Some thoughts about minimal dataset Róbert Urbán Smoking Cessation Center Budapest.
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Transcript of Some thoughts about minimal dataset Róbert Urbán Smoking Cessation Center Budapest.
Some thoughts about minimal dataset
Róbert Urbán
Smoking Cessation Center
Budapest
Why do we collect data?
• Characterizing the users of the service – users’ profile– demographic profile– smoking related profile
• Monitoring and evaluation– interim reports– final report to internal and external stakeholders
• Changes in tobacco behavior – efficacy data– feedback to counselors– information to stakeholders
• Dissemination of experiences and data – media– scientific publications
What type of data
• demographic data
• smoking related data
• general counseling related data
• efficacy related data (efficacy vs. effectiveness)
• client satisfaction
• awareness of quitline
• ad-hoc data
An example of one of our reports
An example of one of our reports (cont.)
An example of an ad hoc research in a quitline setting
Communication about a quitline should concentrate on(1) to increase knowledge and understanding the roles of quitlines in quitting
process among smokers(2) to debunk myths regarding willpower especially among men and (3) to decrease the stigma associated with help seeking in smoking cessation.
Barriers of data collection
What makes it difficult?
Any experience from your practice?
Barriers of collecting data
• Data collection is not easy– Difficulties in recording data during consultation– Lack of time for data collection– Confidentiality issues – ethical practice– Lack of expertise in data management and processing– Technical issues– Data collection is an extra burden on counselors– It also depends on the nature of quitlines (reactive or
proactive; incoming call or referral or Internet registration)– It should be preplanned
What type of questions should we include in MDS?
• Mostly questions with precoded answers.
• Psychometrically sound questions (reliable & valid).
• Questions used in previous surveys for the comparability.
• Number of questions must not create barriers to providing services to our clients.
Reason of callingHow can I help you? (only for incoming call)
Help quitting Help staying quit Refer someone else General information about service
Just to confirm, are you calling for yourself, or calling on behalf of or to help someone else? Calling for yourself for help with quitting Calling for yourself but not for help with quitting Calling on behalf of or to help someone else
Are you? A health professional A friend or family member A community organization, worksite, insurance Other: _________________________________
Source:Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16
(Suppl I): i16-i20)
MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Awareness of quitline
• How did you hear about the quitline? media (possibly more detailed options) other advertising referral (possibly more detailed options) Other, such as ………………….
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
Status – first time or repeat caller
Is this your first call to the quitline in the past year? Yes No Don’t know/Not sure Refused
How many times did you call the quitline in the past 12 months?____ (# of times) don’t know refused not asked
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Smoking related questions
Smoking behaviorsDo you currently smoke cigarettes?
every day some days (if less than 7 days per week)
(occasionally) not at all
(if some days) How many days did you smoke in the last 30 days?
____ days Don’t know Refused Not asked
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
Cigarettes per day (cpd)
• How many cigarettes do you smoke per day on the days you smoke?
____ cigarettes
don’t know
refused
not asked
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
Any other tobacco products?
• What types of tobacco have you used in the past 30 days? Cigarettes
Cigars, cigarillos, or little cigars
A pipe
Chewing tobacco, snuff, or dip
Any other type of tobacco
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
How to measurethe motivation to quit?: stages of change
Are you seriously considering stopping smoking within the next 6 months? Yes No Don’t know/Not sure Refused
Are you planning to stop smoking within the next 30 days? / Do you intend to quit within the next 30 days?*
Yes No Don’t know/Not sure Refused
Source: Starr G, Rogers T, Schooley M, Porter S, Wiesen E, Jamison N. Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs. Atlanta, GA: Centers for Disease Control and Prevention; 2005.
* Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
How to measure the motivation to quit?: number of quit attempts
During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking? Yes No Don’t know/Not sure Refused
Source: Starr G, Rogers T, Schooley M, Porter S, Wiesen E, Jamison N. Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs. Atlanta, GA: Centers for Disease Control and Prevention; 2005.
Variation:
During the past 12 months, how many times have you stopped smoking for one day or longer because you were trying to quit smoking?…… times Don’t know/Not sure Refused
Past quit attempts
How many times in the past have you made a serious quit attempt?
What was the longest period of time that you were able to quit smoking?
The most recent quit attempts: When was your most recent serious attempt to
quit smoking?
How long were you able to stay quit during your most recent quit attempts
Sources: Farkas, Pierce, Zhu et al. (1996). Addiction versus stages of change models in predicting smoking cessation in California. Addiction, 91, 1271-1280.
Measure of addiction – heaviness of smoking index (HSI)
How soon after waking do you smoke your first cigarette? Within 5 minutes (3 points) Within 30 minutes (2 points) Within 1 hour (1 point)
How many cigarettes do you smoke per day? More than 30 per day (3 points) 21 to 30 per day (2 points) 11 to 20 per day (1 point)
Source: Heatherton, T.F., Kozolwski, L., Frecker, R.C., Rickert, W., & Robinson, J. Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day. British Journal of Addiction. 1989. 84: 791-799.
Any other smoking related questions
Demographic variables
• Gender*• Age (year of birth)*• Zip (postal) code – location of residence*• Highest level of completed education*• Occupational status• Marital status• Ethnicity (if it is relevant)
* Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
Follow-up
Intent to treat versus treated clients
Client’s satisfaction
Clients’ satisfaction
Overall, how satisfied were you with the service you received from the quitline? Very satisfied Mostly satisfied Somewhat satisfied Not at all satisfied
don’t know refused not asked
Source: MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Clients’ satisfaction (cont.)If you were to seek help again, would you
contact the quitline? Yes, definitely Yes, I think so No, I don’t think so No, definitely not
Don’t know Refused Not Asked
If no, why not? ______________ (qualitative data)
Source: MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Clients’ satisfaction (cont.)If a friend were in need of similar help, would
you recommend the quitline to him/her? Yes, definitely Yes, I think so No, I don’t think so No, definitely not
Don’t know Refused Not Asked
If no, why not? ______________ (qualitative data)(if yes, why? ______________ )
Source: MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Changes in tobacco behavior
Outcome indicators: abstinence related
• Continuous abstinence: abstinence between quit day and a follow-up time.– 6-month continuous abstinence
• Prolonged abstinence: sustained abstinence after an initial grace period or to a period of sustained abstinence between two follow-ups
• Point prevalence abstinence: abstinence during a time window immediately preceding:– 7-day abstinence at 6 months after quit date– 30-day abstinence at 6 months after quit date
• Repeated point prevalence: point prevalence abstinence at two or more follow-ups between which smoking is allowed.
point prevalence > repeated point prevalence > prolonged abstinence > continuous abstinence
Source: Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine and Tobacco Research. 2003;5(1):13–25.
Questions
• Have you smoked any cigarettes or used other tobacco, even a puff or pinch, in the last 30 days?
Yes No Don’t know Refused Not asked
• Have you smoked any cigarettes or used other tobacco, even a puff or pinch, in the last 7 days?
Yes No Don’t know Refused Not asked
Source: MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Any other tobacco products?
• What types of tobacco have you used in the past 30 days? Cigarettes
Cigars, cigarillos, or little cigars
A pipe
Chewing tobacco, snuff, or dip
Any other type of tobacco
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Smoking behaviors
Do you currently smoke cigarettes? every daysome days (occasionally)
(if less than 7 days per week) not at all
Don’t know Refused Not Asked
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Smoking behaviors
How many days did you smoke in the last 30 days? ____ days
Don’t know Refused Not Asked
MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Cigarettes per day (cpd)
• How many cigarettes do you smoke per day on the days you smoke?
____ cigarettes
don’t know
refused
not asked
Source: Campbell, et al. (2007). Minimal dataset for quitlines: a best practice. Tobacco Control, 16 (Suppl I): i16-i20)
MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Quit attempts
• Since you first called the quitline, seven months ago, did you stop using tobacco for 24 hours or longer because you were trying to quit? Yes No Don’t know Refused Not asked
Medication useSince you first called the quitline seven months ago, have you used
any of the following products or medications to help you quit?
Nicotine patches Nicotine gum Nicotine lozenges Nicotine spray Nicotine inhaler Zyban (also called Wellbutrin or bupropion) Champix (also called varenicline) Other medications to help you quit? (if yes, please
specify):__________________
No products or medications Don’t know Refused Not asked Source: MDS Follow-up Questions 12-30-09 FINAL ©
North American Quitline Consortium, 2009
Other than the quitline or medications
Did you use any other kinds of assistance to help you quit over the past seven months, such as advice from a health professional, or other kinds of quitting assistance?Advice from a health professionalWebsiteTelephone programCounseling programSelf-help materials
Source: MDS Follow-up Questions 12-30-09 FINAL © North American Quitline Consortium, 2009
Further problems to be discussed
• Other tobacco products should be included?• Dealing with different languages
– Translation – backtranslation• Building up electronic database
– preferred program: Excel, SPSS, STATA, SAS, or other– Training if it is needed.
• How to record the data– pen and paper + data entry– Electronic system– Internet based system
• Others
Thank you!