MiQuit: A Study Protocol to Link Low-Income Smokers to a State Tobacco Quitline.

Purpose: To conduct a randomized controlled trial to compare 3 implementation strategies and the impact of facilitated referrals on linkage of Federally Qualified Health Center patients to the Illinois Tobacco Quitline (ITQL).

Methods: This study will be a hybrid type 3 implementation-effectiveness trial guided by 2 implementation science frameworks: reach, effectiveness, adoption, implementation, and maintenance and exploration preparation implementation sustainment. We will evaluate whether sending provider messages through the patient electronic health portal increases patient linkage to the ITQL. We will (1) randomly assign all eligible patients to receive 1 of 3 messages (information about quitting, advice to quit, and advice to quit or cut down), and (2) we will offer a facilitated linkage to the ITQL. For patients who opt into a facilitated referral, we will share their contact information with the ITQL, who will contact them. Four weeks after the initial message, patients who expressed interest in services but were not reached by the ITQL will be rerandomized to 1 of 2 arms, an offer to reconnect to the ITQL or an offer to engage a peer navigator who can help them reconnect to the ITQL. We will assess the implementation strategies' reach, adoption, linkage, and sustainability with the ITQL.

Discussion: This study will provide a new cost-effective and efficient model to link low-income smokers to state tobacco quitlines. Message delivery via patient health portals has important implications for addressing other tobacco-related morbidities.