The Computer Assisted Brief Intervention for Tobacco (CABIT)

DESCRIPTION (provided by applicant): The majority of healthcare providers do not routinely incorporate brief tobacco interventions into their clinical practice despite the publication and dissemination of clinical practice guidelines from numerous organizations (e.g., Healthy People 2010, NCI, AHRQ). Technological advances, such as computerized assessment, interactive video, and tailored feedback reports, hold tremendous potential for addressing the barriers that prevent routine integration of tobacco assessment and interventions into healthcare settings. This Phase I STTR will establish the feasibility and acceptability of the Computer Assisted Brief Intervention for Tobacco (CABIT) and will prepare the way for Phase II efficacy studies. The CABIT will address the limitations of existing products by integrating an automated, empirically-based tobacco assessment with a multimedia intervention in a manner that can be used across a variety of settings. It will consist of four modules: Assessment, Video Intervention, Provider Counseling Guide, and Tailored Feedback Report. The CABIT's innovations include: (1) features facilitating integration into a range of healthcare settings; (2) automated, response adaptive assessment; (3) predictive modeling of relapse risk; and, (4) multimedia interventions. The value proposition for primary and secondary markets is compelling. Its significance lies in its potential to (1) promote compliance with tobacco assessment and counseling mandates from regulatory organizations (e.g., Joint Commission for the Accreditation of Healthcare Organizations, Medicare Services); (2) enable healthcare provider counseling to be more time-efficient and individually tailored; (3) improve the health and longevity of patients; and, (4) decrease costs (e.g., healthcare, lost productivity) associated with tobacco use. The Small Business Concern (Polaris Health Directions) and the Research Institute (Robert Wood Johnson Medical School at Camden) will collaborate on designing, programming, and debugging the CABIT prototype, which will include early end-user input and several layers of quality assurance review and preliminary testing. Once the Project Team is satisfied with the prototype, it will be field-tested in 60 participants drawn from an emergency department, an employee assistance program, and a tobacco dependence clinic. To ensure that the CABIT's feasibility and utility is assessed across a range of readiness to change, we will recruit an equal number of subjects (n=15) from Precontemplation, Contemplation, Preparation, and Action stages. Both qualitative and quantitative end-user evaluations, including depth interviews, process evaluations, and satisfaction ratings, will be used to guide modifications for Phase II submission. The Project Team is multi- disciplinary and has extensive experience pertaining to the content, methods, and samples to be used in this application. Ultimately, the CABIT's significance will lie it is ability to enable healthcare providers to contribute to patients' well-being, health, and longevity by addressing their tobacco use, while helping healthcare organizations to comply in a cost-effective manner with mandates from regulatory organizations (e.g., JCAHO) and to facilitate financial reimbursement of tobacco counseling covered by Medicare and other third party providers.