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Research article
Quitting the quitline: a qualitative study of patient experience of electronic referrals to quitlines
Elizabeth L Albert
Case Western Reserve University Law School
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3091-8771
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: The use of electronic referrals (eReferrals) to state quitlines (QLs) for tobacco-using patients is a promising approach for addressing smoking cessation on a large scale. However, QL contact, enrollment, and completion rates are low. The purpose of this study was to examine the eReferral to QL process from the patient’s perspective in order to inform strategies for improving QL engagement.
Methods : We conducted interviews with 55 patients who agreed to an eReferral at a primary care visit to 1 of 8 safety-net community health centers in Cuyahoga County, Ohio (September 2017-August 2018). Interviews were designed to explore the experiences of three subgroups of patients who subsequently: 1) declined participation in the QL; 2) were unreachable by the QL; or 3) were enrolled in or had completed the QL program. Analysis was guided by a phenomenological approach designed to identify emergent themes.
Results: Reasons for QL program non-completion included changing life circumstances and events making cessation unviable; misunderstandings about the QL; discomfort with telephonic counseling; perceived lack of time for counseling; cell phone barriers; and having already quit smoking. We found that some individuals who were no longer engaged with the QL still desired continued support from the QL.
Conclusions: Participants intentionally and unintentionally disengage from the QL for a wide variety of reasons, several of which are mediated by low socioeconomic status. Integrating QL care with community-based resources that address these mediators could be a promising strategy.
Keywords
tobacco quitlines, tobacco cessation, program use, primary care, qualitative research
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Reviewer #1 agreed
On 07 Apr, 2020
Reviewers invited
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Editor assigned
On 02 Apr, 2020
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Editor invited
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No comments provided
Editorial decision: Minor revision
On 27 Mar, 2020
Review #1 received
Received 22 Mar, 2020
Review #3 received
Received 09 Mar, 2020
Review #2 received
Received 09 Mar, 2020
Reviewer #3 agreed
On 06 Mar, 2020
Reviewer #1 agreed
On 24 Feb, 2020
Reviewer #2 agreed
On 24 Feb, 2020
Reviewers invited
Invitations sent on 05 Feb, 2020
Editor assigned
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Submission checks complete
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Editor invited
On 28 Jan, 2020
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Subject Areas
Preventive Medicine
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Quitting the quitline: a qualitative study of patient experience of electronic referrals to quitlines
Elizabeth L Albert
Case Western Reserve University Law School
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3091-8771
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 23 Jun, 2020
Published
On 09 Jul, 2020
No community comments so far
Editor assigned
On 23 Jun, 2020
Submission checks complete
On 22 Jun, 2020
Editor invited
On 22 Jun, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jun, 2020
Review #1 received
Received 19 Jun, 2020
Reviewer #2 agreed
On 15 Jun, 2020
Review #2 received
Received 15 Jun, 2020
Reviewer #1 agreed
On 11 Jun, 2020
Reviewers invited
Invitations sent on 11 Jun, 2020
Editor assigned
On 08 Jun, 2020
Submission checks complete
On 07 Jun, 2020
Editor invited
On 07 Jun, 2020
No comments provided
Review #2 received
Received 02 Jun, 2020
Editorial decision: Minor revision
On 02 Jun, 2020
Reviewer #2 agreed
On 11 May, 2020
Review #1 received
Received 29 Apr, 2020
Reviewer #1 agreed
On 07 Apr, 2020
Reviewers invited
Invitations sent on 06 Apr, 2020
Editor assigned
On 02 Apr, 2020
Submission checks complete
On 01 Apr, 2020
Editor invited
On 01 Apr, 2020
No comments provided
Editorial decision: Minor revision
On 27 Mar, 2020
Review #1 received
Received 22 Mar, 2020
Review #3 received
Received 09 Mar, 2020
Review #2 received
Received 09 Mar, 2020
Reviewer #3 agreed
On 06 Mar, 2020
Reviewer #1 agreed
On 24 Feb, 2020
Reviewer #2 agreed
On 24 Feb, 2020
Reviewers invited
Invitations sent on 05 Feb, 2020
Editor assigned
On 03 Feb, 2020
Submission checks complete
On 28 Jan, 2020
Editor invited
On 28 Jan, 2020
First submitted
On 15 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Preventive Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: The use of electronic referrals (eReferrals) to state quitlines (QLs) for tobacco-using patients is a promising approach for addressing smoking cessation on a large scale. However, QL contact, enrollment, and completion rates are low. The purpose of this study was to examine the eReferral to QL process from the patient’s perspective in order to inform strategies for improving QL engagement.
Methods : We conducted interviews with 55 patients who agreed to an eReferral at a primary care visit to 1 of 8 safety-net community health centers in Cuyahoga County, Ohio (September 2017-August 2018). Interviews were designed to explore the experiences of three subgroups of patients who subsequently: 1) declined participation in the QL; 2) were unreachable by the QL; or 3) were enrolled in or had completed the QL program. Analysis was guided by a phenomenological approach designed to identify emergent themes.
Results: Reasons for QL program non-completion included changing life circumstances and events making cessation unviable; misunderstandings about the QL; discomfort with telephonic counseling; perceived lack of time for counseling; cell phone barriers; and having already quit smoking. We found that some individuals who were no longer engaged with the QL still desired continued support from the QL.
Conclusions: Participants intentionally and unintentionally disengage from the QL for a wide variety of reasons, several of which are mediated by low socioeconomic status. Integrating QL care with community-based resources that address these mediators could be a promising strategy.
Figure 1