Comparing an Opt-out to an opt-in Approach for Smoking Cessation in VA Primary Care Clinics



Status:Not yet recruiting
Conditions:Smoking Cessation
Therapuetic Areas:Pulmonary / Respiratory Diseases
Healthy:No
Age Range:Any
Updated:4/6/2019
Start Date:July 1, 2019
End Date:March 31, 2022
Contact:Scott E Sherman, MD MPH
Email:Scott.Sherman@va.gov
Phone:(212) 686-7500

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The investigators propose a Type I hybrid effectiveness/implementation study to evaluate two
population-based approaches for increasing use of Quitlines and text messaging at two VA
sites. Specifically, the investigators will test the default bias, examining whether an
opt-out approach to referral is more effective than an opt-in approach. The investigators
will randomly assign teams to either an opt-out or opt-in approach to referring smokers to
treatment. In the opt-out approach, the default is that everyone is referred to treatment
unless they actively choose not to be. In the opt-in approach, people are offered treatment
but must actively choose to enroll in it.

This project is a Type 1 hybrid effectiveness/implementation study to evaluate two
population-based approaches for increasing use of specific evidence-based approaches for
behavioral tobacco dependence treatment, Quitlines and text messaging, at the Manhattan and
Brooklyn campuses of the VA New York Harbor Healthcare System (NYHHS). The project will test
the default bias, examining whether an opt-out approach to referral is more effective than an
opt-in approach. Researchers will randomly assign clinical care teams at each VA campus to
either an opt-out or an opt-in approach to referring smokers to treatment. In the opt-out
approach, the default is that everyone is referred to treatment unless they actively choose
not to be. In the opt-in approach, people are offered treatment but must actively choose to
enroll in it.

Inclusion Criteria:

- Survey Cohort -- Have been seen by an NA on the PACT team in the past 12 months at the
Manhattan or Brooklyn VA campus AND Current smoker

- Nursing Assistants/Registered Nurses -- Work on a PACT at the Manhattan or Brooklyn VA
campus

- Administrative Cohort -- Have been seen by a PACT team at the Manhattan or Brooklyn VA
campus AND Current smoker

- Patient Post-Visit Survey Population -- Had a visit with an NA/RN included in the
study AND Current smoker

Exclusion Criteria:

- Survey Cohort -- Non-English speaking

- Nursing Assistants/Registered Nurses -- None

- Administrative Cohort -- None

- Patient Post-Visit Survey Population -- Non-English speaking
We found this trial at
1
site
New York, New York 10010
Principal Investigator: Scott E. Sherman, MD MPH
Phone: 212-686-7500
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