Arizona Smokers’ Helpline - AZDHS

2y ago
13 Views
2 Downloads
4.62 MB
14 Pages
Last View : 1m ago
Last Download : 2m ago
Upload by : Adalynn Cowell
Transcription

an affiliate of the University of ArizonaArizona Smokers’ HelplineAnnual ReportFiscal Year 2018Breathing Vitality into theLives of Arizonans throughInquiryInnovationInspirationEnvisioning an Arizona where everyoneachieves a healthy lifestyle.

Arizona Smokers’ HelplineAnnual Report: FY18Table of ContentsI.II.III.IV.V.VI.VII.VIII.IX.Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Community Development . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Public-Private Partnerships (PPP). . . . . . . . . . . . . . . . . . . . . . . 3Communications and Online Interactions. . . . . . . . . . . . . . . 3Client Enrollment and CharacteristicsCall volume and Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . 4Client Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Clinical ServicesUtilization of services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Overall Quit Rates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Research and Evaluation Initiatives. . . . . . . . . . . . . . . . . . . . 8Data Brief - High Quality Coaching Promotes in-Program QuitAttempts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Discussion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10List of Figures and Tables. . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Arizona Smokers’ HelplineAnnual Report: FY18I. Executive SummaryIn FY 2018, expanded service provision, quality control, and advanced technology led our strategic initiatives.Significant effort went into the launch of our new web-based platform (ASHLine 2.0) that allows for moretailored services and metric analysis over time. In addition, we addressed quality control efforts throughrobust training initiatives and service call recording with feedback analysis. To further expand reach andmove toward sustainability, new Public-Private Partnership contracts were also formed and implemented.As we look forward and partner with statewide efforts to increase quit attempts, enhanced use of technologywill allow us to do this by supporting greater client engagement in tobacco behavior change services.Regards,Cynthia Thomson, PhD, RDDirector, Arizona Smokers’ HelplineTotal Calls 19,137-32% from FY2017Total Referrals 8,534Total Enrollments 9,034-21% from FY2017-19% from FY20177-Month Tobacco Quit Rate 38%-1% from FY20171 / ASHLINE ANNUAL REPORT FY2018 Figure 1. Program Highlights

Arizona Smokers’ HelplineAnnual Report: FY18II. Community DevelopmentASHLine’s Community Development Team workswith healthcare and community partners topromote tobacco-related health systems changeacross Arizona. We have built and actively maintainan extensive referral network by training andassisting healthcare providers and communityorganizations to connect their members withASHLine. This year, our primary efforts remainedfocused on providing trainings and technicalassistance to our provider referral network tosupport systems change, including the provisionof trainings on Ask, Advise, Refer (AAR) - a brief,evidence-based intervention. During fiscal year2018 (FY18), we increased the number of providerstrained, delivering 111 trainings across 1,308providers in 87 organizations. We added 173 newpartner organizations into our referral networkand received 8,533 proactive referrals. Similar tolast year, the top three referring sectors were acutecare hospitals (28%), behavioral health clinics(20%), and medical practices (16%) (See Figure 2).Figure 2. Referrals by Location Type0Corrections/Probation/Re-Entry 22Work-site 81818HIV/AIDS Specialist1822Public-Private Partnership Contract303942Other Specialist5973Well-Woman Health Check (WWHP)8796Dental/Oral Health Practice202School/University226241Health Insurance Plan7871041Medical Practice139617272369Hospital-Acute Care050010001500200025002 / ASHLINE ANNUAL REPORT FY2018 31IHS/Tribal 638/Native American/American Indian

Arizona Smokers’ HelplineAnnual Report: FY18Table 1. Percent of Referrals Reached and Enrolled by Top Five Location TypesTop Five Location TypesPercent ReachedPercent Enrolled64%63%50%64%73%24%30%15%30%37%Hospital, Acute CareMedical PracticeBehavioral HealthFederally Qualified Health Center (FQHC)/FQHC Look-AlikeHealth Insurance PlanIII. Public-Private Partnerships (PPP)partnerships, ASHLine presented at the January2018 North American Quitline Consortium webinar“Engaging Health Plans and Employers in PurchasingQuitline Services and Improving Access to EvidenceBased Cessation Services”. We also held meaningfuldiscussions with the Arizona Department of HealthServices (ADHS) and Blue Cross Blue Shield of Arizonaaround plans to restrict free access to ASHLine'sservices for health plan members. Tentatively, arestricted eligibility model with a fee-for-serviceoption will be launched in FY2019.IV. Communications and Online InteractionsTo support public awareness and increased accessto tobacco cessation services through ASHLine,online contact request forms were added toASHLine’s website and shared through digital medialinks. The goal was to increase interaction withASLine among individuals who use tobacco andcommunity partners. In FY18, there were just under280,000 visits to ASHLine’s website. We received6,344 online requests from tobacco users to signup for our coaching services and 540 requests to becontacted with more information about our services.Among Arizona institutions, 35 employers and 65healthcare providers also submitted online requestsfor ASHLine to contact them for information onquit programs and obtaining technical assistanceand training support for implementing a referralprogram to ASHLine.3 / ASHLINE ANNUAL REPORT FY2018 Building on groundwork established in FY17,ASHLine’s Public-Private Partnerships (PPP) teamcontinued to build strategic partnerships withemployers, insurance companies, and insurancebrokers to provide their members with high qualitytobacco cessation services. This year, we successfullyestablished two new contracts with employers,including an Arizona county. Previously establishedcontracts with employers were also successfullyrenewed, including a large Phoenix based hospital.To highlight our progress in building these

Arizona Smokers’ HelplineAnnual Report: FY18V. Client Enrollment and CharacteristicsCall volume and EnrollmentThis year, ASHLine received 19,137 total calls. Ofthose, 75% were made during normal businesshours (7am – 8pm) and answered by ASHLine staff(calls made after hours are answered by ContactOne, a live-answer call service). For clients who werealready enrolled, Contact One assisted in connectingclients to their coach via voicemail. For thoseinterested in enrolling, Contact One completed preenrollment and forwarded client information toASHLine. Enrollment staff called clients to completethe enrollment process and assure that clients wereassigned to a quit coach.In FY18, 9,034 clients enrolled at ASHLine. Theseclients entered services as referrals from a partner(e.g., institution healthcare) or as self-referrals.Those who self-referred used three means: (1) theycalled ASHLine directly, using our toll-free line or thenational 1-800-QUIT-NOW line, (2) they submittedan online request to be contacted by an ASHLinerepresentative, (3) or they were pre-enrolled byContact One and then reached through a followup call by an ASHLine enrollment specialist. Thedistribution of each entry mode is shown in Figure3. While the majority of clients enrolled once, 199clients enrolled in ASHLine two or more times in thepast 12 months.This fiscal year, ASHLine reached about 3.0% of alladult tobacco users in Arizona. Among self-referredclients, the majority (41%) reported hearing aboutASHLine through a media advertisement, on thetelevision, internet, radio, newspaper, or brochure.Others referral sources were healthcare providers(34%), or friend or family members (12%) (See Figure4). ASHLine’s promotional reach remains localized inMaricopa and Pima counties, where approximately75% of ASHLine clients reside.Figure 3. Distribution of ASHLine Enrolled Clients by Referral Types58%11%6%Self-referral(Call to ASHLine)Self-referral(Online request)Self-referral(Contact One)Partner Referral4 / ASHLINE ANNUAL REPORT FY2018 25%

Arizona Smokers’ HelplineAnnual Report: FY18Figure 4. How Self-Referred Clients Reported Hearing about ASHLine12%Media10%Healthcare Provider41%2%Community OrganizationsFormer ClientFamily/Friends34%Figure 5. ASHLine Client Enrollment by ila1%La uz0%Cochise2%5 / ASHLINE ANNUAL REPORT FY2018 Maricopa59%

Arizona Smokers’ HelplineAnnual Report: FY18Client CharacteristicsTable 2. Client CharacteristicsASHLine clients’ demographic characteristics haveremained fairly uniform across the past years. InFY18, the majority of clients were female (56%), NonHispanic (84%), and white (79%). Over half wereuninsured or AHCCCS beneficiaries, and 80% reportedhaving either a chronic or a mental health condition,or both. However, compared to last year, this year thepercentage of Hispanic clients declined from 21% to16% while those identifying as “other race” increasedfrom 2% to 7%. We also observed a slight decline inthe proportion of AHCCCS clients from 40% to 37%and an increase in the percentage of clients usingelectronic cigarettes (from 5% to 12%).Table 3. Percent Enrolled by AHCCCS Insurance -HispanicHispanic84%16%RaceWhiteBlack / African AmericanAsianHawaiianAmerican IndianMultiracialOther Race79%7%1%0%2%3%7%InsuranceAHCCCSMedicarePrivate ectronic Cigarette UseTobacco Use OnlyElectronic Cigarette Use89%12%Age2425 - 4445 - 64654%30%50%17%Comorbid ConditionNoneChronic Health Condition OnlyMental Health Condition OnlyChronic and Mental Health Condition20%24%19%37%6 / ASHLINE ANNUAL REPORT FY2018 AHCCCS Insurance PlansUnited Healthcare Community PlanMercy Care PlanHealth Choice AZUniversity Family CareCare 1st ArizonaMercy Maricopa IntergratedCentpatico Integrated CareHealth Net of ArizonaMaricopa Health PlanPhoenix Health PlanBridgeway Health Solutions - LTCRefusedGenderFemaleMale

Arizona Smokers’ HelplineAnnual Report: FY18VI. Clinical ServicesFigure 6. Quit RatesUtilization of servicesASHLine uses a client-directed, collaborative approachbased on elements of cognitive behavioral therapyand motivational interviewing. Our services includebehavioral coaching support and free nicotinereplacement therapy in the form of gum, patches,and lozenges to clients who are uninsured or haveprivate insurance. This year, we added new coachingprotocols that standardize our services to a total ofseven coaching sessions per client with a focus on goalsetting early in the process (see Data Brief on pg. 9).During FY18, 85% of clients received at least onecoaching session and 54% reported using cessationmedication during their quit attempt wheninterviewed at 7-month followup. On average, clientsreceived 3.5 coaching sessions. This year there wereenhanced efforts to use text messaging to reachand communicate with clients. An estimated 63% ofclients requested and received SMS messages fromtheir coach. A total of 19,093 messages were sent fromASHLine coaches to clients and clients returned 7,331messages to their coach.7-Month Tobacco Quit Rate 38.3%7-Month Tobacco & E-Cigarette Quit Rate 34%National Quit Rates for Quitlines 27.6%*Based on FY17 survey of quitlines in North Americanconducted by NAQC (North American Quitline Consortium)Overall Quit RatesOur overall tobacco quit rate for FY 2018 was 38.3%.The quit rate for clients who reported being fullynicotine abstinent (tobacco and e-cigarettes) was34%. As in past years, abstinence rates are higher forclients who use cessation medication and receivemore coaching sessions (see Figure 7).Figure 7. Quit Rates By Number of Coaching Sessions and Medication UseNo Quit Meds56.4%43.7%34.3%30.2%25.2%28.6%1-23-4Number of Coaching Sessions5 7 / ASHLINE ANNUAL REPORT FY2018 Quit Meds

Arizona Smokers’ HelplineAnnual Report: FY18VII. Research and Evaluation InitiativesAt ASHLine, a team of interdisciplinary researcherscollaborate on original tobacco cessation researchprojects. We disseminate our findings to thescientific community through presentationsat professional conferences and by publishingmanuscripts in scientific journals. This year, wepresented at six conferences, including: ArizonaPublic Health Association, the American Society ofPreventative Oncology, the Society of BehavioralMedicine, the College of Problems on DrugDependence, and the Society for Research onNicotine and Tobacco. We also published fourresearch articles in peer-reviewed journals. Thesepapers included studies that examined quitoutcomes among ASHLine callers who experiencedcomorbid health conditions, how quit outcomesfor ASHLine callers varied by mode of entry intothe program, and factors that predict clients’ reenrollment with the cdisease/tobacco-free-az/#reportsTo improve ASHLine’s services, this year weconducted several quality improvement projects toevaluate current and recently implemented serviceprotocols. These projects include developingenhanced metrics to monitor enrollment callsto ensure that staff are following establishedprotocols and customer service etiquette. We havealso initiated use of checklists and scorecards toverify that coaching calls adhere to best practicesin the field. This includes assessing the quality ofgoals ASHLine coaches set with clients (see DataBrief on pg. 9). Our aim is to improve the qualityof goal setting using a collaborative and evidencebased approach that improves our clients' abilityto make a successful in-program quit attempt.Finally, to assure the quality of ongoing services,we launched a Secret Shopper program. Resultsfrom this initiative are currently being utilized toimplement changes that improve service delivery,including our responsiveness to addressing callers'needs.8 / ASHLINE ANNUAL REPORT FY2018 Members of ASHLine's research team wereawarded funding on two grants to conductprospective research. One grant is funded bythe Qatar National Research Fund (Nair, PI) toexamine the feasibility of establishing a quitlinein the State of Qatar, a country with extremelyhigh tobacco prevalence rates and no structuredservices to support cessation. The second grant isa NIH-funded two year grant (Nair and Allen, CoPIs) to examine whether quit dates that are timedduring selected phases of a woman’s menstrualcycle can promote higher quit rates as comparedto untimed quit dates. Results from this studywill have applications for how quitlines can tailorsmoking cessation programs for premenopausalfemale smokers.Importantly, our research efforts extend toexamining programmatic aspects of ASHLine’sservices. These are published as quarterly databriefs on the ADHS website. Past year data briefsexamined factors that predict client re-enrollment,how clients receiving additional coaching sessionsare affected by their quit status, and the quality ofcoaching to assist clients in setting quit date goals.Copies of these data briefs are located here:

Arizona Smokers’ HelplineAnnual Report: FY18VIII. Data BriefHigh Quality Quit Date CoachingPromotes in-Program Quit AttemptsIn our previous data brief, quit date coaching amongASHLine coaches was evaluated and suggestedthat 75% of clients are encouraged by their coachto set a quit date goal during the first coachingsession; 61% actually set a quit date during this firstsession. In follow-up, a more detailed evaluation ofthe quality of quit date coaching and its relationshipwith clients’ in-program quit attempts (i.e., goingfor at least 24 hours without using any tobaccoprior to exiting ASHLine’s services) was performed.Our analysis examined if high-quality goal settingwas related to the frequency of making an inprogram quit attempt. For this analysis, we useda standardized checklist and audio call recordinganalysis. We assessed calls from 90 different clientsessions using the quality checklist. Low-qualitycoaching was scored as receiving three or fewerpoints and high quality was scored as recievingfour or more points.1 Points were awarded for:ResultsFindings show that clients who received high-qualityquit date coaching were more likely to make an in-DiscussionThese findings highlight the importance of highquality quit date coaching as an evidence-basedstrategy to assist clients in setting quit dates. The quitdate quality scale stresses the importance of settinga proximal quit date (within 2 weeks) and combiningit with NRT or other cessation medications. Theseappear to be important elements for promotingin-program quitting. Setting a quit date can bechallenging to tobacco users. However, early andopen discussions around setting quit date goals,clarifying program objectives, normalizing clients’expectations, and using motivational interviewingto identify strategies can facilitate a coach-clientrelationship and increase clients’ confidence aroundstopping smoking. Next steps include evaluatinglong-term quit status among clients receiving highversus low quality quit date coaching . It will also beimportant to review individual-level differences incoaches' ability to support early and effective quitdate coaching. Evidence suggests this should be astandard practice to support all callers enrolling inquitline coaching services.9 / ASHLINE ANNUAL REPORT FY2018 1. Encouraging clients to set a quit date goal inthe first coaching session2. Setting a calendar specific goal date (mm/dd/yy)3. The quit date is set within two weeks of thefirst coaching session4. Setting a date that allows time for clients tofirst obtain cessation medication5. Discouraging cutting down prior to the quit date6. Explaining that success requires completeabstinence7. Providing examples of effective behaviorchange and medication use strategiesprogram quit attempt. As shown in Figure 1, highquality coaching resulted in more clients setting quitdate goals and making in-program quit attempts.Sixty-five percent of clients who received highquality coaching made a quit attempt compared to36% of clients who received low-quality coaching. In amultivariable regression model, clients who receivedhigh quality coaching had four times higher odds ofmaking an in-program quit attempt as compared toclients who received low quality coaching.

Arizona Smokers’ HelplineAnnual Report: FY18Figure 8. Number of Clients Who Set Quit Date Goals and Made In-Program Quit Attempts by Qualityof Quit Date CoachingSet Quit Date4540Made Quit Attempt4235302525202714151050High Quality CoachingLow Quality Coaching1.Lorencatto F, West R, Bruguera C, Brose LS, Michie S. Assessing the Quality of Goal Setting in Behavioural Support for Smoking Cessation and itsAssociation with Outcomes. Ann Behav Med. 2016;50:310-318.10 / ASHLINE ANNUAL REPORT FY2018 REFERENCES

Arizona Smokers’ HelplineAnnual Report: FY18List of Figures and TablesFigure 1. Program Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Figure 2. Referrals by Location Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Table 1. Percentage of Referrals Reached and Enrolled by Top Five Location Types. . 3Figure 3. Distribution of ASHLine Enrolled Clients by Referral Types . . . . . . . . . . . . . . . 4Figure 4. How Self-Referred Clients Reported Hearing about ASHLine. . . . . . . . . . . . . . 5Figure 5. ASHLine Client Enrollment by County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Table 2. Client Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Table 3. Percent Enrolled by AHCCCS Insurance Plans. . . . . . . . . . . . . . . . . . . . . . . . . 6Figure 6. Quit Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Figure 7. Quit Rates By Number of Coaching Sessions and Medication Use. . . . . . . . . 7Figure 8. Number of Clients Who Set Quit Date Goals and Made In-Program QuitAttempts by Quality of Quit Date Coaching. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1011 / ASHLINE ANNUAL REPORT FY2018

Breathing Vitality into theLives of Arizonans throughInquiryInnovationInspirationEnvisioning an Arizona where everyoneachieves a healthy lifestyle.For more information about the Arizona Smokers’ Helpline:ASHLineUniversity of ArizonaMel and Enid Zuckerman College of Public HealthArizona Smokers’ HelplineAbrams Public Health Center3950 S. Country Club Road, Suite 300Tucson, Arizona 85714t. 800-55-66-222f. 520-318-7222w. ashline.orge. info@ashline.orgFor questions regarding our report, please contact Dr. Uma Nair at: umanair@email.arizona.edu Contents Copyright 2017, University of Arizona. All rights reserved.

Mercy Care Plan 21% United Healthcare Community Plan 17% University Family Care 7% Health Choice AZ 7% Mercy Maricopa Intergrated 7% Care 1st Arizona 4% Health Net of Arizona 3% Centpatico Integrated Care 0% Phoenix Health Plan 0% Maricopa Health Plan 0% Refused 8% Bridgeway Health Solutions - LTC AHCCC nsurance Plans Table 2. Client .

Related Documents:

201 E. Orchid Lane 3030 S. Donald Ave. 1521 W. Vernon Box L31 6)36 W. Aie1ia Ave. )4836 S. Tenth St. Phoenix, Arizona Phoenix, Arizona Prescott, Arizona Tempe, Arizona Tucson, Arizona Phoenix, Arizona Sedona, Arizona Phoenix, Arizona Phoenix, Arizona Tucson, Arizona 85021 85020 8571b 85007 86336 85033 85OL0 Eugene Zerby 1520 E. Waverly S

California Smokers in Australia (CASA): A Randomised Controlled Trial Examined the effects packaging has on smoking cognitions and behavior Obtained license for 8 images used in Australia and selected 3 to rotate on repackaging of US smokers' own cigarettes Adaptive choice-based conjoint task included at baseline and follow-up 12 Approach Explored US smokers' willingness to .

to the dearth of data around online harassment in Pakistan. The Helpline officially began taking calls on December 1, 2016. The Helpline is operational everyday between 9 a.m. to 5 p.m. The Helpline team can also be contacted outside of office timings through email at helpdesk@digitalrightsfoundation.pk. ABOUT: PAKISTAN'S FIRST CYBER .

078723201 arizona call-a-teen center for excellence 078924001: arizona charter academy 110422105 arizona city elementary school 108909001: arizona college prep academy 070280243 arizona college prep erie campus 070280145: arizona college prep oakland campus 108507001 arizona collegiate high school 078971001: arizona conservatory for arts and .

Smoke and Mirrors 03 About Forest EU Forest EU is a campaign that informs smokers about the issues that affect them in the European Union and engages with stakeholders so the views of informed adult smokers and non-smokers with an interest in tobacco policy are considered within the EU’s decision-making process.

method. Direct estimates of mortality cannot be made because there is a lack of longitudinal studies on the differential mortality of smokers, former smokers and non-smokers, necessary to provide RR estimates for smoking-related diseases and mortality.

and may not be archived in the data dump. Version 2 data submitted to AZ-PIERS after the July 2016 deadline will still be saved in the primary AZ-PIERS database as accessed by Report Writer. AZ-PIERS reports will begin to focus on Version 3 data. If you have any questions, please email Anne.Vossbrink@azdhs.gov E) Extended Data Definitions

inquiry-based instruction supported 5E learning cycle . In the instruction based on 5E learning cycle method, teaching and learning activities and lesson plans were designed to maximize students active involvement in the learning process. The topics included in the lesson plans were about the three units of fifth-grade sciences book; they included: hidden strangles (microbes, viruses, diseases .