Home health care nurses as a new channel for smoking cessation treatment: outcomes from project CARES (Community-nurse Assisted Research and Education on Smoking).
BACKGROUND
Clinical guidelines for smoking cessation may not be sufficient for helping some subgroups of smokers quit. Incorporating smoking cessation into home-based medical care can proactively reach high-risk smokers who may not have access to (or spontaneously seek) smoking cessation.


METHODS
Home health care nurses (N = 98) were randomly assigned to deliver either Motivational Enhancement (ME; Motivational Interviewing + Carbon Monoxide Feedback) or Standard Care (AHCPR Guidelines for smoking cessation) to their patients. Seventy percent of patients were eligible and willing to participate (N = 273; 54% female, mean age = 57 years, 83% Caucasian, 41% < high school education). The study was conducted in Providence, RI, USA from 1998 to 2003.


RESULTS
Biochemically verified continuous abstinence rates at the 12-month follow-up were 4.2% (SC) and 8.7% (ME) for intent to treat analyses, and 5.2% (SC) and 11.8% (ME) using all available cases (P > 0.05). ME reported more quit attempts and significantly greater reductions in the number of cigarettes smoked per day at all follow-ups through 12 months of post-treatment (all P values < 0.05).


CONCLUSIONS
Use of an existing public health channel such as home health care to reach smokers who vary in their motivation to quit could have the potential for large public health impact.
Borrelli
Belinda
B
The Centers for Behavioral and Preventive Medicine, Brown Medical School/The Miriam Hospital, Coro West Building, Suite 500, One Hoppin Street, Providence, RI 02903, USA. Belinda_Borrelli@Brown.edu
Novak
Scott
S
Hecht
Jacki
J
Emmons
Karen
K
Papandonatos
George
G
Abrams
David
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D024802:Nurse's Role; D015397:Program Evaluation; D012237:Rhode Island; D016540:Smoking Cessation / Q000379:methods*