Parent eReferral to Tobacco Quitline

Not Applicable

Completed

Conditions: Secondhand Smoke

Interventions: Behavioral: Quitline Delivered Treatment

Registration Number: NCT02997735

Lead Sponsor: Children's Hospital of Philadelphia

Brief Summary: Secondhand smoke (SHS) exposure is a significant public health problem in that it both harms children and is widely prevalent, affecting more than 40% of US children. Tobacco cessation quitlines are effective in helping smokers quit, but few smokers make use of their services. Electronic health record-based systems that automate referral of interested parents to quitlines through pediatric settings may increase the proportion of smokers who successfully enroll in treatment.

Detailed Description: This is a randomized controlled study of electronic quitline referral compared to standard practice. Parent enrollment in the quitline will be reported to the study team by the state tobacco quitline, managed by the Pennsylvania Department of Health.

This is a single site study at one large outpatient pediatric practice. Eligible study participants are parents/caregivers (hereafter referred to as "parents"), 18 years of age or older, who are present for the child's healthcare (both well-child and acute) visit, who smoke, and who are interested in receiving treatment through the tobacco quitline.

The intervention is electronic referral to the tobacco quitline for parent smokers. The referral process will be embedded in a tobacco treatment clinical decision support (CDS) tool, created to help pediatricians provide counseling and treatment to parent smokers. The primary outcome of interest is smoker enrollment in the quitline, defined as the proportion of parent smokers identified in the clinic that enroll in quitline treatment compared across the intervention (electronic referral) and control (standard practice) approaches. Secondary outcomes include patient and parent demographic and behavioral factors associated with successful enrollment.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 484

Inclusion Criteria

18 years of age or older
Parent/caregiver who presents for their child's healthcare (both well-child and acute) visit
Current smoker
Interested in being referred to the tobacco quitline

Exclusion Criteria

Less than 18 years of age
Parent/caregiver who smokes but is not present during their child's healthcare visit
Not interested in referral to the tobacco quitline

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Electronic Quitline Referral	Quitline Delivered Treatment	The electronic quitline referral will be embedded within the Tobacco Treatment CDS tool, a CDS system previously developed to help pediatricians provide smoking cessation counseling and treatment to parents who smoke, modeled off the CEASE intervention, an evidence-based approach for implementing smoking cessation treatment of parents in the pediatric setting. The parental tobacco treatment CDS tool prompts the pediatric clinician to ask the parent about smoking status and assess interest in quitting (at all well-child and acute visits), links to an electronic nicotine replacement therapy prescription for parents interested in quitting, and guides appropriate documentation. Electronic referral to the quitline will be made by clicking an automated link embedded in the tool that will send the parent smokers' names and telephone numbers (entered by the clinician) directly to the Pennsylvania (PA) Free Quitline.
Standard of Practice	Quitline Delivered Treatment	All procedures implemented in the standard referral approach will be identical to those in the electronic referral approach with the exception of providing the telephone number for the Quitline to the parent (rather than electronic referral). The clinician workflow will be nearly the same, in that the clinician will use the link embedded in the tobacco treatment CDS tool to add the quitline to the patient's discharge paperwork (rather than automatically refer to the quitline).

Primary Outcome Measures

Name	Time	Method
Number of Parent Smokers Who Enrolled in Quitline	Through study completion, up to 1 year	Proportion of parent smokers identified in clinic that enroll in quitline treatment compared across the intervention (electronic referral) and control (standard of practice) approaches. Primary analysis wibased on an intent to treat approach and includes all subjects randomized at their referral visit.

Secondary Outcome Measures

Name	Time	Method
Number of Calls With the Quitline	Through study completion, up to 1 year	Total number of parent contacts with the quitline post-enrollment, compared between intervention and control and reported by the PA Quitline
Number of Parents Who Quit Smoking	Through study completion, up to 1 year	Self-reported parent quit rates post-enrollment, compared between the intervention and control and reported by the PA Quitline