Crisis as Opportunity NAQC NCTOH, June 9 th , 2009 Phoenix, AZ
Highlights from the 2009 NAQC Annual Survey of Quitlines Prepared by: ERDU, Mignonne Guy, Jessie...
Transcript of Highlights from the 2009 NAQC Annual Survey of Quitlines Prepared by: ERDU, Mignonne Guy, Jessie...
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Highlights from the 2009 NAQC Annual Survey
of Quitlines
Prepared by: ERDU, Mignonne Guy, Jessie Saul, and the NAQC Annual Survey Workgroup
July 22, 2010
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Background of Annual Survey
Conducted Annually 2004-2006, 2008, 2009• Research Partners:
– 2008 and 2009 Evaluation, Research and Development Unit, University of Arizona
– 2006 Center for Tobacco Research and Intervention, University of Wisconsin
– 2005 University of California, San Diego
– 2004 Tobacco Technical Assistance Consortium
Informs research and practice
Is an iterative process
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2009 Annual Survey Methods
2009 Survey completed in Two Waves• Wave 1 email-based with telephone follow-up:
– Questions: 1) Quitline budgets, changes over time, impacts, 2) Funding sources, 3) Promotion and utilization of services, and 4) Surges in call volume and impacts
• Wave 2 web-based with telephone follow-up: – Questions: 1) General Information, hours, services offered, 2)
Materials used, 3) Counselling services and protocols, 4) Utilization, and 5) Evaluation
63 quitline funders and their service providers were asked to respond:• 53 US and Territories quitlines (100% Wave 1, 98% Wave 2)• 10 Canadian quitlines (100% Wave 1 and 2)
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BUDGET
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For the first time, the median and total US quitline budgets decreased in FY10
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Median quitline budgets in Canada have stayed relatively constant from FY05 – FY10
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Median budget for services and medications US, 2005-2010
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Median budget for servicesCanada, 2005-2010
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The majority of US quitlines report receiving funds from CDC or MSA funds
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For US quitlines, the highest proportion of funds come from MSA, general funds, and dedicated
tobacco tax funds
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The majority of Canadian quitlines report receiving funds from provincial general funds
or Health Canada
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For Canadian quitlines, the highest proportion of funds come from Health Canada and
provincial general funds
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DESCRIPTION OF SERVICES
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General Service Description FY09All quitlines responding reported having counseling
services available at least five days per week for a minimum of eight hours per day
49 or 94% of US and 9 or 90% of Canadian quit lines also offered counseling service on at least one day of the weekend
13 quitlines (11 or 21% of US and 2 or 20% of Canadian) reported having live pick-up of incoming calls (may or may not have counseling services available) 24 hours a day, 7 days a week
77% of US (n=41) and 80% of Canadian (n=8) quitlines reported closing on holidays
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All US and Canadian quitlines provide multiple proactive counseling sessions FY09
Phone counseling services
USN = 53
CAN N = 10
%(n)
%(n)
Minimal/brief intervention—client-initiated —1-10 minutes57%(30)
100%(10)
Single session counseling more than 10 minutes—client-initiated72%(38)
100%(10)
Multiple sessions—client-initiated (i.e., reactive, client calls in for each follow up)
45%(24)
100%(10)
Multiple sessions—counselor-initiated (i.e., proactive, cessation specialist / counselor / coach calls client for follow up)
100% (53)
100%(10)
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More Canadian than US quitlines provide interactive web-based programs to help
tobacco users quit FY09
Internet-based services
USN = 53
CANN = 10
%(n)
%(n)
Information about the quitline72%(38)
80%(8)
Information about tobacco cessation74%(39)
80%(8)
Self-directed web-based intervention to help tobacco users quit42%(22)
70%(7)
Automated email messages30%(16)
50%(5)
Chat rooms28%(15)
70%(7)
Interactive counseling and/or email messaging to cessation specialist/counselor/ coach to help tobacco users quit
28%(15)
40%(4)
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Nearly all US and Canadian quitlines refer to other services, have fax referral programs, and mail information
to tobacco users FY09
Other services
US(n = 53)
CAN(n = 10)
%(n)
%(n)
Voice mail with call backs or mailed information or self-help resources59%(31)
70%(7)
Recorded messages for help with quitting (e.g., phone tree)59%(31)
20%(2)
Referral to other services94%(50)
90%(9)
Fax referral for healthcare providers and other referral sources94%(50)
100%(10)
Mailed information or self help resources (provided through the quitline)83%(44)
90%(9)
Text messaging to cell phones (integrated with telephone counseling)2%(1)
10%(1)
IVR (Interactive Voice Response) (integrated with telephone counseling)2%(1)
20%(2)
Other15%(8)
0%(0)
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Language of Counseling Service FY09
52 1051
1
8
2 11 11
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US Primary Service Providers FY09
12
63 3
17
The figure below shows the organizations (n=17) that were the primary service provider of counseling services for US quitlines
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Canadian Service Providers FY09
The majority of Canadian quitlines (60%) had counseling services provided by the Canadian Cancer Society, Ontario Division
6
1 1 1 1
1 1 1 1
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Language of Cessation Materials FY09
52
111
11
51
11
9
10
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Specialized Materials for Special Populations FY09
51 US quitlines (96%) and 6 Canadian quitlines (60%) send specialized materials to special populations. These include:
6
2
3
21
21
3 3
11
2
51 49
41 40
2025
11 1066
15 1
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Specialized Materials for Racial/Ethnic Populations FY09
76% of US and 10% of Canadian quitlines offers specialized materials to callers of racial/ethnic populations. These include:
1214
37
1
1 11
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MEDICATIONS
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Provision of Quitting Medication FY09
Patch Gum Lozenge Zyban ChantixNasal Spray
InhalerANY Meds
US (N=53)
Provide free medication 76% 60% 42% 4% 2% 2% 4% 70%
Provided discounted meds 8% 8% 8% 4% 6% 4% 4% 8%
Provided voucher to redeem meds 9% 8% 8% 6% 8% 6% 6% 9%
Canada (N=10)
Provide free medication - - - - - - - -
Provided discounted meds - - - - - - - -
Provided voucher to redeem meds - - - - - - - -
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Free Medication ProvisionUS Quitlines, FY09
Free Meds Type
# Providing Type of
Free Meds
N
(Providing weeks data)
Median # of Weeks
Provided
Minimum # of Weeks
Maximum # of Weeks
Patch 40 39 4 2 10
Gum 32 31 4 2 8
Lozenge 22 22 6 2 12
Zyban 2 2 10 8 12
Inhaler 2 2 5 2 8
Chantix 1 1 12 12 12
Nasal Spray
1 1 8 8 8
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Provision of Quitting Medication FY10
Patch Gum Lozenge Zyban ChantixNasal Spray
Inhaler
US (N=53)
Provide free medication 79% 60% 42% 6% 4% 2% 2%
Provided discounted meds 4% 4% 4% 2% 4% 2% 2%
Provided voucher to redeem meds 4% 2% 2% 4% 6% 2% 2%
Canada (N=10)
Provide free medication - - - - - - -
Provided discounted meds - - - - - - -
Provided voucher to redeem meds - - - - - - -
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Free NRT Eligibility CriteriaUS (N=52), FY10
Of the 52 US quitlines providing some form of free meds, the eligibility criteria included:
7
3833
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PROMOTION AND OUTREACH
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Types of Media/Promotions and Outreach Activities FY09-10, US Quitlines
FY09 (N=52) FY10 (N=52)
Paid Media/Promotions
TV 73% 58%
Radio 62% 65%
Newspaper ads 40% 35%
Billboards 35% 25%
Online advertising 40% 52%
Earned media 73% 73%
Outreach
Information display at health fairs, meetings, workshops, conferences
88% 85%
Building healthcare referral networks 79% 88%
Building other referral networks 75% 77%
Other 25% 31%
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Types of Media/Promotions and Outreach Activities FY09-10, Canadian quitlines
FY09 (N=10) FY10 (N=10)
Paid Media/Promotions
TV 70% 80%
Radio 60% 50%
Newspaper ads 70% 60%
Billboards 10% 10%
Online advertising 70% 80%
Earned media 90% 100%
Outreach
Information display at health fairs, meetings, workshops, conferences
100% 90%
Building healthcare referral networks 100% 100%
Building other referral networks 80% 100%
Other 30% 60%
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Promotions/Outreach for Priority/Specialized Populations FY10
3431
276
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UTILIZATION
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US Promotional Reach FY 2005-2009
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Canada Promotional Reach FY 2005-2009
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Where are we now?
FY09 Reach
Promotional Reach
(# of tobacco users completing an intake)
Median (N)
Treatment Reach
(# receiving evidence based services)
Median (N)
US 1.2% (49) 0.7% (46)
Canada 0.3% (9) 0.3% (3)
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US Quitlines Promotional Reach and Spending per Smoker FY09
CDC recommendation: 8% reach, $10.53 per smoker
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US Quitlines Treatment Reach and Spending Per Smoker FY09
CDC recommendation: 6% reach, $10.53 per smoker
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Canada Quitlines Promotional Reach and Spending Per Smoker FY09
CDC recommendation: 8% reach, $10.53 per smoker
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The majority of quitline callers are cigarette users FY09
US (median) Canada (median)
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The majority of quitline callers are everyday/daily smokers FY09
US (median) Canada (median)
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Most quitline callers are female FY09
US (median) Canada (median)
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Utilization FY09 – Level of Education US
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Utilization FY09– Ethnicity and Race US
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Insurance Status of Callers FY09
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EVALUATION
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Evaluation FY09
50 US quitlines (94%) and 4 Canadian quitlines (40%) conduct follow-up evaluations
Most quitlines have follow-up evaluation conducted by:• staff other than quitline staff (e.g., internal evaluation unit) (US
n=24; Canada n=1),• an outside evaluation firm (US n=18; Canada n=2)
Next most commonly cited was evaluation conducted by: • quitline staff (US n=13; Canada n=1)• the funding agency (US n=4) • an other source (US n=2)
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Evaluation FY09
The types of evaluation data collected by those quitlines that conduct follow-up evaluations include:
• Customer satisfaction:
US (94%, 50), Canada (40%, 4)
• Quitting outcome:
US (94%, 50), Canada (30%, 3)
• Staff performance:
US (70%, 37), Canada (10%, 1)
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Evaluation – Sampling Strategy FY09
The sampling strategy used by Quitlines for follow-up evaluations include:• Random sampling: US (53%, 28), Canada (10%, 1)
• Census Sampling (all callers): US (45%, 24), Canada (10%, 1)
• Continuous sampling (year-round): US (26%, 14), Canada (10%, 1)
• Cohort sampling (time-limited): US (8%, 4), Canada (10%, 1)
• Periodic sampling (within one year or across multiple years): US (6%, 3), Canada (10%, 1)
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Evaluation – Sampling Time Points FY09 N %
US (N=53)
3 months after registration/first contact 15 28
4 months after registration/first contact 11 21
6 months after registration/first contact 12 23
7 months after registration/first contact 34 62
12 months after registration/first contact 13 25
13 months after registration/first contact 13 25
Other 2 4
Canada (N=10)
7 months after registration/first contact 1 10
Other 2 20
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Evaluation – Sampling Criteria FY09
US (N=53) Canada (N=10)
Sample all those who… N % N %
Call (regardless of reason) 6 11 - -
Are current tobacco users at first call 29 55 2 20
Are former tobacco users at first call 19 36 1 10
Are 18 years and older 24 45 1 10
Register for counseling 20 38 - -
Receive counseling (begin first call) 16 30 1 10
Receive medications 7 13 - -
Consent to follow-up 31 59 2 20
Set a quit date 3 6 1 10
Complete all counseling session 3 6 - -
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ADDITIONAL INFORMATION AND RESOURCES
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2009 Annual Survey Web Page
http://www.naquitline.org/?page=survey2009
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Using Annual Survey Data
http://www.naquitline.org/?page=surveyrequestdata
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NEW! Quitline Map
www.naquitline.org, click on “About
Quitlines/Quitline Map”
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NEW! Revised Quitline ProfilesSame information•Phone numbers•Hours of operation•Languages•Services offered•Materials provided•Medications•Service provider•Eligibility
New information•Provider (e.g., fax) referral information
•Smoke-free laws•Tobacco tax rates•Quitline metrics (reach, spending per smoker, quit rate)
•Context for quitline metrics
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New controls for profiles
• Each quitline will be able to edit most profile fields in real-time
• Launch and training for new profiles in Fall, 2010
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SURVEY FEEDBACK AND QUESTIONS
• Feedback from members about FY09 survey process, suggestions for 2010 survey
• 2010 survey timeline:• Finalize survey by July 31• Launch in October 2010• Data collection Oct-Nov 2010
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For more information on the survey or on NAQC’s data request and review process, please contact;
Jessie Saul, Ph.D.Director of ResearchNorth American Quitline Consortium3030 N. Central Ave, Ste 602Phoenix, AZ 85012Ph: 602.279-2719Email: [email protected]