A Proactive Outreach Strategy Using a Local Area Code to Refer Unassisted Smokers in a Safety Net He
Thursday, January 19, 2023
Posted by: Natalia Gromov
Valencia CV, Dove MS, Cummins
SE, Kirby C, Zhu SH, Giboney P, Yee HF, Tu SP, Tong EK.
A Proactive Outreach
Strategy Using a Local Area Code to Refer Unassisted Smokers in a Safety Net
Health System to a Quitline: A Pragmatic Randomized Trial.
Nicotine Tob Res. 2023 Jan 1;25(1):43-49. doi: 10.1093/ntr/ntac156. PMID:
36103393; PMCID: PMC9717369.
Introduction: Proactive
outreach offering tobacco treatment is a promising strategy outside of clinical
settings, but little is known about factors for engagement. The study objective
is to examine the impact of caller area code in a proactive, phone-based
outreach strategy on consenting low-income smokers to a quitline e-referral.
Aims and methods: This
pragmatic randomized trial included unassisted adult smokers (n = 685), whose
preferred language was English or Spanish, in a Los Angeles safety-net health
system. Patients were randomized to receive a call from a local or generic
toll-free area code. Log-binomial regression was used to examine the
association between area code and consent to a quitline e-referral, adjusted
for age, gender, language, and year.
Results: Overall,
52.1% of the patients were contacted and, among those contacted, 30% consented
to a referral. The contact rate was higher for the local versus generic area
code, although not statistically significant (55.6% vs. 48.7%, p = .07). The
consent rate was higher in the local versus generic area code group (adjusted
prevalence ratio 1.29, 95% CI 1.01-1.65) and also higher for patients under 61
years old than over (adjusted prevalence ratio 1.47, 95% CI 1.07-2.01), and
Spanish-speaking than English-speaking patients (adjusted prevalence ratio
1.40, 95% CI 1.05-1.86).
Conclusions: Proactive
phone-based outreach to unassisted smokers in a safety net health system
increased consent to a quitline referral when local (vs. generic) area codes
were used to contact patients. While contact rate did not differ by area code,
proactive phone-based outreach was effective for engaging younger and
Spanish-speaking smokers.
Implications: Population-based
proactive phone-based outreach from a caller with a local area code to
unassisted smokers in a safety net health system increases consent to an
e-referral for quitline services. Findings suggest that a proactive phone-based
outreach, a population-based strategy, is an effective strategy to build on the
visit-based model and offer services to tobacco users, regardless of the
motivational levels to quit.
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