title: Evaluation and costs of volunteer telephone cessation follow-up counseling for Veteran smokers discharged from inpatient units: a quasi-experimental, mixed methods study.
abstract: BACKGROUND
  The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to evaluate the volunteer telephone smoking cessation counseling follow-up program implemented as part of the inpatient Tobacco Tactics intervention in a Veterans Affairs (VA) hospital.
  
  
  METHODS
  This was a quasi-experimental, mixed methods design that collected data through electronic medical records (EMR), observations of telephone smoking cessation counseling calls, interviews with staff and Veterans involved in the program, and intervention costs.
  
  
  RESULTS
  Reach: Of the 131 Veterans referred to the smoking cessation telephone follow-up program, 19% were reached 0-1 times, while 81% were reached 2-4 times. Effectiveness: Seven-day point-prevalence 60-day quit rates (abstracted from the EMR) for those who were reached 2-4 times were 26%, compared to 8% among those who were reached 0-1 times (p = 0.06). Sixty-day 24-hour point-prevalence quit rates were 33% for those reached 2-4 times, compared to 4% of those reached 0-1 times (p < 0.01). Adoption and Implementation: The volunteers correctly followed protocol and were enthusiastic about performing the calls. Veterans who were interviewed reported positive comments about the calls. The cost to the hospital was $21 per participating Veteran, and the cost per quit was $92. Maintenance: There was short-term maintenance (about 1 year), but the program was not sustainable long term.
  
  
  CONCLUSIONS
  Quit rates were higher among those Veterans that had greater participation in the calls. Joint Commission standards for inpatient smoking with follow-up calls are voluntary, but should these standards become mandatory, there may be more motivation for VA administration to institute a hospital-based, volunteer telephone smoking cessation follow-up program.
  
  
  BACKGROUND
  ClinicalTrials.Gov NCT01359371.
authors: Ohio State University, College of Nursing, Columbus, USA ; Ann Arbor VA Center for Clinical Management Research, Health Services Research and Development, P.O. Box 130170, Ann Arbor, MI 48113-0170 USA ; University of Michigan, Department of Psychiatry, Ann Arbor, USA.
authors: Sonia A
authors: SA
authors: Duffy
authors: Ann Arbor VA Center for Clinical Management Research, Health Services Research and Development, P.O. Box 130170, Ann Arbor, MI 48113-0170 USA.
authors: Lee A
authors: LA
authors: Ewing
authors: Ann Arbor VA Center for Clinical Management Research, Health Services Research and Development, P.O. Box 130170, Ann Arbor, MI 48113-0170 USA.
authors: Samantha A
authors: SA
authors: Louzon
authors: University of Michigan, School of Nursing, Ann Arbor, USA.
authors: David L
authors: DL
authors: Ronis
authors: Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, USA ; Center for Healthcare Studies and Departments of Psychiatry & Behavioral Sciences and Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, USA.
authors: Neil
authors: N
authors: Jordan
authors: Ann Arbor VA Center for Clinical Management Research, Health Services Research and Development, P.O. Box 130170, Ann Arbor, MI 48113-0170 USA.
authors: Molly
authors: M
authors: Harrod
keywords: Peer support; Smoking cessation; Telephone calls; Tobacco cessation; Veterans