This phase IV trial examines the effectiveness of a multi-level smoking cessation program for high-risk women in rural communities. Cigarette smoking is a major risk factor for cervical cancer in women. Rural primary care practices and providers often lack the electronic health record support to pre-identify smokers for services, as well as lack the necessary counseling training and access to comprehensive cessation programs. Implementing evidence-based smoking cessation programs in rural Appalachia may decrease the rates of cigarette smoking and as a result decrease the rates of cervical cancer.
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Acceptability of intervention - delivery of AAC
Timeframe: Up to 6 months
Acceptability of intervention - referral rate
Timeframe: Up to 6 months
Fidelity to the intervention: counseling calls
Timeframe: Day after phone counseling during the span of the intervention (one year)
Fidelity to the intervention: provider visits
Timeframe: At time of in person visit for a one week span, every other month during the span of the intervention (one year)
Sustainability of the intervention: clinic continuation of Break Free
Timeframe: During the span of the final phase of study (2 years)
Sustainability of the intervention: counseling sessions
Timeframe: During the span of the final phase of study (2 years)
Sustainability of the intervention: counseling sessions per smoker
Timeframe: During the span of the final phase of study (2 years)
Sustainability of the intervention: EHR documentation
Timeframe: During the span of the final phase of study (2 years)
Cost-effectiveness of intervention
Timeframe: Up to 6 months
Effectiveness of intervention at increasing brief cessation counseling: Change over time
Timeframe: 3 months, 6 months, 12 months
Point prevalence
Timeframe: Up to 7 days
Floating abstinence
Timeframe: Up to 7 days
Prolonged abstinence
Timeframe: At each follow-up visit over the span of the intervention (1 year)
Provider satisfaction
Timeframe: Mid-points of each provider arm during the intervention year (1 year)
Staff satisfaction
Timeframe: Mid-points of each provider arm during the intervention year (1 year)
Smoker satisfaction with Break Free counseling
Timeframe: At the end of each Break Free counseling sessions during the intervention year (year 1)
Smoker satisfaction during Break Free counseling
Timeframe: At the end of each Break Free counseling sessions during the intervention year (year 1)
Smoker satisfaction after Break Free program
Timeframe: At 6 months after completion of Break Free counseling
Change in provider knowledge
Timeframe: Baseline, post-training (same day), 1 year
Change in provider attitudes
Timeframe: Baseline, post-training (1 day), 1 year
Change in provider's normative beliefs
Timeframe: Baseline, post-training (1 day), 1 year
Change in provider's perceived behavioral control
Timeframe: Baseline, post-training (1 day), 1 year
Effectiveness of intervention of Improved provider knowledge and attitude
Timeframe: Baseline, post-training (1 day), 1 year