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Trial registered on ANZCTR
Registration number
ACTRN12624000395538
Ethics application status
Not required
Date submitted
7/02/2024
Date registered
3/04/2024
Date last updated
3/08/2024
Date data sharing statement initially provided
3/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Financial incentives for smoking and vaping cessation in South Australia: evaluation of the Incentive to Quit (I2Q) pilot program.
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Scientific title
Financial incentives for smoking and vaping cessation in South Australia: evaluation of the Incentive to Quit (I2Q) pilot program for smokers, vapers and dual users
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Secondary ID [1]
311405
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
Qualitative evaluation registration: ACTRN12623000842662
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Health condition
Health condition(s) or problem(s) studied:
tobacco smoking
332676
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Condition category
Condition code
Mental Health
329382
329382
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0
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Addiction
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The Incentive to Quit (I2Q) pilot aims to reduce harms associated with smoking and vaping by; i) training health professionals (HPs) on delivering brief smoking cessation advice, ii) providing eligible smokers and vapers with financial incentives, iii) referring participants to the Quitline counselling service (via hard copy recommendation, encouragement to contact Quitline by HP or by research staff, or by direct link), and iv) providing pocket-sized resources developed for this program (hard copy) and links to existing online resources with content to facilitate and support quit attempts.
For health professionals, four levels of education + training will be available to develop skills, knowledge, and confidence in providing brief advice, and understanding issues specific to priority group support:
• 5-minute I2Q program education: Outline the I2Q program, explain how to enrol smokers/vapers & provide resources
• 15-minute I2Q education + training: Outline + basic tips discussion for supporting smoker/vaper quit attempts
• 60-minute I2Q education + population group tailored training: Outline + basic tips + tailored support and education relevant for individual population groups
• 30- to 60-minute “Essentials training for HPs”: Extended training support to equip HPs with the skills, confidence, and knowledge to support smokers/vapers to quit
Training will be delivered in person by Houd Research Group personnel who have experience in delivering smoking cessation services across local health networks. This training has been/will be made available throughout November 2022 to December 2024 to account for HP staff turnover.
Participants will be offered several sources of cessation support on their quit smoking journey at three time-points: baseline ($20), 3-months ($20 if tried to quit, $50 if have quit OR had >4 Quitline talks), and 6-months ($20 if tried to quit, $80 if have quit). Milestone achievements include attempts to quit smoking, participation in Quitline counselling, and successful quitting confirmed through biochemical validation.
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Intervention code [1]
327841
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Behaviour
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Intervention code [2]
328074
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Lifestyle
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Comparator / control treatment
Historical control. Efficacy data from program participants will be compared with smoking cessation rates from the literature (Vidrine 2013). Quitline data for 12 months prior (March 2023-March 2024) to I2Q will be compared with 2 years post-I2Q.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Potential efficacy of the I2Q program to encourage smoker/vaper abstinence.
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Assessment method [1]
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Biochemically validated abstinence, assessed via carbon monoxide testing for smokers, or saliva cotinine test for vapers.
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Timepoint [1]
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3-month and 6-month follow-up post baseline enrolment.
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Primary outcome [2]
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Feasibility of the I2Q program by smokers/vapers
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Assessment method [2]
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Reach: 1) Proportion of potentially eligible smokers who attend one of the three participating health service groups who are not enrolled in the I2Q program, as per data from study database
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Timepoint [2]
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3-months and 6-months post baseline enrolment.
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Primary outcome [3]
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Feasibility of the I2Q program by smokers/vapers
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Assessment method [3]
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Efficacy: 1) Self-reported (via survey designed specifically for this program) smoking quit attempts at 3-month follow-up and 6-month follow-up.
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Timepoint [3]
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3-months and 6-months post baseline enrolment
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Secondary outcome [1]
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Effect of training health professionals on confidence toward offering quit smoking support to clients
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Assessment method [1]
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1-7 Likert scales and questionnaires, designed specifically for this program
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Timepoint [1]
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Pre-training, immediately post-training, 6-months after training
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Secondary outcome [2]
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Effect of training health professionals on knowledge toward offering quit smoking support to clients
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Assessment method [2]
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1-7 Likert scales and questionnaires, designed specifically for this program
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Timepoint [2]
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Pre-training, immediately post-training, 6-months after training
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Secondary outcome [3]
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Effect of training health professionals on attitude toward offering quit smoking support to clients
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Assessment method [3]
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1-7 Likert scales and questionnaires, designed specifically for this program
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Timepoint [3]
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Pre-training, immediately post-training, 6 months after training
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Secondary outcome [4]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by smokers/vapers
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Assessment method [4]
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Adoption: 1) The number of smokers enrolling in Quitline counselling as per data from study database
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Timepoint [4]
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3-months and 6-months post baseline enrolment
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Secondary outcome [5]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by smokers/vapers
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Assessment method [5]
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1) Average number of smokers offered I2Q program enrolment, average number using Quitline, and average number of 3-month, and 6-month follow-ups by each HP agreeing to participate in the program, as per data from study database (composite outcome)
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Timepoint [5]
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3-months and 6-months post baseline enrolment
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Secondary outcome [6]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by smokers/vapers
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Assessment method [6]
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Maintenance: 1) The number of smokers returning for follow-up incentives at 3- and 6-months, as per data in study database
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Timepoint [6]
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3-months and 6-months post baseline enrolment
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Secondary outcome [7]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by HPs
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Assessment method [7]
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Reach: 1) Proportion of individual HPs within each health service group who agree to participate in the I2Q program by enrolling potentially eligible smokers, compared to the estimated number of HPs employed during the I2Q program period, as per data from study database compared with health service site records.
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Timepoint [7]
432193
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3-months and 6-months post baseline enrolment
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Secondary outcome [8]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by HPs
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Assessment method [8]
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Efficacy: 1) Changes to HP behaviours, knowledge, attitudes, confidence, and motivation to deliver brief quit smoking advice using 7-point Likert scales (designed specifically for this program) at education/training commencement and 6-month follow-up. Composite outcome.
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Timepoint [8]
432194
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3-months and 6-months post baseline enrolment
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Secondary outcome [9]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by HPs
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Assessment method [9]
432195
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Adoption: 1) HPs who underwent at least one component of the I2Q program training, as per data from study database
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Timepoint [9]
432195
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3-months and 6-months post baseline enrolment
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Secondary outcome [10]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by HPs
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Assessment method [10]
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Implementation: 1) Average numbers of HP-reported mechanisms through which smokers are recruited into the I2Q program, as per data from study database
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Timepoint [10]
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3-months and 6-months post baseline enrolment
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Secondary outcome [11]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by HPs
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Assessment method [11]
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Maintenance: 1) Extent to which HPs continue to enrol smokers into the I2Q program over time, as per data from study database
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Timepoint [11]
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3-months and 6-months post baseline enrolment
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Secondary outcome [12]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by smokers/vapers
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Assessment method [12]
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Reach: 2) Number of referrals to Quitline in 12 months prior to I2Q, compared with 2 years post-I2Q. Comparison of data from study database with Quitline data.
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Timepoint [12]
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3-months and 6-months post baseline enrolment
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Secondary outcome [13]
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(PRIMARY OUTCOME) Feasibility of the I2Q program by smokers/vapers
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Assessment method [13]
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Implementation 2) Average number of potentially eligible smokers completing all ‘top level’ incentive components, receiving $150. As per data from study database.
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Timepoint [13]
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3-months and 6-months post baseline enrolment
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Secondary outcome [14]
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Feasibility of the I2Q program by HPs
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Assessment method [14]
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Reach 2) Proportion of HPs who recruit at least one smoker into the program, as per data from study database
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Timepoint [14]
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Post-study completion
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Secondary outcome [15]
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(PRIMARY OUTCOME) Feasibility of I2Q program by HPs
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Assessment method [15]
433098
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Adoption 2) Proportion of HPs who attend Quit training, compared to those who do not register, as per data from study database
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Timepoint [15]
433098
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Post-study completion
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Secondary outcome [16]
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(PRIMARY OUTCOME) Feasibility of I2Q program by HPs
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Assessment method [16]
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Adoption 3) Number of unique HPs referring to Quitline, as per data from study database
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Timepoint [16]
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Post-study completion
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Eligibility
Key inclusion criteria
Smokers, vapers and dual users are eligible for the I2Q program if they are:
• Attending one of the 4 participating NALHN services as an inpatient or outpatient between 03/04/2024 and 31/12/2024:
• Aboriginal health
• Mental health
• Cardiac health
• Respiratory health
• Daily smoker of at least 1 cigarette or equivalent (e.g. cigarillo, cigar, snuff) per day, OR 10 cigarettes per week
• OR “regular” electronic cigarette (e-cig) user/vaper (noting “regular” is self-reported by the patient as we do not yet have a clear definition of what constitutes regular vaping)
• At least 18 years of age
• Willing to make a quit attempt to stop smoking and/or vaping within 2 weeks of enrolment
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Participants who are unable to communicate effectively in English will be excluded from the study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Feasibility and acceptability of the program will be evaluated through the systematic, rigorous RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework. The RE-AIM framework: The RE-AIM framework has been operationalised to evaluate tobacco control services. It builds on several models, including systems-based and social-ecological thinking, as well as community-based and public health intervention development. This will allow tracking of essential program elements to identify relevant information to inform recommendations for I2Q program sustainability, up-scale, and expansion.
Means and standard deviations (SD) will evaluate change scores for Likert scale questionnaires across each health service group. Each of the five RE-AIM dimensions are represented on a 0 to 1 scale (or 0% to 100%), allowing each domain to be plotted on a graph, representing each participating hospital for direct comparison. Descriptive statistics such as means + SD will explore assessment outcomes. Statistical analyses for proportions will be performed using the Stata procedure fracreg (fractional regression: fracreg outcome period i.healthservice, vce(cluster clinicianid)). Dropouts and loss to follow-ups will be reported as relevant assessment outcomes in this pilot evaluation.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
4/04/2024
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Actual
4/04/2024
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Date of last participant enrolment
Anticipated
31/12/2024
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Actual
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Date of last data collection
Anticipated
31/07/2025
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Actual
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Sample size
Target
450
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Accrual to date
20
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Drug and Alcohol Services South Australia
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Address [1]
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Country [1]
315666
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Australia
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Primary sponsor type
Other
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Name
Houd Research Group
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
317768
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Country [1]
317768
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Ethics approval
Ethics application status
Not required
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Ethics committee name [1]
314545
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Aboriginal Health Research Ethics Committee
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Ethics committee address [1]
314545
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https://ahcsa.org.au/research-and-ethics/ethical-review-ahrec
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Ethics committee country [1]
314545
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Australia
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Date submitted for ethics approval [1]
314545
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08/04/2024
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Approval date [1]
314545
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Ethics approval number [1]
314545
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Ethics committee name [2]
314630
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SA Department for Health and Wellbeing Human Research Ethics Committee
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Ethics committee address [2]
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https://www.sahealth.sa.gov.au/wps/wcm/connect/public%2Bcontent/sa%2Bhealth%2Binternet/about%2Bus/health%2Band%2Bmedical%2Bresearch/research%2Bethics/sa%2Bhealth%2Bhuman%2Bresearch%2Bethics%2Bcommittees/sa%2Bdepartment%2Bfor%2Bhealth%2Band%2Bageing%2Bhuman%2Bresearch%2Bethics%2Bcommittee
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Ethics committee country [2]
314630
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Australia
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Date submitted for ethics approval [2]
314630
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28/02/2024
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Approval date [2]
314630
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Ethics approval number [2]
314630
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Ethics committee name [3]
314631
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University of Adelaide Human Research Ethics Committee
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Ethics committee address [3]
314631
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https://www.adelaide.edu.au/research-services/ethics-compliance-integrity/human-research-ethics/human-research-ethics-committee
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Ethics committee country [3]
314631
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Australia
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Date submitted for ethics approval [3]
314631
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08/04/2024
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Approval date [3]
314631
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Ethics approval number [3]
314631
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Summary
Brief summary
Reducing tobacco use is an urgent national health priority in Australia, as it is the leading cause of preventable death and disability. The Incentive to Quit (I2Q) pilot aims to reduce harms associated with smoking and vaping by; i) training health professionals on delivering brief smoking cessation advice, ii) providing eligible smokers and vapers with financial incentives, iii) referring participants to the Quitline counselling service, and iv) providing pocket-sized resources with content to facilitate and support quit attempts. For health professionals, four levels of education + training will be available to develop skills, knowledge, and confidence in providing brief advice, and understanding issues specific to priority group support. Participants will be offered several sources of support to increase chances of success in their quit smoking journey at three time-points: baseline, 3-months, and 6-months. Milestone achievements include attempts to quit smoking, participation in Quitline counselling, and successful quitting confirmed through biochemical validation. Feasibility and acceptability of the program will be evaluated through the systematic, rigorous RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework. The primary outcome is to determine potential efficacy of the I2Q program to encourage smoker/vaper abstinence as an adjunct to standard health service delivery, evaluated by the number of smokers with biochemically validated abstinence at 3-month and 6-month follow-up, and the number of smokers that enrolled into the I2Q program. Secondary outcomes are to determine the feasibility and acceptability of the I2Q program to support smoker quit attempts, and potential for up-scale and expansion.
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Trial website
houdresearch.com.au/i2q
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Kristin Carson-Chahhoud
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Address
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Houd Research Group, 13 Rossall St, Somerton Park, 5044, SA
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Country
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Australia
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Phone
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+61 0412708879
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Mrs Kelsey Sharrad
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Address
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Houd Research Group, 13 Rossall St, Somerton Park, 5044, SA
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Country
131967
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Australia
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Phone
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+61 0412 708 879
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Fax
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Email
131967
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[email protected]
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Contact person for scientific queries
Name
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Kristin Carson-Chahhoud
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Address
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Houd Research Group, 13 Rossall St, Somerton Park, 5044, SA
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Country
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Australia
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Phone
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+61 0412708879
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Fax
131968
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Email
131968
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
22070
Study protocol
Study protocol will be available via citation once...
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Download to PDF