Effectiveness of a Multi-Level Smoking Cessation Program for High-Risk Women in Rural Communities

Purpose

This phase IV trial examines the effectiveness of a multi-level smoking cessation program for high-risk women in rural communities. Cigarette smoking is a major risk factor for cervical cancer in women. Rural primary care practices and providers often lack the electronic health record support to pre-identify smokers for services, as well as lack the necessary counseling training and access to comprehensive cessation programs. Implementing evidence-based smoking cessation programs in rural Appalachia may decrease the rates of cigarette smoking and as a result decrease the rates of cervical cancer.

Condition

  • Tobacco-Related Carcinoma

Eligibility

Eligible Ages
Between 18 Years and 64 Years
Eligible Genders
All
Accepts Healthy Volunteers
Yes

Criteria

Inclusion Criteria:

- HEALTH SYSTEM/CLINIC

- Based in one of the Appalachian regions included in this program project

- Provides care to female smokers

- PROVIDER

- Practicing in one of the participating health systems

- Involved in patient care

- PATIENT

- Females

- Age 18 to 64

- Smokers who consume at least 5 cigarettes per day (less than the minimum in most
cessation studies, yet still enough to show signs of nicotine dependence)

- Ready to quit smoking in the next 6 months

- English-speaking

- Able to participate in counseling

- Willing to try smoking cessation pharmacotherapy

- Not pregnant

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Prevention
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Arm I (early arm) 		Providers undergo training over 60 minutes to explain the Break Free program and basics of quitting smoking during months 13-24. Female smokers interested in quitting in the next 6 months will be referred to an in-person counseling session at the clinic. Participants then receive 4 phone counseling over 15-20 minutes with a trained tobacco treatment specialist.
  • Other: Survey Administration
    Ancillary studies
  • Other: Tobacco Cessation Counseling
    Receive referred to counseling session
  • Other: Tobacco Cessation Counseling
    Receive phone counseling
  • Other: Training
    Undergo training
    Other names:
    • Training Programs
Active Comparator
Arm II (delayed arm) 		Female smokers receive usual care during months 13-24. Providers undergo training over 60 minutes to explain the Break Free program and basics of quitting smoking during months 25-36. Female smokers interested in quitting in the next 6 months will be referred to an in-person counseling session at the clinic. Participants then receive 4 phone counseling over 15-20 minutes with a trained tobacco treatment specialist.
  • Other: Best Practice
    Receive usual care
    Other names:
    • standard of care
    • standard therapy
  • Other: Survey Administration
    Ancillary studies
  • Other: Tobacco Cessation Counseling
    Receive referred to counseling session
  • Other: Tobacco Cessation Counseling
    Receive phone counseling
  • Other: Training
    Undergo training
    Other names:
    • Training Programs

Recruiting Locations

More Details

NCT ID
NCT04340531
Status
Active, not recruiting
Sponsor
Ohio State University Comprehensive Cancer Center

Detailed Description

PRIMARY OBJECTIVES: I. Determine the effectiveness of a core component of an integrated cervical cancer prevention program designed to help female smokers quit by standardizing clinical practice supports and protocols. (Service outcomes) II. Determine satisfaction with the multilevel intervention. (Client outcomes) III. Test the sustainability of the multilevel intervention via training of providers and staff on counseling and billing for evidence-based smoking cessation services. (Implementation outcomes) OUTLINE: IMPLEMENTATION OF TOBACCO-USER IDENTIFICATION SYSTEM: Clinics and systems develop and implement minimally required electronic tracking and reporting systems for identification of smokers during months 1-12. GROUP RANDOMIZED TRIAL: Providers and participants are randomized to 1 of 2 arms. ARM I (EARLY ARM): Providers undergo training over 60 minutes to explain the Break Free program and basics of quitting smoking during months 13-24. Female smokers interested in quitting in the next 6 months will be referred to an in-person counseling session at the clinic. Participants then receive 4 phone counseling over 15-20 minutes with a trained tobacco treatment specialist. ARM II (DELAYED ARM): Female smokers receive usual care during months 13-24. Providers undergo training over 60 minutes to explain the Break Free program and basics of quitting smoking during months 25-36. Female smokers interested in quitting in the next 6 months will be referred to an in-person counseling session at the clinic. Participants then receive 4 phone counseling over 15-20 minutes with a trained tobacco treatment specialist.