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Topics
- Behavioral Health (1)
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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 5 of 5 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