Utilization and effectiveness of telephone counseling for African-Americans

Empirical and experimental research

Prepared for the NAQC Seminar, Ensuring Quality Quitline Services to Priority Populations: Challenges and Opportunities

Vance Rabius, PhD

October 9, 2009

Quitline and Disparities

Is Quitline relevant in our efforts to alleviate disparities in health care for African-Americans?

Do African-Americans use Quitline?

Quitline use is a function of promotion.

Do African-Americans benefit from Quitline?

Empirical Research Partners

Quitline Utilization

African-Americans tend to use Quitline services in proportionsgreater than their representation in the smoking community

Texas - 2001-2008 - 28,559 Quitline callers18% of Quitline callers and 9% of Texas smokers and 12% of Texas population are African-American

Louisiana - 2005-2008 - 13,861 Quitline callers33% of Quitline callers and26% of Louisiana smokers and 33% of Louisiana population are African-American

Washington DC - 2006-2008 - 3,050 Quitline callers89% of Quitline callers and63% of Washington DC smokers and 57% of Washington DC population are African-American

Clinical Trial I - 2000-2001

Design

2-group treatment/controlSelf-help materials vs. self-help materials and access to up to 5 telephone counseling sessionsPhase I & II – 3522 clients

Results Counseling benefits young adult smokersHealth Psychology Article

Quitline Benefits

African-Americans tend to benefit from Quitline services at rates comparable to European-Americans

N = 3523, 15% African-American - Clinical Trial I - Presented at the 23rd Annual Meeting of the Society for Behavioral Medicine, Washington, DC ( April 2002)

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5

10

15

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25

Self-Help Counseling Self-Help Counseling

Qu

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ate

Quit Rates as a Function of Treatment and Race/Ethnicity

African-American European-American

Clinical Trial II - 2002-2004

Effects of number and duration of counseling sessionstalk time – boosters

6,322 participants

3 x 2 plus control3 counseling protocols w/ or w/out access to boosters

Tobacco Control Article

Quitline Benefits by Race/Ethnicity

African-American Quitline callers tend to display comparable rates of current depressive mood and comparable quit rates as European-American callers

African-American - 45.2% Sad or Blue European-American – 45.5% Sad or Blue

N = 6,322, 17% African-American - Clinical Trial II - Presented at the 2007 Cancer Disparities Conference, New Orleans, Louisiana ( April 2007)

Quit Rates as a Function of Treatment and Race/Ethnicity

African-American European-American

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2

4

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8

10

12

Self-Help Counseling Self-Help Counseling

Qu

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ate

Citations:Rabius, V, McAlister, AL, Geiger, A, Huang, P, & Todd, R. (2004). Telephone Counseling Increases Cessation Rates among Young Smokers. Health Psychology, 23, 539-541.

Rabius, V, Pike, KJ, Hunter, J, Wiatrek, D, & McAlister, AL. (2007). Effectiveness of Frequency and Duration in Telephone Counseling for Smoking Cessation. Tobacco Control. 16, Suppl 1, i71-i74.

Contact information:

Vance Rabius, PhDSenior ScientistAmerican Cancer SocietyNational Cancer Information Center11701 Stonehollow DriveAustin, TX 78758

512-997-3920 - phone512-997-3961 - faxvrabius@cancer.org - email