A computerized bilingual decision aid – placed in safety-net clinics and health fairs – can prompt Hispanic and other smokers to set a quit date and choose effective treatments.
A study in the May issue of the Journal of Health Care for the Poor and Underserved presents a new way to connect with Hispanic smokers by addressing language barriers and extending outreach.
“The kiosk can reach a significant number of Latino smokers, who are usually even less likely to benefit from evidence-based smoking cessation resources (quit lines and medications) compared to other ethnic groups,” said lead author A. Paula Cupertino, Ph.D. However, she said it also could help uninsured and underserved smokers in the general population.
The kiosk queried users about smoking behaviors and provided informational printouts, including an optional referral to a quit line. After using the kiosk, approximately 80 percent of participants planned to quit at a specific time within a month.
“It’s very tailored to the patient,” Cupertino said. “It’s not us saying, ‘Here’s a treatment plan.’ The decision aid interacts with the patient and asks, ‘Are you interested in doing this?’”
Users who answered “no” would receive motivational messages. For instance, “We understand you’re not ready. Now, you know there are resources,” said Cupertino, an assistant professor of preventive medicine and public health at University of Kansas Medical Center in Kansas City.
“We want to empower them with information and it’s fine if at the end they’re not ready to quit,” she added. “Something may happen in their lives next week and they may be ready, or next year.”
One hundred twenty-eight smokers participated in the study and 30 percent of them used the decision aid in Spanish.
With the decision aid, 95.3 percent opted for medication with nicotine patches or bupropion and 70.3 percent requested the quit line. Two months later, researchers called participants to follow up: Of those they reached, 63.7 percent said they had used pharmacotherapy and 15.7 percent had used the quit line, and 20.2 percent were smoke-free for one week. Those who still smoked cut their intake nearly in half, from about 14 cigarettes a day down to about seven.
The decision aid serves as a catalyst for smokers to talk about cessation with health care providers. “They will be equipped to actively discuss their smoking status and their interest in quitting and in using resources,” Cupertino said. “So it’s kind of meeting the provider halfway.”
“The kiosk and intervention appeared to be very well-received and could be an important addition to the way in which we share information about cessation treatment with smokers,” said Emily Burns, M.D., an assistant professor in epidemiology at the University of Colorado School of Public Health in Denver.
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Journal of Health Care for the Poor and Underserved: Contact Editor Virginia M. Brennan at (615) 327-6819 or firstname.lastname@example.org. Online, visit http://www.press.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/
Cupertino AP, et al. Feasibility of a Spanish/English computerized decision aid to facilitate smoking cessation efforts in underserved communities. J Health Care Poor Underserved 21(2), 2010.