test. Support persons whose smoker does not call the Helpline will be censored at week
26. The mean change in Support Provided Measure total score at weeks 4 and 26 will be
compared between treatment groups using a two-sample t-test (Primary Aim 2). For each
dependent variable, a secondary analysis, using logistic regression or analysis of
covariance as appropriate, will be performed to assess treatment effects adjusting for any
baseline characteristics that are found to differ between groups.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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