The Medi-Cal Incentives to Quit Smoking Project: Impact of Statewide Outreach Through Health Channels.

Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 8704773 Publication Model: Print Cited Medium: Internet ISSN: 1873-2607 (Electronic) Linking ISSN: 07493797 NLM ISO Abbreviation: Am J Prev Med Subsets: MEDLINE

Publication: Amsterdam : Elsevier Science
Original Publication: [New York, NY] : Oxford University Press, [c1985-

Health Promotion/*methods ; Hotlines/*methods ; Poverty/*psychology ; Smokers/*psychology ; Smoking Cessation/*methods; Adult ; Aged ; California ; Counseling/statistics & numerical data ; Female ; Health Promotion/economics ; Hotlines/statistics & numerical data ; Humans ; Longitudinal Studies ; Male ; Medicaid/economics ; Medicaid/statistics & numerical data ; Middle Aged ; Motivation ; Patient Participation/economics ; Patient Participation/psychology ; Patient Participation/statistics & numerical data ; Poverty/economics ; Poverty/statistics & numerical data ; Program Evaluation ; Reimbursement, Incentive/economics ; Reimbursement, Incentive/statistics & numerical data ; Smokers/statistics & numerical data ; Smoking Cessation/economics ; Smoking Cessation/statistics & numerical data ; Telephone ; Tobacco Use Cessation Devices/economics ; United States

Introduction: Little is known about how incentives may encourage low income smokers to call for quitline services. This study evaluates the impact of outreach through health channels on California Medicaid (Medi-Cal) quitline caller characteristics, trends, and reach.
Study Design: Longitudinal study.
Setting/participants: Medi-Cal quitline callers.
Intervention: Statewide outreach was conducted with health providers, Medi-Cal plans (all-household mailings with tracking codes), and public health organizations (March 2012-July 2015). For incentives, Medi-Cal callers could ask for a $20 gift card; in September 2013, callers were offered free nicotine patches.
Main Outcome Measures: Caller characteristics were compared with chi-square analyses, joinpoint analysis of call trends was performed accounting for Medi-Cal population growth, referral source among Medi-Cal and non-Medi-Cal callers was documented, and the annual percentage of the population reached who called the Helpline was calculated. Analyses were conducted 2016-2018.
Results: Total Medi-Cal callers were 92,900, a 70% increase from prior annual averages: 12.4% asked for the financial incentive, 17.3% reported the mailing code, and 73.3% received nicotine patches while offered. Among the two thirds of callers who completed counseling, 15.5% asked for the financial incentive, and 13.6% reported the mailing code. A joinpoint analysis showed call trends increased 23% above expected for the Medi-Cal population growth after mailings to providers and members began, and decreased after outreach ended. Annual reach increased from 2.3% (95% CI=2.1, 2.6) in 2011 to peak at 4.5% (95% CI=3.6, 5.3) in 2014. Among subgroups with higher reach rates, some also had higher rates of asking for the financial incentive (African Americans, American Indian), reporting the tracking code (whites), or both (aged 45-64 years). Medi-Cal callers were more likely than non-Medi-Cal callers to report providers (32.3% vs 23.8%) and plans (19.7% vs 1.4%) as their referral source, and less likely to cite media (20.2% vs 44.4%, p<0.001).
Conclusions: Statewide outreach through health channels incentivizing Medi-Cal members increased the utilization and reach of quitline services.
Supplement Information: This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.
(Copyright © 2018. Published by Elsevier Inc.)

P30 DK092924 United States DK NIDDK NIH HHS

Date Created: 20181121 Date Completed: 20191111 Latest Revision: 20191111

20221213

10.1016/j.amepre.2018.07.031

30454670