Ohio’s Fax Referral Initiatives Reach, Enrollment and Participant Characteristics Jeff Willett,...
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![Page 1: Ohio’s Fax Referral Initiatives Reach, Enrollment and Participant Characteristics Jeff Willett, PhD Director, NYS Tobacco Control Program March 4 th and.](https://reader036.fdocuments.in/reader036/viewer/2022062518/56649f505503460f94c73052/html5/thumbnails/1.jpg)
Ohio’s Fax Referral Initiatives
Reach, Enrollment and Participant Characteristics
Jeff Willett, PhDDirector, NYS Tobacco Control Program
March 4th and 6th, 2009
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Fax Referral
• The Ohio Tobacco Quit Line began providing statewide services in September, 2004.
• Fax referral was introduced in the first year to increase health provider referral.
• An average of 68 fax referrals were received per month prior to the study period.
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Fax Referral
• Goal: to reduce quit line marketing costs by establishing a sustainable, high volume referral stream from health professionals.
• Three initiatives were developed or expanded to increase health provider utilization of the fax referral. – Fax Five– Hospital Outreach– Community Promotion
![Page 4: Ohio’s Fax Referral Initiatives Reach, Enrollment and Participant Characteristics Jeff Willett, PhD Director, NYS Tobacco Control Program March 4 th and.](https://reader036.fdocuments.in/reader036/viewer/2022062518/56649f505503460f94c73052/html5/thumbnails/4.jpg)
Fax Five
• Direct marketing initiative aimed at health professionals.– Phase I: Promotional folder and 5 fax referral
forms placed in the May/June issue of Ohio Medicine.
– Phase II: Peer Writing Campaign utilizing the Quit Line’s Advisory Panel. Sent personal letters and 5 fax referral forms to 25,970 health professionals in March, 2007.
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Hospital Outreach
• A hospital-focused outreach program funded in March, 2006.
• 51 hospitals received a small stipend to institute a fax referral process.
• Rigorous training component– Daylong in-person training– 5 one-hour training calls
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Community Promotion
• Health professional training program conducted by community tobacco control grantees.
• Beginning January, 2007 all 50 OTPF community grantees were required to “Promote Ohio Quits” including distribution of and training related to health professional quit kits.
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Evaluation
• Evaluation Period June ’06 – Oct. ’07
• Fax referral forms including tracking codes for each initiative
• Fax referrals not tied to study initiatives were treated as “other”
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Fax Referrals ReceivedJune 2006 – October 2007
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Fax Five
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Outreach
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Community
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Referrals ≠
Enrollments
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Outcomes of fax referral call attempts by initiativeJune 2006 – October 2007 (%)
Community(n=1,956)
Hospital (n=1,916)
Fax Five(n=1,065)
Other(n=2,014)
Total(n=6,951)
Enrolled 24.4% 21.3% 28.4% 22.3% 23.6%
Information only 3.4% 3.5% 4.5% 5.6% 4.2%
Declined 13.6% 14.0% 13.2% 14.0% 13.8%
Unreachable 58.6% 61.2% 53.9% 58.1% 58.5%
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Examining the “Unreachable”
Rate
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3rd Call Dispositions for the April 2007 “Unreachable” Fax Referrals (N=368)
Disconnect / Wrong Number
21 5.7%
No Answer, Busy, Hang up
101 27.5%
Voice mail message
183 49.7%
Message left with household
63 17.1%
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Comparing Fax and Traditional
Enrollments
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Quit line enrollee characteristics, by fax referral initiative and fax referral status (%)
Fax referral status
Fax (n=1,616)
Non-fax (n=36,273)
Gender
Male 33 42
Female 67 59
Age
Less than 35 21 31
35-64 72 65
65+ 8 4
Comorbidity
One or more 60 36
Note: Bold values indicate a cell count that was higher than expected values; italicized values indicate a cell count that was lower than expected values, p<0.001.
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Quit line enrollee characteristics, by fax referral initiative and fax referral status (%)
Fax referral status
Fax (n=1,616)
Non-fax (n=36,273)
Education
Less than HS 24 12
HS/GED 41 40
More than HS 35 47
Insurance Status
Private 57 78
Medicaid 11 4
Medicare 8 3
Uninsured 23 16
Note: Bold values indicate a cell count that was higher than expected values; italicized values indicate a cell count that was lower than expected values, p<0.001.
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Reach
• The three initiatives dramatically increased fax referral to the Ohio Tobacco Quit Line.– 68 referrals per month during year before
initiatives– 412 referrals per month during study period– Fax Five: cost-effective, least sustainable
• Can kick-off fax referral expansion
– Community: slow growth, most sustainable
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Enrollment
• 23.6% of fax referred individuals enrolled
• 18% actively declined enrollment (information only or declined all service)
• Based on one-month disposition data– An estimated 40% of fax referrals passively
decline enrollment (do not return voice mail or personal messages left by Quit Line)
• Raises questions about patients actual readiness to quit.
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Participant Characteristics
• Fax referred individuals were more likely to be lower educated, to be uninsured and to have public insurance.
• Compared to non-fax enrollments driven largely by media efforts, costs per enrollment were much higher for fax referrals.
![Page 22: Ohio’s Fax Referral Initiatives Reach, Enrollment and Participant Characteristics Jeff Willett, PhD Director, NYS Tobacco Control Program March 4 th and.](https://reader036.fdocuments.in/reader036/viewer/2022062518/56649f505503460f94c73052/html5/thumbnails/22.jpg)
Questions?
Willett J, Hood N, Burns E, Swetlick J, Wilson S, Lang D, Levinson A. Clinical Fax Referrals to a Tobacco Quitline: Reach, Enrollment and Participant Characteristics. American Journal of Preventive Medicine;36(4):XXX–XXX; April 2009.