Medicaid-insured Client Characteristics and Quit Outcomes at the Arizona Smokers' Helpline.
Friday, May 21, 2021
Posted by: Natalia Gromov
Brady BR, O'Connor PA,
Martz MP, Grogg T, Nair US.
Medicaid-insured Client
Characteristics and Quit Outcomes at the Arizona Smokers' Helpline.
J Behav Health Serv Res. 2021 May 4. doi: 10.1007/s11414-021-09756-2. Epub
ahead of print. PMID: 33948874.
Medicaid-insured individuals who smoke experience disparities in quitting and
are a priority population for assistance. This retrospective cohort study of
Arizona Smokers' Helpline clients (Jan 2014-Mar 2019) examined the association
between insurance status, treatment, and smoking cessation. When compared to
clients with non-Medicaid insurance or no insurance, clients with Medicaid
(26%) were more likely to be female, referred directly to the ASHLine by a
healthcare or community partner, smoke in the home, and report having a mental
health condition. They also were less likely to utilize cessation medication
and reported receiving less social support to quit. Controlling for these and
other theoretically relevant variables, insurance status was stratified (Medicaid,
non-Medicaid, and uninsured), and quit outcomes were compared by level of
treatment (4 treatment groups: more and less than 3 coaching sessions and
cessation medication use yes/no). Compared to clients who received 3+ coaching
sessions, those who had less than 3 coaching sessions had significantly lower
adjusted odds of quitting. Results were similar regardless of cessation
medication use or insurance status. There is no indication that treatment
effects differ by insurance status. While insurance status appears to proxy for
other important factors like low social and economic status and higher
comorbidity prevalence, in a quitline setting, quitting is associated with
additional, high-quality coaching. Where coaching sessions may offset social
and economic barriers to quitting, quitlines may consider focusing on assisting
Medicaid-insured clients to connect and engage with treatment.
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