Worksite Phone Counseling for Smoking Cessation

Study Overview
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Brief Summary
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Social support is poorly understood but likely to influence outcomes of behavior change efforts. Social support may take a directive or nondirective approach. In directive support, the person attempting a behavior change is told what to do and even what to think. In nondirective support, the person attempting the behavior change decides what to discuss. In some contexts, interactions of race or income with social support have been reported. This is a randomized controlled trial of directive and nondirective coaching in the context of a smoking quitline offered to employees of two large corporations.

Detailed Description
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BACKGROUND Given the association of smoking with low socioeconomic status, the potential of telephone counseling for smoking cessation to reach diverse audiences needs evaluation. In addition, different approaches to counseling have not been systematically examined, and may differentially affect reach, retention, and success. PURPOSE To describe employee participation and outcomes in a trial of two counseling styles for telephone-based smoking cessation support. APPROACH Employees and spouses of two large organizations are invited to participate in a trial of a telephone quitline. Participants are randomized to one of two coaching styles. A protocol-driven (Directive) coaching approach follows a script for each of seven calls over 9 weeks. A participant-centered (Nondirective) coaching approach allowed smokers to select topics of interest, with prompting by the coach as needed. A computer assisted telephone interview program and database provide topics in correct sequence for directive coaching, allow coaches to indicate topics during nondirective coaching, and track time spent on topics in both conditions. PREDICTOR VARIABLES Demographics, smoking history and conventional self-reported measures of nicotine dependence, smoking urges, preference for patient-centric care, and depression are collected at baseline. OUTCOMES The primary outcome measure is self-reported abstinence from smoking for 7 days at the time of last follow up, 6 or 12 months after baseline assessment. ANALYSES Interactions of Race and Income with coaching approach are analyzed. Based on results with asthma patients, a positive interaction of low income with nondirective coaching is tested.

Official Title
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Worksite Phone Counseling for Smoking Cessation

Conditions
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Smoking Cessation

Intervention / Treatment
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* Behavioral: Nondirective smoking cessation coaching
* Behavioral: Directive smoking cessation coaching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Smoking employee or spouse in contemplation, action, or recently entering maintenance stage of change English speaking Exclusion Criteria: Smoker in precontemplation stage of change

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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Directive<br>Participants receive up to 7 directive smoking cessation coaching telephone calls from the quitline over 9 weeks. | Behavioral: Directive smoking cessation coaching<br>* Quitline coach follows a pre-specified agenda for each call, and does not allow participant to deviate from the agenda.<br>|
| Experimental: Nondirective<br>Participants receive up to 7 nondirective smoking cessation coaching telephone calls from the quitline over 9 weeks. | Behavioral: Nondirective smoking cessation coaching<br>* Quitline coach allows participant to set agenda for each call.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Smoking Abstinence for 7 Days at Last Contact | By self report, the participant has smoked no cigarettes in the past 7 days on the date of last post-intervention assessment, which occurs 6 to 12 months after enrollment. | 6-12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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social support, Directive coaching, Nondirective coaching, smoking cessation quitline