title: Health evaluation and referral assistant: a randomized controlled trial to improve smoking cessation among emergency department patients.
abstract: BACKGROUND
  Computer technologies hold promise for implementing tobacco screening, brief intervention, and referral to treatment (SBIRT). This study aims to evaluate a computerized tobacco SBIRT system called the Health Evaluation and Referral Assistant (HERA).
  
  
  METHODS
  Smokers (n = 421) presenting to an emergency department were randomly assigned to the HERA or a minimal-treatment Control and were followed for 3 months. Analyses compared smoking cessation treatment provider contact, treatment initiation, treatment completion, and smoking behavior across condition using univariable comparisons, generalized estimating equations (GEE), and post hoc Chi square analyses.
  
  
  RESULTS
  HERA participants were more likely to initiate contact with a treatment provider but did not differ on treatment initiation, quit attempts, or sustained abstinence. Subanalyses revealed HERA participants who accepted a faxed referral were more likely to initiate treatment but were not more likely to stop smoking.
  
  
  CONCLUSIONS
  The HERA promoted initial contact with a smoking cessation provider and the faxed referral further promoted treatment initiation, but it did not lead to improved abstinence.
  
  
  BACKGROUND
  ClinicalTrials.gov number NCT01153373.
authors.affiliation: Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, LA-189, 55 Lake Avenue North, Worcester, MA, 01655, USA. Edwin.Boudreaux@umassmed.edu.
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Boudreaux
authors.affiliation: Departments of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA. Beau_Abar@URMC.Rochester.edu.
authors.forename: Beau
authors.initials: B
authors.lastname: Abar
authors.affiliation: Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA. Brianna.Haskins@umassmed.edu.
authors.forename: Brianna
authors.initials: B
authors.lastname: Haskins
authors.affiliation: Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA. Baumann-B@CooperHealth.edu.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bauman
authors.affiliation: Polaris Health Directions, Inc, Langhorne, PA, USA. grant@polarishealth.com.
authors.forename: Grant
authors.initials: G
authors.lastname: Grissom
mesh_terms: D000328:Adult; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000458:organization & administration*; D016037:Single-Blind Method; D016540:Smoking Cessation / Q000379:methods*; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000628:therapy