Building a tobacco cessation telehealth care management program for veterans with posttraumatic stress disorder

Abstract

Background: Veterans with posttraumatic stress disorder (PTSD) have high rates of smoking. Motivational interviewing (MI) enhances readiness for change.

Objective: To test the feasibility and fidelity of home telehealth care management strategy to improve quit rates.

Design: A telehealth device delivered a cessation curriculum while a nurse supported veterans through weekly MI telephone calls. Treatment fidelity was evaluated. Outcomes measures included changes in smoking behaviors, stage of change, dose effect, and participant satisfaction with intervention.

Results: There was a correlation (r = -.677; p = .03) at the end of treatment between readiness to change and number of cigarettes smoked per day. As 11 participants progressed along stages of change, they smoked fewer cigarettes per day. Two (20%) quit smoking. The nurse adhered to MI principles. Participants were highly satisfied and 100% felt curriculum delivered new information and respected choices.

Conclusions: It was feasible to deliver the home telehealth care management intervention with high treatment fidelity. Participants were motivated to change smoking behaviors.

Keywords: behavioral; telehealth; tobacco cessation.