A novel opt-in vs opt-out approach to referral-based treatment of tobacco use in Veterans Affairs (VA) primary care clinics: A provider-level randomized controlled trial protocol

Yaa Haber, Steven S. Fu, Erin Rogers, Kim Richter, Craig Tenner, Joanna Dognin, Keith Goldfeld, Heather T. Gold, Scott E. Sherman

Research output: Contribution to journalArticlepeer-review

Abstract

To determine whether an opt-out approach is effective for referral to treatment for tobacco use, we designed a clinical reminder for nurses in a primary care setting that provides a referral for patients who smoke cigarettes. We will use a two-arm, cluster-randomized design to assign nurses at the VA New York Harbor Healthcare System to test which mode of referral (opt-in vs opt-out) is more effective. All patients will be referred to evidence-based treatment for tobacco cessation including counseling from the New York State Quitline, and VetsQuit, a text messaging-based system for tobacco cessation counseling. We will measure patient engagement with the referral both in the short and long term to determine if referral modality had an impact on tobacco cessation treatment. We will also measure nurse engagement with the referral before, during, and after the implementation of the reminder to determine whether an opt-out approach is cost effective at the health system level. At the conclusion of this project, we expect to have developed and tested an opt-out system for increasing tobacco cessation treatment for Veterans in VA primary care and to have a thorough understanding of factors associated with implementation. Trial Registration: Clinicaltrials.gov Identifier NCT03477435

Original languageEnglish (US)
Article number106716
JournalContemporary Clinical Trials
Volume116
DOIs
StatePublished - May 2022

Keywords

  • Electronic health record
  • Opt-out approach
  • Smoking cessation
  • Telephone quit lines
  • Text message cessation program
  • Tobacco treatment
  • Tobacco use

ASJC Scopus subject areas

  • Pharmacology (medical)

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