Interpersonal Communication and Smoking Cessation in the Context of an Incentive-Based Program: Survey Evidence From a Telehealth Intervention in a Low-Income Population

Abstract

The tobacco epidemic disproportionately affects low-income populations, and telehealth is an evidence-based strategy for extending tobacco cessation services to underserved populations. A public health priority is to establish incentive-based interventions at the population level in order to promote long-term smoking cessation in low-income populations. Yet randomized clinical trials show that financial incentives tend to encourage only short-term steps of cessation, not continuous smoking abstinence. One potential mechanism for increasing long-term cessation is interpersonal communication (IPC) in response to population-level interventions. However, more research is needed on IPC and its influence on health behavior change, particularly in the context of incentive-based, population-level programs. This study used survey data gathered after a population-level telehealth intervention that offered $20 incentives to low-income smokers for being connected to Minnesota’s free quitline in order to examine how perceived incentive importance and IPC about the incentive-based program relate to both short-term and long-term health behavior change. Results showed that IPC was strongly associated with initial quitline utilization and continuous smoking abstinence as measured by 30-day point prevalence rates at 7-month follow-up. Perceived incentive importance had weak associations with both measures of cessation, and all associations were nonsignificant in models adjusting for IPC. These results were found in descriptive analyses, logistic regression models, and Heckman probit models that adjusted for participant recruitment. In sum, a behavioral telehealth intervention targeting low-income smokers that offered a financial incentive inspired IPC, and this social response was strongly related to utilization of intervention services as well as continuous smoking abstinence.

An interpersonal nutrition campaign and maternal knowledge and childhood feeding practices: a case study from mothers in rural Indonesia

“…And in others, IPC may be used as a tool to deconstruct messages communicated elsewhere. In this case, IPC may act as a moderator and mediator of other information sources, for example, media [20,21] and then be a functional agent for behavior change [22,23] In a study conducted in Nepal, an IPC intervention that involved dialogue groups to discuss information gathered elsewhere and was then effective at shaping attitudes and perceptions about reproductive health topics [24]. Some messages communicated to broad audiences may be in generic, impersonal tones (e.g., a brief television segment) that has an impact on knowledge acquisition, especially with repeated exposures.…”

Behavioral change in response to a statewide tobacco tax increase and differences across socioeconomic status

“…These complementary programs should consider using media that encourages quit attempts (e.g., the “TIPS” campaign; see McAfee et al, 2013), as well as provide resources and access to cessation services (Keller et al, 2015; Slater et al, 2016; Haas et al, 2015). Programs could also attempt to alter multilevel and social processes that influence tobacco-related disparities (Twyman et al, 2014), as well as harness processes that are inherent in the quitting process such as social support and social contexts that provide pro-change mechanisms (Parks et al, 2016; Kingsbury et al, 2016). Since mechanisms that underlie the relationship between low-SES and smoking status include stress, social networks, neighborhood effects, and limited access to health education materials (Pampel et al, 2010), complementary programs need to address these multilevel risk factors through media, easily accessible counseling, and free cessation services.…”

Project reach: Piloting a risk-tailored smoking cessation intervention for lung screening

“…There is also cost-effectiveness of increased smoking cessation in the CT screening context (Evans and Wolfson, 2011). Smoking cessation programs that coincide with lung cancer screening are likely to produce better smoking cessation success rates and increase motivation to quit than just CT screening alone (Davis et al, 2015; Parks et al, 2016). Correspondingly, undergoing screening may enhance abstinence motivation and quitting among current smokers and may prevent relapse among former smokers (Tammemagi et al, 2014).…”

“…Patients may have a lung cancer screening CT ordered as part of an annual visit with their primary care provider, or even outside of a visit, and screenings are performed at a later time and could be done at several locations (Davis et al, 2015). There are also several options for discussing lung screening results (Parks et al, 2016). Capturing patients for tobacco cessation services when they are navigating this process can be challenging because of the diversity of patient flow through the system (An et al, 2006; Battaglia et al, 2016; Mak et al, 2015; Parks et al, 2016).…”