title: Utilization of services in a randomized trial testing phone- and web-based interventions for smoking cessation.
abstract: BACKGROUND
  Phone counseling has become standard for behavioral smoking cessation treatment. Newer options include Web and integrated phone-Web treatment. No prior research, to our knowledge, has systematically compared the effectiveness of these three treatment modalities in a randomized trial. Understanding how utilization varies by mode, the impact of utilization on outcomes, and predictors of utilization across each mode could lead to improved treatments.
  
  
  METHODS
  One thousand two hundred and two participants were randomized to phone, Web, or combined phone-Web cessation treatment. Services varied by modality and were tracked using automated systems. All participants received 12 weeks of varenicline, printed guides, an orientation call, and access to a phone supportline. Self-report data were collected at baseline and 6-month follow-up.
  
  
  RESULTS
  Overall, participants utilized phone services more often than the Web-based services. Among treatment groups with Web access, a significant proportion logged in only once (37% phone-Web, 41% Web), and those in the phone-Web group logged in less often than those in the Web group (mean = 2.4 vs. 3.7, p = .0001). Use of the phone also was correlated with increased use of the Web. In multivariate analyses, greater use of the phone- or Web-based services was associated with higher cessation rates. Finally, older age and the belief that certain treatments could improve success were consistent predictors of greater utilization across groups. Other predictors varied by treatment group.
  
  
  CONCLUSIONS
  Opportunities for enhancing treatment utilization exist, particularly for Web-based programs. Increasing utilization more broadly could result in better overall treatment effectiveness for all intervention modalities.
authors.affiliation: Free & Clear, Inc., Clinical and Behavioral Sciences, Seattle, WA, USA. susan.zbikowski@freeclear.com
authors.forename: Susan M
authors.initials: SM
authors.lastname: Zbikowski
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Jack
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McClure
authors.forename: Mona
authors.initials: M
authors.lastname: Deprey
authors.forename: Harold S
authors.initials: HS
authors.lastname: Javitz
authors.forename: Timothy A
authors.initials: TA
authors.lastname: McAfee
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Catz
authors.forename: Julie
authors.initials: J
authors.lastname: Richards
authors.forename: Terry
authors.initials: T
authors.lastname: Bush
authors.forename: Gary E
authors.initials: GE
authors.lastname: Swan
mesh_terms: D001552:Benzazepines / Q000008:administration & dosage; D003376:Counseling / Q000379:methods*; D034742:Electronic Mail; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018722:Nicotinic Agonists / Q000008:administration & dosage; D011810:Quinoxalines / Q000008:administration & dosage; D016540:Smoking Cessation / Q000379:methods*; D013685:Telecommunications; D013689:Telephone; D016896:Treatment Outcome; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline