Socioeconomic Disparities in Telephone-Based Treatment of Tobacco Dependence

Varghese, Merilyn; Sheffer, Christine E.; Stitzer, Maxine; Landes, Reid D.; Brackman, S. Laney; Munn, Tiffany

doi:10.2105/ajph.2014.301951

Cited by 21 publications

(25 citation statements)

References 54 publications

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“…For example, those with higher SES have consistently achieved greater rates of long term abstinence compared to those with lower SES following participation in tobacco dependence treatment programs. 67, 75 Therefore, it is not surprising that alternative or enhanced treatments have been suggested for health conditions 19, 39, 74 including LBP 9, 17 that specifically consider the circumstances of patients with low SES. Previous suggestions have also indicated that self-management approaches, particularly those incorporating cognitive behavioral principles, may be more appropriate for higher SES individuals.…”

Section: Discussionmentioning

confidence: 99%

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Beneciuk

Hill

Campbell

et al. 2017

The Journal of Pain

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Identification of patient characteristics influencing treatment outcomes is a top low back pain (LBP) research priority. Results from the STarT Back Trial support the effectiveness of prognostic stratified care for LBP compared to current best care, however patient characteristics associated with treatment response have not yet been explored. The purpose of this secondary analysis was to identify treatment-effect modifiers within the STarT Back Trial at 4 months follow-up (n=688). Treatment response was dichotomized using back-specific physical disability measured by the Roland-Morris Disability Questionnaire (≥7). Candidate modifiers were identified using previous literature and evaluated using logistic regression with statistical interaction terms to provide preliminary evidence of treatment-effect modification. Socioeconomic status (SES) was identified as an effect modifier for disability outcomes (OR = 1.71, P=.028). High SES patients receiving prognostic stratified care were 2.5 times less likely to have a poor outcome compared to low SES patients receiving best current care (OR = 0.40, P=.006). Education level (OR = 1.33, P=.109) and number of pain medications (OR = 0.64, P=.140) met our criteria for effect modification with weaker evidence (0.20>P≥0.05). These findings provide preliminary evidence for SES, education, and number of pain medications as treatment-effect modifiers of prognostic stratified care delivered in the STarT Back Trial. Perspective This analysis provides preliminary exploratory findings about the characteristics of patients who might least likely benefit from targeted treatment using prognostic stratified care for low back pain.

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Section: Discussionmentioning

confidence: 99%

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Beneciuk

Hill

Campbell

et al. 2017

The Journal of Pain

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“…Lower SES groups smoke at 3 to 4 times the prevalence of higher SES groups making tobacco use one of the greatest contributors to health disparities (BRFSS - Centers for Disease Control and Prevention, 2012). While motivation to quit and attempts to quit show no socioeconomic gradient, lower SES groups are less likely to successfully quit once they begin smoking even when provided with a variety of treatments and treatment modalities (Agrawal et al, 2008, Barbeau, Krieger & Soobader, 2004, Centers for Disease Control and Prevention, 2005, Fagan et al, 2007, Ferguson et al, 2005, Kotz & West, 2009, Reid et al, 2010, Trinidad et al, 2011, Wetter et al, 2005a, Sheffer et al, 2012b, Varghese et al, 2014, Kandel, Griesler & Schaffran, 2009). At present, tobacco use is the leading contributor to health disparities in the US and elsewhere, and unlike many other health disparities, tobacco-related cancer health disparities actually appear to be increasing (Jha et al, 2006, Kanjilal et al, 2006, Mokdad et al, 2004).…”

Section: What Is the Extent Of The Ses Gradient Among Important Healtmentioning

confidence: 99%

A Competing Neurobehavioral Decision Systems model of SES-related health and behavioral disparities

Bickel

Moody

Quisenberry

et al. 2014

Preventive Medicine

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We propose that executive dysfunction is an important component relating the socioeconomic status gradient of select health behaviors. We review and find evidence supporting an SES gradient associated with (1) negative health behaviors (e.g., obesity, excessive use of alcohol, tobacco and other substances), and (2) executive dysfunction. Moreover, the evidence supports that stress and insufficient cognitive resources contribute to executive dysfunction and that executive dysfunction is evident among individuals who smoke cigarettes, are obese, abuse alcohol, and use illicit drugs. Collectively these data supports the dual system model of cognitive control, referred to here as the Competing Neurobehavioral Decision Systems hypothesis. The implications of these relationships for intervention and social justice considerations are discussed.

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“…This manual-driven, multicomponent cognitive behavioral treatment for tobacco dependence has been delivered in multiple modalities (i.e., group, individual, and telephone), used in numerous studies [17-20,56-59], and is considered comprehensive, well-established, and consistent with the Public Health Service Clinical Practice Guideline [22]. When delivered in the group treatment modality, the treatment consists of 6 weekly closed-group 60-minute sessions with 5-10 participants.…”

Section: Methodsmentioning

confidence: 99%

“…The research team reviewed conceptual models of socioeconomic and tobacco use disparities [12,25,28,30-35,60] and the findings associated with disparities in tobacco dependence treatment outcomes [17,18,20,58,61,62]. We identified eight modifiable factors associated with socioeconomic disparities that were prominent in both theoretical frameworks and treatment outcome studies: stress and stress management, negative affect regulation, smoking in response to negative affect, delay discounting, locus of control, impulsiveness, smoking policies in the home, and treatment utilization (e.g., medication and session attendance).…”

Section: Methodsmentioning

confidence: 99%

“…While motivation and attempts to quit smoking show few socioeconomic differences, smokers of lower socioeconomic status (SES) are less likely to achieve long term abstinence once they begin smoking [7-15]. Standard evidence-based treatments for tobacco dependence attract lower SES smokers [16-20]; however, there are significant socioeconomic disparities in treatment retention and long-term treatment outcomes even when treatment adherence, clinical, environmental, and demographic factors are accounted for [17-24]. Estimates indicate that the highest SES smokers are at least twice as likely to achieve long-term abstinence as the lowest SES smokers after treatment regardless of treatment modality [18,20].…”

Section: Introductionmentioning

confidence: 99%

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The Process of Adapting the Evidence-Based Treatment for Tobacco Dependence for Smokers of Lower Socioeconomic Status

et al. 2015

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Introduction Tobacco use is the leading cause of preventable death and disease and contributes significantly to socioeconomic health disparities. The prevalence of smoking among individuals of lower socioeconomic status (SES) in the US, many of whom are African American (AA), is three to four times greater than the prevalence of smoking among individuals of higher SES. The disparity in tobacco dependence treatment outcomes between lower and higher SES smokers contributes to tobacco-related health disparities and calls for adapting evidence-based treatment to more fully meet the needs of lower SES smokers. Aims We sought to adapt the evidence-based treatment for tobacco dependence using recommended frameworks for adapting evidence-based treatments. Methods We systematically applied the recommended steps for adapting evidence-based treatments described by Barrera and Castro and Lau. The steps included information gathering, preliminary adaptation design, preliminary adaptation tests, and adaptation refinement. We also applied the PEN-3 Model for incorporating AA values and experiences into treatment approaches and a community-engaged approach. Results/Findings Findings from each step in the process contributed to the results. The final results were incorporated into a revised treatment called the RITCh Study Tobacco Dependence Treatment Manual and Toolkit. Conclusions To our knowledge, this is the first adaptation of evidence-based treatment for tobacco dependence that has systematically applied these recommended frameworks. The efficacy of the treatment to reduce treatment outcome disparities is now being examined in a randomized controlled trial in which the revised treatment is being compared with a standard, individualized cognitive-behavioral approach.

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Socioeconomic Disparities in Telephone-Based Treatment of Tobacco Dependence

Cited by 21 publications

References 54 publications

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

A Competing Neurobehavioral Decision Systems model of SES-related health and behavioral disparities

The Process of Adapting the Evidence-Based Treatment for Tobacco Dependence for Smokers of Lower Socioeconomic Status

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