title: A pre-post pilot study of a brief, web-based intervention to engage disadvantaged smokers into cessation treatment.
abstract: BACKGROUND
  People with low education and/or income are more likely to smoke, less likely to quit, and experience disparately poor health outcomes compared to those with education and income advantage. Cost-effective strategies are needed to inform and engage this group into effective cessation treatments. We developed a novel, web-based, motivational, decision-support system that was designed to engage disadvantaged smokers into tobacco cessation treatment. We piloted the system among smokers in a primary care safety net clinic.
  
  
  METHODS
  Thirty-nine eligible subjects were assessed at baseline and used the decision-support system; 38 were assessed 2 months later. Chi-square or Fisher's exact tests were used to assess whether participants who used the program were more likely to use cessation treatment than a randomly selected group of 60 clinic patients.
  
  
  RESULTS
  Thirty-nine percent of smokers initiated cessation treatment after using the decision-support system, compared to 3 percent of the comparison group (Fisher's exact = 21.2; p = 0.000). Over 10 percent achieved continuous abstinence over the 2-month follow-up. Users were satisfied with the program - 100 percent stated they would recommend it to a friend.
  
  
  CONCLUSIONS
  Our data indicate that this web-based, motivational, decision-support system is feasible, satisfactory, and promising in its ability to engage smokers into cessation treatment in a primary care safety net clinic. Further evaluation research is warranted.
authors: Geisel School of Medicine at Dartmouth, Department of Psychiatry, Psychiatric Research Center, 105 Pleasant St, Concord, NH, 03301, USA. Mary.f.brunette@dartmouth.edu.
authors: Mary F
authors: MF
authors: Brunette
authors: Geisel School of Medicine at Dartmouth, Department of Psychiatry, Psychiatric Research Center, 105 Pleasant St, Concord, NH, 03301, USA. wgunn@crhc.org.|Concord Hospital Family Health Center, Concord, USA. wgunn@crhc.org.
authors: William
authors: W
authors: Gunn
authors: Concord Hospital Family Health Center, Concord, USA. halvarez@crhc.org.
authors: Hilary
authors: H
authors: Alvarez
authors: Concord Hospital Family Health Center, Concord, USA. pfinn@crhc.org.
authors: Patricia C
authors: PC
authors: Finn
authors: Geisel School of Medicine at Dartmouth, Department of Psychiatry, Psychiatric Research Center, 105 Pleasant St, Concord, NH, 03301, USA. pgeiger@dartmouth.edu.
authors: Pamela
authors: P
authors: Geiger
authors: Geisel School of Medicine at Dartmouth, Department of Psychiatry, Psychiatric Research Center, 105 Pleasant St, Concord, NH, 03301, USA. joelle.ferron@dartmouth.edu.
authors: Joelle C
authors: JC
authors: Ferron
authors: Geisel School of Medicine at Dartmouth, Department of Psychiatry, Psychiatric Research Center, 105 Pleasant St, Concord, NH, 03301, USA. gregory.mchugo@dartmouth.edu.
authors: Gregory J
authors: GJ
authors: McHugo
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology; D003376:Counseling / Q000379:methods; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009042:Motivation; D017060:Patient Satisfaction; D010865:Pilot Projects; D011203:Poverty; D064876:Safety-net Providers / Q000458:organization & administration; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*; D012959:Socioeconomic Factors; D061485:Tobacco Use Cessation Devices
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