Smoking Cessation E-Visit

Study Overview
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Brief Summary
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The goal of this study is to develop, refine, and complete preliminary feasibility testing of a smoking cessation electronic visit (e-visit) for implementation in primary care/family medicine. The investigators will conduct a feasibility RCT (N=51) of the smoking cessation e-visit as compared to treatment as usual (TAU), delivered via primary care, with primary objective to provide effect size estimates for a larger RCT. Primary outcomes cluster around: 1) treatment feasibility, 2) treatment acceptability, 3) treatment satisfaction, 4) evidence-based cessation treatment utilization, and 5) cessation-related outcomes (quit attempt incidence, abstinence). It is hypothesized that participants randomized to the e-visit condition as compared to those randomized to the TAU condition will have higher rates of cessation treatment utilization (medications, counseling) and superior cessation-related outcomes.

Official Title
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Development and Testing of a Smoking Cessation E-Visit for Implementation in Primary Care

Conditions
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Smoking

Intervention / Treatment
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* Behavioral: Smoking cessation e-visit
* Behavioral: Treatment As Usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: current smoking, defined as smoking 5+ cigarettes/day, for 20+ days out of the last 30, for the last 6+ months age 18+ enrolled in Epic's MyChart program or willing to sign up for MyChart possess a valid e-mail address that is checked daily to access follow-up assessments and MyChart messages English fluency Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Smoking cessation electronic visit (e-visit)<br>This group will be sent 1) an invitation to complete an electronic visit (e-visit) focused on cigarette smoking and 2) an invitation to complete a follow-up e-visit one-month after the initial e-visit. | Behavioral: Smoking cessation e-visit<br>* electronic visits (e-visits) for smoking cessation<br>|
| Active Comparator: Treatment As Usual<br>This group will be provided information about the state quitline and about the importance of quitting smoking and it will be recommended that they contact their PCP to schedule a medical visit to discuss quitting smoking. | Behavioral: Treatment As Usual<br>* Information about the state quitline and about the importance of quitting smoking and a recommendation to contact one's PCP to schedule a medical visit to discuss quitting smoking<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Who Utilized Smoking Cessation Treatment | Number of participants who utilized smoking cessation treatment since last assessment. | Month 1 | 
| Number of Participants Who Utilized Smoking Cessation Treatment | Number of participants who utilized smoking cessation treatment since last assessment. | Month 3 | 
| Cigarettes Smoking | Cigarettes per day reduction greater than 50% | Month 1 | 
| Cigarettes Smoking | Cigarettes per day reduction greater than 50% | Month 3 | 
| Quit Attempts | Quit attempts since last contact | Month 1 | 
| Quit Attempts | Quit attempts since last contact | Month 3 | 
| 24-hour Quit Attempt | Quit attempt lasting 24 hours since last contact | Month 1 | 
| 24-hour Quit Attempt | Quit attempt lasting 24 hours since last contact | Month 3 | 
| Seven-day Point Prevalence Abstinence | Participant has not had a cigarette in the past 7 days | Month 1 | 
| Seven-day Point Prevalence Abstinence | Participant has not had a cigarette in the past 7 days | Month 3 | 
| Floating Abstinence | Participant has gone 7+ days without a cigarette since last contact. | Month 1 | 
| Floating Abstinence | Participant has gone 7+ days without a cigarette since last contact. | Month 3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| E-visit Completion | Number of participants that completed the e-visit | Month 1 | 
| Provider Fidelity | Reviewing within Epic whether the provider administered treatment consistent with e-visit recommendations | Month 1 | 
| E-visit Ease of Use | Participants reported Agree or Strongly Agree to finding the e-visit easy to use question | Month 1 | 
| Time to Complete the E-visit | Time (days) to complete the e-visit among participants that completed the e-visit. | Month 1 |