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Internet-enhanced proactive telephone counseling

Institution: Veterans Medical Research Foundation
Investigator(s): Leslie Lenert, M.D., M.S.
Award Cycle: 2002 (Cycle 11) Grant #: 11RT-0096 Award: $674,731
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
Telephone counseling services are very effective tools in helping smokers quit. One of the most respected services, the California Smokers Helpline (1-800-NO-BUTTS), receives thousands of calls each month. Because resources are limited, the service is only able counsel about half of the callers. This study will look at the use of email and the web, as an aid to the counselors of the California Smokers' Helpline, to both enhance communication and reduce costs.

One of the reasons why telephone counseling is so effective is the one to one service offered by the counselor. The counselor uses his/her skills to respond to the client’s particular needs. The bond between counselor and client helps the client find the strength to quit. There are, however, problems with telephone counseling. Both smoker and counselor have to be available at the same time. Teaching is clearly harder over the phone as no visual aids are available. Another problem is that the counselor has no way of talking to the client between calls. Clients may be lost because counselors cannot help them during crucial times.

We think that using the Internet may solve the problem. More and more Americans are using the Internet and about 90% of them use email. Email is useful because both people do not have to be on-line at the same time. We can also make web sites where a group of users can share information among themselves, and it is possible for one person to tailor materials to be viewed by another person.

The project team will build a web site featuring a set of counselor-controlled tools. Working closely with the counselors from the Helpline, we will look for ways to make their work flow more efficient. The team will look for tools and material that the counselors use that bring the best results and build similar ones for use on the web. Emphasis will be put on building tools that best support the counselor's work.

We will use the telephone, email, and the web to make the program more a part of the clients every day life. Using email and the web will also reduce the number of counselor hours required to provide the service. The site will include lessons to give the client skills for quitting, and tracking tools for the client to record and monitor his/her progress. For example, if a counselor and a client agree that the client should track his cigarette use and cut down to 5 cigarettes a day, one week prior to quitting, the web site will have the ability to detect if the smoker is having difficulty meeting this goal.

The software will be evaluated in a series of 5 pilot studies. Each study will optimize the functioning on one part of the program.