Evaluation and costs of volunteer telephone cessation follow-up counseling for Veteran smokers discharged from inpatient units: a quasi-experimental, mixed methods study
Sonia A. Duffy 1, 2, 3  
Lee A. Ewing 2
David L Ronis 4
Neil Jordan 5, 6
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Ohio State University, College of Nursing, Columbus, USA
Ann Arbor VA Center for Clinical Management Research, Health Services Research and Development, Ann Arbor, USA
University of Michigan, Department of Psychiatry, Ann Arbor, USA
University of Michigan, School of Nursing, Ann Arbor, USA
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
Sonia A. Duffy   

Ohio State University, College of Nursing, Columbus, USA
Publication date: 2015-02-05
Tobacco Induced Diseases 2015;13(February):4
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.

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.

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 per participating Veteran, and the cost per quit was . Maintenance: There was short-term maintenance (about 1 year), but the program was not sustainable long term.

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.

Trial registration:
ClinicalTrials.Gov NCT01359371.

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