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Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers
BACKGROUND: The Cancer Center Cessation Initiative (C3I) was launched in 2017 as a part of the NCI Cancer Moonshot program to assist NCI-designated cancer centers in developing tobacco treatment programs for oncology patients. Participating centers have implemented varied evidence-based programs tha...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033545/ https://www.ncbi.nlm.nih.gov/pubmed/33836840 http://dx.doi.org/10.1186/s43058-021-00144-7 |
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author | Salloum, Ramzi G. D’Angelo, Heather Theis, Ryan P. Rolland, Betsy Hohl, Sarah Pauk, Danielle LeLaurin, Jennifer H. Asvat, Yasmin Chen, Li-Shiun Day, Andrew T. Goldstein, Adam O. Hitsman, Brian Hudson, Deborah King, Andrea C. Lam, Cho Y. Lenhoff, Katie Levinson, Arnold H. Prochaska, Judith Smieliauskas, Fabrice Taylor, Kathryn Thomas, Janet Tindle, Hilary Tong, Elisa White, Justin S. Vogel, W. Bruce Warren, Graham W. Fiore, Michael |
author_facet | Salloum, Ramzi G. D’Angelo, Heather Theis, Ryan P. Rolland, Betsy Hohl, Sarah Pauk, Danielle LeLaurin, Jennifer H. Asvat, Yasmin Chen, Li-Shiun Day, Andrew T. Goldstein, Adam O. Hitsman, Brian Hudson, Deborah King, Andrea C. Lam, Cho Y. Lenhoff, Katie Levinson, Arnold H. Prochaska, Judith Smieliauskas, Fabrice Taylor, Kathryn Thomas, Janet Tindle, Hilary Tong, Elisa White, Justin S. Vogel, W. Bruce Warren, Graham W. Fiore, Michael |
author_sort | Salloum, Ramzi G. |
collection | PubMed |
description | BACKGROUND: The Cancer Center Cessation Initiative (C3I) was launched in 2017 as a part of the NCI Cancer Moonshot program to assist NCI-designated cancer centers in developing tobacco treatment programs for oncology patients. Participating centers have implemented varied evidence-based programs that fit their institutional resources and needs, offering a wide range of services including in-person and telephone-based counseling, point of care, interactive voice response systems, referral to the quitline, text- and web-based services, and medications. METHODS: We used a mixed methods comparative case study design to evaluate system-level implementation costs across 15 C3I-funded cancer centers that reported for at least one 6-month period between July 2018 and June 2020. We analyzed operating costs by resource category (e.g., personnel, medications) concurrently with transcripts from semi-structured key-informant interviews conducted during site visits. Personnel salary costs were estimated using Bureau of Labor Statistics wage data adjusted for area and occupation, and non-wage benefits. Qualitative findings provided additional information on intangible resources and contextual factors related to implementation costs. RESULTS: Median total monthly operating costs across funded centers were $11,045 (range: $5129–$20,751). The largest median operating cost category was personnel ($10,307; range: $4122–$19,794), with the highest personnel costs attributable to the provision of in-person program services. Monthly (non-zero) cost ranges for other categories were medications ($17–$573), materials ($6–$435), training ($96–$516), technology ($171–$2759), and equipment ($10–$620). Median cost-per-participant was $466 (range: $70–$2093) and cost-per-quit was $2688 (range: $330–$9628), with sites offering different combinations of program components, ranging from individually-delivered in-person counseling only to one program that offered all components. Site interviews provided context for understanding variations in program components and their cost implications. CONCLUSIONS: Among most centers that have progressed in tobacco treatment program implementation, cost-per-quit was modest relative to other prevention interventions. Although select centers have achieved similar average costs by offering program components of various levels of intensity, they have varied widely in program reach and effectiveness. Evaluating implementation costs of such programs alongside reach and effectiveness is necessary to provide decision makers in oncology settings with the important additional information needed to optimize resource allocation when establishing tobacco treatment programs. |
format | Online Article Text |
id | pubmed-8033545 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80335452021-04-09 Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers Salloum, Ramzi G. D’Angelo, Heather Theis, Ryan P. Rolland, Betsy Hohl, Sarah Pauk, Danielle LeLaurin, Jennifer H. Asvat, Yasmin Chen, Li-Shiun Day, Andrew T. Goldstein, Adam O. Hitsman, Brian Hudson, Deborah King, Andrea C. Lam, Cho Y. Lenhoff, Katie Levinson, Arnold H. Prochaska, Judith Smieliauskas, Fabrice Taylor, Kathryn Thomas, Janet Tindle, Hilary Tong, Elisa White, Justin S. Vogel, W. Bruce Warren, Graham W. Fiore, Michael Implement Sci Commun Research BACKGROUND: The Cancer Center Cessation Initiative (C3I) was launched in 2017 as a part of the NCI Cancer Moonshot program to assist NCI-designated cancer centers in developing tobacco treatment programs for oncology patients. Participating centers have implemented varied evidence-based programs that fit their institutional resources and needs, offering a wide range of services including in-person and telephone-based counseling, point of care, interactive voice response systems, referral to the quitline, text- and web-based services, and medications. METHODS: We used a mixed methods comparative case study design to evaluate system-level implementation costs across 15 C3I-funded cancer centers that reported for at least one 6-month period between July 2018 and June 2020. We analyzed operating costs by resource category (e.g., personnel, medications) concurrently with transcripts from semi-structured key-informant interviews conducted during site visits. Personnel salary costs were estimated using Bureau of Labor Statistics wage data adjusted for area and occupation, and non-wage benefits. Qualitative findings provided additional information on intangible resources and contextual factors related to implementation costs. RESULTS: Median total monthly operating costs across funded centers were $11,045 (range: $5129–$20,751). The largest median operating cost category was personnel ($10,307; range: $4122–$19,794), with the highest personnel costs attributable to the provision of in-person program services. Monthly (non-zero) cost ranges for other categories were medications ($17–$573), materials ($6–$435), training ($96–$516), technology ($171–$2759), and equipment ($10–$620). Median cost-per-participant was $466 (range: $70–$2093) and cost-per-quit was $2688 (range: $330–$9628), with sites offering different combinations of program components, ranging from individually-delivered in-person counseling only to one program that offered all components. Site interviews provided context for understanding variations in program components and their cost implications. CONCLUSIONS: Among most centers that have progressed in tobacco treatment program implementation, cost-per-quit was modest relative to other prevention interventions. Although select centers have achieved similar average costs by offering program components of various levels of intensity, they have varied widely in program reach and effectiveness. Evaluating implementation costs of such programs alongside reach and effectiveness is necessary to provide decision makers in oncology settings with the important additional information needed to optimize resource allocation when establishing tobacco treatment programs. BioMed Central 2021-04-09 /pmc/articles/PMC8033545/ /pubmed/33836840 http://dx.doi.org/10.1186/s43058-021-00144-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Salloum, Ramzi G. D’Angelo, Heather Theis, Ryan P. Rolland, Betsy Hohl, Sarah Pauk, Danielle LeLaurin, Jennifer H. Asvat, Yasmin Chen, Li-Shiun Day, Andrew T. Goldstein, Adam O. Hitsman, Brian Hudson, Deborah King, Andrea C. Lam, Cho Y. Lenhoff, Katie Levinson, Arnold H. Prochaska, Judith Smieliauskas, Fabrice Taylor, Kathryn Thomas, Janet Tindle, Hilary Tong, Elisa White, Justin S. Vogel, W. Bruce Warren, Graham W. Fiore, Michael Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers |
title | Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers |
title_full | Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers |
title_fullStr | Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers |
title_full_unstemmed | Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers |
title_short | Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers |
title_sort | mixed-methods economic evaluation of the implementation of tobacco treatment programs in national cancer institute-designated cancer centers |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033545/ https://www.ncbi.nlm.nih.gov/pubmed/33836840 http://dx.doi.org/10.1186/s43058-021-00144-7 |
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