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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedHitsman B, Matthews PA, Papandonatos GD B, Matthews PA, Papandonatos GD
An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.
The purpose of this study was to test the initial effectiveness of an electronic health record (EHR)-automated population health management (PHM) intervention for smoking cessation among adult patients. The researchers included 190 participants from a federally qualified health center in Chicago who self-identified as smokers as documented in the electronic health records and who completed a longitudinal "needs assessment of health behaviors to strengthen health programs and services” baseline survey. Participants were then randomly assigned to the PHM intervention (N=97) or the enhanced usual care (EUC) group (N=93). Primary outcomes were treatment engagement, utilization, and self-reported smoking cessation. In the PHM group, 25.8% of participants engaged in treatment, 21.6% used treatment, and 16.3% were abstinent at 28 weeks. There was no engagement of the quitline among EUC participants, and an abstinence rate of 6.4%. The researchers concluded that a PHM approach that can address unique barriers for low-income individuals may be an important addition to clinic-based care.
AHRQ-funded; HS021141.
Citation: Hitsman B, Matthews PA, Papandonatos GD B, Matthews PA, Papandonatos GD .
An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.
Transl Behav Med 2022 Oct 7;12(9):892-99. doi: 10.1093/tbm/ibac026..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Tobacco Use, Tobacco Use: Smoking Cessation, Low-Income
Senft Everson N, Klein WMP, Lee SS
Dispositional optimism and optimistic bias: associations with cessation motivation, confidence, and attitudes.
This study tested whether 2 conceptually overlapping constructs, dispositional optimism (generalized positive expectations) and optimistic bias (inaccurately low risk perceptions), may have different implications for smoking treatment engagement. A cohort of predominantly Black, low-income Southern Community Cohort study smokers (n=880) were surveyed on their dispositional optimism and pessimism, comparative lung cancer risk, and information to calculate objective lung cancer risk. Perceived risk was categorized as accurate, optimistically-biased, or pessimistically-biased. The Life Orientation Test-Revised subscales was used with 0 = neutral, and 12 = high optimism/pessimism. Mean dispositional optimism/pessimism scores were 8.41 and 5.65 respectively. Perceived lung cancer risk was 38% accurate, with 27% optimistically-biased and 35% pessimistically-biased. Accuracy was unrelated to dispositional optimism, though optimistically biased smokers had higher dispositional pessimism. Dispositional optimism was associated with higher confidence and favorable precision treatment attitudes. Lower motivation and less favorable precision treatment attitudes were shown for those with optimistically-biased (vs. accurate) risk perception.
AHRQ-funded; HS02612.
Citation: Senft Everson N, Klein WMP, Lee SS .
Dispositional optimism and optimistic bias: associations with cessation motivation, confidence, and attitudes.
Health Psychol 2022 Sep;41(9):621-29. doi: 10.1037/hea0001184..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Behavioral Health
Kowitt SD, Goldstein AO, Cykert S
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
This study investigated the outcomes of an evidence-based cardiovascular disease risk reduction tool called Heart Health Now to improve rates for tobacco cessation screening and counseling in small primary care practices in North Carolina. This tool was developed as part of AHRQ’s EvidenceNow initiative. This stepped wedge, stratified, cluster randomized trial looked at 28 practices that were staffed by 10 or fewer clinicians and had an electronic health record. Heart Health Now consisted of education tools, onsite practice facilitation for a year, and a practice-specific cardiovascular population management dashboard that included monthly, measure-specific run charts to help guide quality improvement. The practices included in their analyses consisted of 78,120 patients, and 17,687 smokers. From pre- to post-intervention, screening rates significantly increased from 82.7 to 96.2%. Cessation support rates also significantly increased from 44.3% to 50.1%. Some of the practices associated with improvement included being in an academic health center or faculty, having more clinicians, and having a lower percentage of White patients.
AHRQ-funded; HS023912.
Citation: Kowitt SD, Goldstein AO, Cykert S .
A heart healthy intervention improved tobacco screening rates and cessation support in primary care practices.
J Prev 2022 Jun;43(3):375-86. doi: 10.1007/s10935-022-00672-5..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Screening, Primary Care, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions
Schnitzer K, Senft N, Tindle HA
Understanding engagement behaviors and rapport building in tobacco cessation telephone counseling: an analysis of audio-recorded counseling calls.
This study explored smokers’ and counselors’ engagement and rapport-building behaviors in telephone counseling for smoking cessation and patterns of these behaviors by smokers’ psychiatric symptoms. The study transcribed audio-recorded counseling calls among recently hospitalized participants enrolled in a smoking cessation randomized controlled trial (RCT). The study used baseline RCT data to explore frequencies of smokers’ behaviors among smokers who reported more symptoms of depression (PHQ8 ≥ 10) or anxiety (GAD7 ≥ 10) at study entry. A total of 37 participants were included, who were mostly female (23), White (26), with a median age of 58. At study entry many participants experienced moderate-to-severe symptoms of depression (18/37) and anxiety (22/37). Counselor-led behaviors included building off priority interaction, empathy, normalizing challenges, reframing and summarizing, validating achievements, and expressing shared experiences. Participant-led engagement behaviors occurred more often among patients with higher baseline depression and anxiety symptoms compared to those with lower symptom scores.
AHRQ-funded; HS026122.
Citation: Schnitzer K, Senft N, Tindle HA .
Understanding engagement behaviors and rapport building in tobacco cessation telephone counseling: an analysis of audio-recorded counseling calls.
J Subst Abuse Treat 2022 Apr;135:108643. doi: 10.1016/j.jsat.2021.108643..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Patient and Family Engagement, Lifestyle Changes
Dorilas E, Hill SC, Pesko MF
AHRQ Author: Hill SC
Tobacco surcharges associated with reduced ACA marketplace enrollment.
Researchers used 2014-19 administrative data on enrollees in the federally facilitated Affordable Care Act Marketplace, HealthCare.gov, to examine the relationships among surcharge rates, total Marketplace enrollment, and enrollment by tobacco users. They found that the tobacco surcharge rate was associated with lower total enrollment as well as a reduced share of total enrollees who reported any tobacco use. Further, tobacco surcharges have a significantly larger effect on tobacco users' share of enrollment in rural areas than in urban areas, which may contribute to urban-rural health disparities.
AHRQ-authored.
Citation: Dorilas E, Hill SC, Pesko MF .
Tobacco surcharges associated with reduced ACA marketplace enrollment.
Health Aff 2022 Mar;41(3):398-405. doi: 10.1377/hlthaff.2021.01313..
Keywords: Tobacco Use, Policy, Health Insurance
Elkhadragy N, Corelli RL, Russ AL
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Researchers conducted a long-term, qualitative follow-up study of faculty participants in the Rx for Change: Clinician-Assisted Tobacco Cessation workshop. All study participants reported implementing components of Rx for Change at their institution. The researchers’ analysis yielded eight major themes pertaining to faculty perceptions and experiences with implementation. They found that participation in the train-the-trainer workshop increased self-reported confidence for teaching tobacco cessation, and faculty valued access to useful, updated tools for teaching. Furthermore, the newly-acquired counseling skills were deemed helpful for treating patients' tobacco use and dependence in clinical practice.
AHRQ- funded; HS022119.
Citation: Elkhadragy N, Corelli RL, Russ AL .
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Res Social Adm Pharm 2019 Dec;15(12):1436-45. doi: 10.1016/j.sapharm.2019.01.005..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Education: Continuing Medical Education
Maclean JC, Pesko MF, Hill SC
AHRQ Author: Hill SC
Public insurance expansions and smoking cessation medications.
The authors examined public insurance expansion on use of smoking cessation medications. The Affordable Care Act expanded coverage of these medications with financing with Medicaid. Data was analyzed from retail and online pharmacies from 2011 to 2017, and the expansion increased smoking cessation prescriptions by 24% in new medication use.
AHRQ-authored.
Citation: Maclean JC, Pesko MF, Hill SC .
Public insurance expansions and smoking cessation medications.
Econ Inq 2019 Oct;57(4):1798-820. doi: 10.1111/ecin.12794..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Health Insurance, Medication, Substance Abuse, Medicaid
Senft N, Sanderson M, Selove R
Attitudes toward precision treatment of smoking in the Southern Community Cohort Study.
Precision interventions using biological data may enhance smoking treatment, yet are understudied among smokers who are disproportionately burdened by smoking-related disease. In this study, the investigators surveyed smokers in the NCI-sponsored Southern Community Cohort Study, consisting primarily of African-American, low-income adults. The researchers concluded that among disproportionately burdened community smokers, most held favorable attitudes toward precision smoking treatment.
AHRQ-funded; HS026122.
Citation: Senft N, Sanderson M, Selove R .
Attitudes toward precision treatment of smoking in the Southern Community Cohort Study.
Cancer Epidemiol Biomarkers Prev 2019 Aug;28(8):1345-52. doi: 10.1158/1055-9965.Epi-19-0179..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Substance Abuse, Social Determinants of Health, Cancer: Lung Cancer, Cancer
Chu KH, Colditz J, Malik M
Identifying key target audiences for public health campaigns: leveraging machine learning in the case of hookah tobacco smoking.
Current social media platforms provide researchers with opportunities to better identify and target specific audiences and even individuals. However, the investigators were not aware of systematic research attempting to identify audiences with mixed or ambivalent views toward hookah tobacco smoking (HTS). The objective of their study was to (1) confirm previous research showing positively skewed HTS sentiment on Twitter using a larger dataset by leveraging machine learning techniques and (2) systematically identify individuals who exhibit mixed opinions about HTS via the Twitter platform and therefore represent key audiences for intervention.
AHRQ-funded; HS022989.
Citation: Chu KH, Colditz J, Malik M .
Identifying key target audiences for public health campaigns: leveraging machine learning in the case of hookah tobacco smoking.
J Med Internet Res 2019 Jul 8;21(7):e12443. doi: 10.2196/12443..
Keywords: Health Promotion, Public Health, Social Media, Tobacco Use, Tobacco Use: Smoking Cessation
Kalkhoran S, Thorndike AN, Rigotti NA
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
This study compared current smoking and quitting-related characteristics of low-income US adults with and without serious mental illness (SMI) who received healthcare at federally funded health centers. Using data from the Health Center Patient Survey, researchers concluded that the lower quit ratio in the SMI population suggests that advice alone is unlikely to be sufficient. They recommend augmented strategies to promote smoking cessation and to reduce the excess burden of tobacco-related disease in patients with SMI.
AHRQ-funded; HS025378.
Citation: Kalkhoran S, Thorndike AN, Rigotti NA .
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
J Gen Intern Med 2019 Jun;34(6):986-91. doi: 10.1007/s11606-019-04857-3..
Keywords: Behavioral Health, Lifestyle Changes, Low-Income, Tobacco Use, Vulnerable Populations
Schnall R, Carcamo J, Porras T
Use of the phase-based model of smoking treatment to guide intervention development for persons living with HIV who self-identify as African American tobacco smokers.
To address the issue of developing effective tobacco cessation interventions for persons with HIV, this study conducted six focus group sessions with 45 African American smokers who are living with HIV in order to understand barriers to smoking cessation and strategies to help overcome these barriers. The participants articulated key components for incorporation into tobacco cessation intervention: personalized plans for quitting, reminders about the plan, and a support system. Participants also described barriers to use of pharmacotherapy, such as adverse side effects of nicotine gum and patch, and expressed concerns about negative health effects of some oral medications. The authors conclude that their findings provide information on the components of a tobacco cessation intervention for persons living with HIV.
AHRQ-funded; HS025071.
Citation: Schnall R, Carcamo J, Porras T .
Use of the phase-based model of smoking treatment to guide intervention development for persons living with HIV who self-identify as African American tobacco smokers.
Int J Environ Res Public Health 2019 May 15;16(10). doi: 10.3390/ijerph16101703..
Keywords: Human Immunodeficiency Virus (HIV), Primary Care: Models of Care, Racial and Ethnic Minorities, Tobacco Use, Tobacco Use: Smoking Cessation
Gianfrancesco MA, Trupin L, Shiboski S
Smoking is associated with higher disease activity in rheumatoid arthritis: a longitudinal study controlling for time-varying covariates.
Prior studies around the relationship between smoking and rheumatoid arthritis (RA) disease activity have reported inconsistent findings, which may be ascribed to heterogeneous study designs or biases in statistical analyses. In this study, the investigators examined the association between smoking and RA outcomes using statistical methods that account for time-varying confounding and loss to followup. They found that smoking was associated with higher levels of disease activity in RA.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Trupin L, Shiboski S .
Smoking is associated with higher disease activity in rheumatoid arthritis: a longitudinal study controlling for time-varying covariates.
J Rheumatol 2019 Apr;46(4):370-75. doi: 10.3899/jrheum.180262..
Keywords: Arthritis, Tobacco Use
Iyer AS, Holm KE, Bhatt SP
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
This study compared the frequency of anxiety/depressive symptoms of current and former smokers with and without COPD and their use of anxiolytic-hypnotics/antidepressants. A cohort of 5331 current/former smokers were surveyed. About 25% of smokers with and without COPD had anxiety/depressive symptoms. Unmedicated smokers tended to be African American, male, have no health insurance, have severe-very severe COPD and higher respiratory symptoms/exacerbation history.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Holm KE, Bhatt SP .
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
J Psychosom Res 2019 Mar;118:18-26. doi: 10.1016/j.jpsychores.2019.01.002..
Keywords: Anxiety, Medication, Respiratory Conditions, Depression, Behavioral Health, Anxiety, Tobacco Use
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Chu KH, Escobar-Viera CG, Matheny SJ
Tobacco cessation mobile app intervention (Just Kwit! study): protocol for a pilot randomized controlled pragmatic trial.
The aims of this pilot study were to assess the impact on tobacco cessation of using a smartphone app compared with usual care and to generate feasibility data to inform a future fully powered clinical trial. The authors suggest that data generated by this study can be used for larger fully powered trials such as comparative effectiveness studies against apps developed by academics or health scientists based on behavioral theories, or cost-effectiveness analyses of mobile interventions.
AHRQ-funded; HS022989.
Citation: Chu KH, Escobar-Viera CG, Matheny SJ .
Tobacco cessation mobile app intervention (Just Kwit! study): protocol for a pilot randomized controlled pragmatic trial.
Trials 2019 Feb 26;20(1):147. doi: 10.1186/s13063-019-3246-2..
Keywords: Health Information Technology (HIT), Patient-Centered Outcomes Research, Tobacco Use, Young Adults
Forster M, Amy GL, Areba E
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
The authors investigated whether internal assets (IAs), factors that promote healthy youth development, can mitigate the adverse effects of psychosocial risks on tobacco use. Their results indicated that every additional psychosocial risk factor was associated with an increase in the odds of using tobacco and in the estimated number of products used. IAs were inversely associated with tobacco use and attenuated the association between cumulative psychosocial risks and use. They concluded that bolstering resilience by facilitating students' IAs represents a promising direction for youth-focused prevention efforts.
AHRQ-funded; HS022236.
Citation: Forster M, Amy GL, Areba E .
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
Addict Behav 2019 Feb;89:240-47. doi: 10.1016/j.addbeh.2018.10.014..
Keywords: Tobacco Use, Children/Adolescents, Risk, Education
Livingston CJ, Freeman RJ, Costales VC
AHRQ Author: Niebuhr DW
Electronic nicotine delivery systems or e-cigarettes: American College of Preventive Medicine's practice statement.
E-cigarettes or or electronic nicotine delivery systems (ENDS) have rapidly gained popularity in the U.S. Controversy exists about the safety and efficacy of ENDS. This paper describes the American College of Preventive Medicine's Prevention Practice Committee’s consensus-based evidence review process to develop a practice statement for the American College of Preventive Medicine.
AHRQ-authored
Citation: Livingston CJ, Freeman RJ, Costales VC .
Electronic nicotine delivery systems or e-cigarettes: American College of Preventive Medicine's practice statement.
Am J Prev Med 2019 Jan;56(1):167-78. doi: 10.1016/j.amepre.2018.09.010.
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Keywords: Guidelines, Prevention, Substance Abuse, Tobacco Use