Support person interventions to increase use of quitline services among racially diverse low-income smokers: A pilot study

Abstract

Introduction Social support from nonsmokers may have a role in prompting smokers to use evidence-based cessation treatment. Prior studies found that an intervention for nonsmoking support persons (SPs) was effective for promoting smokers' use of free, state quitline services. This pilot study adapted and assessed feasibility of this intervention for a racially diverse, low-income population. Methods Single group, non-randomized design enrolling SP-smoker dyads with low income status enrolled in one of three study “waves” of 10 pairs each. Participants were recruited using flyers and in-person outreach methods. The SP intervention included a 1-session coaching call and written materials; study waves 2 and 3 also included text messaging and a monetary incentive for smokers who used quitline services. Using content analysis, the intervention was iteratively adapted based on SP feedback. Baseline measures assessed socio-demographics, dyad and tobacco use characteristics. Follow-up assessments were conducted among SPs at 1-month follow-up and among smokers at 3-months follow-up. Feasibility indicators were recruitment, retention, and SP intervention acceptability and adherence. Secondary outcomes were smokers' use of any quitline service verified by quitline staff and 7-day, point prevalence, biochemically verified smoking abstinence at 3 months. Results Recruitment of 30 dyads was feasible; in-person recruitment methods were the most successful. SPs who completed follow-up assessments found the intervention acceptable, suggesting only minor content modifications, and they perceived the quitline information as novel. But the study had some feasibility challenges (e.g., SP coaching call completion: 60% and SP study retention: 53%). At 3 months, 2 smokers (7%) had used any quitline service and 13% were biochemically confirmed smoking abstinent. Conclusions This pilot study demonstrated feasibility of recruiting SP-smoker dyads from diverse, low-income communities. While the intervention was well received, its delivery was not feasible in this population. Results suggest that further consumer adaptation of the intervention is needed among both SPs and smokers.

The Barriers and Facilitators of eHealth-Based Lifestyle Intervention Programs for People With a Low Socioeconomic Status: Scoping Review

“…In the various stages of the development and evaluation of the intervention (ie, problem definition, development, and implementation for the study) [ 48 , 50 , 59 , 60 , 64 , 66 , 69 , 70 , 84 ], several studies involved stakeholders, which included family members, experts, key informants [ 50 , 61 , 69 , 75 , 84 , 86 ], health professionals, and end users [ 48 , 54 , 64 - 66 , 68 - 70 , 73 , 75 , 83 ]. However, some studies provided little information on the identification of stakeholders and did not clarify the level of involvement of stakeholders and end users [ 37 , 44 , 50 , 56 , 66 , 70 , 78 , 79 , 81 , 83 , 87 ]. The studies used multiple methods, such as interviews, focus groups, and user testing [ 50 , 54 , 57 , 64 - 70 , 73 , 75 , 83 ], to gain insights from end users and stakeholders.…”

“…Studies adapted these interventions and the delivery modality for use in different low SES groups. Nevertheless, many studies retained most of the content and components of the existing interventions [ 45 , 56 , 57 , 61 , 70 , 72 , 77 , 79 , 81 , 87 ]. Many studies chose to adapt the content of the intervention and apply linguistic and content simplification, such as using plain language and low content load through the use of images and videos [ 57 , 61 , 70 , 81 , 86 , 87 ].…”

“…Nevertheless, many studies retained most of the content and components of the existing interventions [ 45 , 56 , 57 , 61 , 70 , 72 , 77 , 79 , 81 , 87 ]. Many studies chose to adapt the content of the intervention and apply linguistic and content simplification, such as using plain language and low content load through the use of images and videos [ 57 , 61 , 70 , 81 , 86 , 87 ]. Some studies also made cultural adaptations by using updated cultural components [ 61 , 86 ], translating the content into a second language (eg, Spanish), and employing bilingual coaches [ 61 , 86 ].…”

A Digital Cancer Ecosystem to Deliver Health and Psychosocial Education as Preventive Intervention

“…They propose, among others, that eHealth intervention should suit the day-to-day of the person, have personal communication, and adapt it to literacy level and life situation. In this regard, there are other studies that detail the importance of coaches in studies with participants with low SES [ 30 , 33 , 34 ]. In our sample, we have not seen differences by sociodemographic variables between users and non-users, of the educational campus (level 2).…”

Targeting Nonsmokers to Help Smokers Quit: Features of a Large-scale Intervention

“…11,18,19 However, when it comes to quit attempts and sustained cessation in particular, interventions encouraging nonsmoker support for smokers have not shown consistent results, [20][21][22] and evidence for effective ways to activate nonsmokers to intervene and to provide appropriate support is scant. 11,23 In fact, some actions by nonsmokers such as "nagging" can decrease cessation efforts by smokers, producing the opposite effect from that intended. 24,25 Most smokers say that quitting is difficult.…”