Laura Twyman, Scott Walsberger, Amanda L. Baker, Sima Ahmadi, Christopher Oldmeadow, Marianne Weber, Sharon Lawn, Marita Hefler, Jennifer Bowman, Philippa Boss, Karina Ko, Alexandra Scott, Brigitte Fienberg, Christina Watts, Alecia Brooks, Rebecca Ireland, Billie Bonevski
{"title":"一项旨在增加澳大利亚社区管理精神卫生组织戒烟支持的组织变革计划的结果：一项聚类随机对照试验","authors":"Laura Twyman, Scott Walsberger, Amanda L. Baker, Sima Ahmadi, Christopher Oldmeadow, Marianne Weber, Sharon Lawn, Marita Hefler, Jennifer Bowman, Philippa Boss, Karina Ko, Alexandra Scott, Brigitte Fienberg, Christina Watts, Alecia Brooks, Rebecca Ireland, Billie Bonevski","doi":"10.1111/add.16733","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>To test the effectiveness of an organisational change intervention aimed at increasing the offer of nicotine replacement therapy (NRT) in community managed mental health organisations.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>A pragmatic cluster randomised controlled trial with cluster as the unit of randomisation and six- and nine-month follow-up from baseline.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Twelve clusters comprising 26 sites providing community based, psychosocial support to people with severe mental illness in New South Wales, Australia, were randomised to control (<i>n</i> = 13 sites, <i>n</i> = 118 consumers) or intervention (<i>n</i> = 13 sites, <i>n</i> = 139 consumers) arms between 2018 and 2019.</p>\n </section>\n \n <section>\n \n <h3> Participants</h3>\n \n <p>Eligible consumers (aged 16 years and older; self-reported daily or occasional cigarette use) completed surveys at baseline (<i>n</i> = 257) and at six- (<i>n</i> = 162, 63%) and nine-month follow-up (<i>n</i> = 144, 56%).</p>\n </section>\n \n <section>\n \n <h3> Intervention</h3>\n \n <p>The intervention included a financial grant, face-to-face and on-line training and proactive monthly support to guide implementation. The active control condition included on-line training and generic, scheduled support via email.</p>\n </section>\n \n <section>\n \n <h3> Measurements</h3>\n \n <p>The primary outcome was whether consumers reported receiving an offer of NRT at nine-month follow-up. Secondary outcomes at the consumer, staff and organisational level were also measured.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Consumers in the intervention group had statistically significantly higher odds of being offered NRT at nine-month follow-up compared with control (intention to treat missing = no offer: 38% versus 7%, odds ratio 5.72, 95% confidence interval = 2.2, 14.9). There were no statistically significant differences in seven-day point prevalence or continuous abstinence at six- or nine-month follow-ups.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>An organisational change-based program led to an increase in the offer of nicotine replacement therapy (NRT) nine months after program initiation in community managed mental health organisations, compared with active control. There was evidence of greater NRT use in the intervention condition at nine months but no evidence of differences on abstinence measures at six or nine months.</p>\n </section>\n </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"120 5","pages":"937-950"},"PeriodicalIF":5.2000,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of an organisational change program aimed at increasing smoking cessation support within Australian community managed mental health organisations: A cluster randomised controlled trial\",\"authors\":\"Laura Twyman, Scott Walsberger, Amanda L. Baker, Sima Ahmadi, Christopher Oldmeadow, Marianne Weber, Sharon Lawn, Marita Hefler, Jennifer Bowman, Philippa Boss, Karina Ko, Alexandra Scott, Brigitte Fienberg, Christina Watts, Alecia Brooks, Rebecca Ireland, Billie Bonevski\",\"doi\":\"10.1111/add.16733\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>To test the effectiveness of an organisational change intervention aimed at increasing the offer of nicotine replacement therapy (NRT) in community managed mental health organisations.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>A pragmatic cluster randomised controlled trial with cluster as the unit of randomisation and six- and nine-month follow-up from baseline.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Setting</h3>\\n \\n <p>Twelve clusters comprising 26 sites providing community based, psychosocial support to people with severe mental illness in New South Wales, Australia, were randomised to control (<i>n</i> = 13 sites, <i>n</i> = 118 consumers) or intervention (<i>n</i> = 13 sites, <i>n</i> = 139 consumers) arms between 2018 and 2019.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Participants</h3>\\n \\n <p>Eligible consumers (aged 16 years and older; self-reported daily or occasional cigarette use) completed surveys at baseline (<i>n</i> = 257) and at six- (<i>n</i> = 162, 63%) and nine-month follow-up (<i>n</i> = 144, 56%).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Intervention</h3>\\n \\n <p>The intervention included a financial grant, face-to-face and on-line training and proactive monthly support to guide implementation. The active control condition included on-line training and generic, scheduled support via email.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Measurements</h3>\\n \\n <p>The primary outcome was whether consumers reported receiving an offer of NRT at nine-month follow-up. Secondary outcomes at the consumer, staff and organisational level were also measured.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Findings</h3>\\n \\n <p>Consumers in the intervention group had statistically significantly higher odds of being offered NRT at nine-month follow-up compared with control (intention to treat missing = no offer: 38% versus 7%, odds ratio 5.72, 95% confidence interval = 2.2, 14.9). There were no statistically significant differences in seven-day point prevalence or continuous abstinence at six- or nine-month follow-ups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>An organisational change-based program led to an increase in the offer of nicotine replacement therapy (NRT) nine months after program initiation in community managed mental health organisations, compared with active control. There was evidence of greater NRT use in the intervention condition at nine months but no evidence of differences on abstinence measures at six or nine months.</p>\\n </section>\\n </div>\",\"PeriodicalId\":109,\"journal\":{\"name\":\"Addiction\",\"volume\":\"120 5\",\"pages\":\"937-950\"},\"PeriodicalIF\":5.2000,\"publicationDate\":\"2025-02-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Addiction\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/add.16733\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/add.16733","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Outcomes of an organisational change program aimed at increasing smoking cessation support within Australian community managed mental health organisations: A cluster randomised controlled trial
Aim
To test the effectiveness of an organisational change intervention aimed at increasing the offer of nicotine replacement therapy (NRT) in community managed mental health organisations.
Design
A pragmatic cluster randomised controlled trial with cluster as the unit of randomisation and six- and nine-month follow-up from baseline.
Setting
Twelve clusters comprising 26 sites providing community based, psychosocial support to people with severe mental illness in New South Wales, Australia, were randomised to control (n = 13 sites, n = 118 consumers) or intervention (n = 13 sites, n = 139 consumers) arms between 2018 and 2019.
Participants
Eligible consumers (aged 16 years and older; self-reported daily or occasional cigarette use) completed surveys at baseline (n = 257) and at six- (n = 162, 63%) and nine-month follow-up (n = 144, 56%).
Intervention
The intervention included a financial grant, face-to-face and on-line training and proactive monthly support to guide implementation. The active control condition included on-line training and generic, scheduled support via email.
Measurements
The primary outcome was whether consumers reported receiving an offer of NRT at nine-month follow-up. Secondary outcomes at the consumer, staff and organisational level were also measured.
Findings
Consumers in the intervention group had statistically significantly higher odds of being offered NRT at nine-month follow-up compared with control (intention to treat missing = no offer: 38% versus 7%, odds ratio 5.72, 95% confidence interval = 2.2, 14.9). There were no statistically significant differences in seven-day point prevalence or continuous abstinence at six- or nine-month follow-ups.
Conclusions
An organisational change-based program led to an increase in the offer of nicotine replacement therapy (NRT) nine months after program initiation in community managed mental health organisations, compared with active control. There was evidence of greater NRT use in the intervention condition at nine months but no evidence of differences on abstinence measures at six or nine months.
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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