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Smoking cessation and care management for veterans with posttraumatic stress disorder: a study protocol for a randomized controlled trial.

Peterson J, Prochazka AV, Battaglia C - BMC Health Serv Res (2015)

Bottom Line: Smoking remains the leading cause of preventable illness and mortality in the United States.Outcomes are self-reported 24-hour quit attempts, progression along the stages of change and 7-day point prevalence quit smoking rates for the intervention group compared to usual care alone.Our study builds on previous studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA. jamie.peterson@va.gov.

ABSTRACT

Background: Smoking remains the leading cause of preventable illness and mortality in the United States. Individuals with Posttraumatic Stress Disorder (PTSD) have smoking rates higher than that of others and fewer individuals with PTSD have quit smoking. This randomized controlled trial was designed to test the effectiveness of integrating telehealth care management and smoking cessation with motivational interviewing for Veterans with PTSD.

Methods/design: All smokers with PTSD, regardless of their desire to quit, were invited to participate. Enrollment occurred between November 2009 and April 2013. Target enrollment was 120 participants. Enrolled participants were randomized to either the control group, receiving usual care including a telehealth PTSD program, with a device that delivered PTSD information and in-home care management, or the intervention group, which included (1) a telehealth PTSD program, (2) motivational interviewing-based smoking cessation curricula via the telehealth device, and (3) weekly motivational interviewing counseling phone calls. Outcomes are self-reported 24-hour quit attempts, progression along the stages of change and 7-day point prevalence quit smoking rates for the intervention group compared to usual care alone. Secondary outcomes include participants' perception of care coordination, patient satisfaction with motivational interviewing, PTSD symptoms, pain, depression and quality of life.

Discussion: Motivational interviewing has been shown to increase readiness for change and smoking cessation care has been shown to be more successful when incorporated into in-person mental health care. Our study builds on previous studies. It integrates a written smoking cessation curriculum and phone-based motivational interviewing counseling into an established PTSD home telehealth care coordination program. This paper describes the design and methods of our randomized control trial.

Trial registration: ClinicalTrials.gov, NCT00908882, May 22, 2009.

No MeSH data available.


Related in: MedlinePlus

Conceptual model.
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Fig4: Conceptual model.

Mentions: Integrated within the PTSD Health Buddy, the intervention utilizes the Transtheoretical Model of Change (TTM) as the theoretical framework on which to structure the MI curriculum and counseling. TTM [22,23] is based on the principle that individuals are at various stages of readiness to make a behavior change, like quitting smoking. As individuals progress towards making a change to a behavior, they move along categories referred to as the stages of change. Our conceptual model (FigureĀ 4) is based on both the Chronic Care Model and the TTM. We hypothesize behavior change will result from strengthening self-management skills and enhancing motivation to move along the stages of change.Figure 4


Smoking cessation and care management for veterans with posttraumatic stress disorder: a study protocol for a randomized controlled trial.

Peterson J, Prochazka AV, Battaglia C - BMC Health Serv Res (2015)

Conceptual model.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4325951&req=5

Fig4: Conceptual model.
Mentions: Integrated within the PTSD Health Buddy, the intervention utilizes the Transtheoretical Model of Change (TTM) as the theoretical framework on which to structure the MI curriculum and counseling. TTM [22,23] is based on the principle that individuals are at various stages of readiness to make a behavior change, like quitting smoking. As individuals progress towards making a change to a behavior, they move along categories referred to as the stages of change. Our conceptual model (FigureĀ 4) is based on both the Chronic Care Model and the TTM. We hypothesize behavior change will result from strengthening self-management skills and enhancing motivation to move along the stages of change.Figure 4

Bottom Line: Smoking remains the leading cause of preventable illness and mortality in the United States.Outcomes are self-reported 24-hour quit attempts, progression along the stages of change and 7-day point prevalence quit smoking rates for the intervention group compared to usual care alone.Our study builds on previous studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA. jamie.peterson@va.gov.

ABSTRACT

Background: Smoking remains the leading cause of preventable illness and mortality in the United States. Individuals with Posttraumatic Stress Disorder (PTSD) have smoking rates higher than that of others and fewer individuals with PTSD have quit smoking. This randomized controlled trial was designed to test the effectiveness of integrating telehealth care management and smoking cessation with motivational interviewing for Veterans with PTSD.

Methods/design: All smokers with PTSD, regardless of their desire to quit, were invited to participate. Enrollment occurred between November 2009 and April 2013. Target enrollment was 120 participants. Enrolled participants were randomized to either the control group, receiving usual care including a telehealth PTSD program, with a device that delivered PTSD information and in-home care management, or the intervention group, which included (1) a telehealth PTSD program, (2) motivational interviewing-based smoking cessation curricula via the telehealth device, and (3) weekly motivational interviewing counseling phone calls. Outcomes are self-reported 24-hour quit attempts, progression along the stages of change and 7-day point prevalence quit smoking rates for the intervention group compared to usual care alone. Secondary outcomes include participants' perception of care coordination, patient satisfaction with motivational interviewing, PTSD symptoms, pain, depression and quality of life.

Discussion: Motivational interviewing has been shown to increase readiness for change and smoking cessation care has been shown to be more successful when incorporated into in-person mental health care. Our study builds on previous studies. It integrates a written smoking cessation curriculum and phone-based motivational interviewing counseling into an established PTSD home telehealth care coordination program. This paper describes the design and methods of our randomized control trial.

Trial registration: ClinicalTrials.gov, NCT00908882, May 22, 2009.

No MeSH data available.


Related in: MedlinePlus