Publications by Stephen F. Rothemich for Health Policy Center

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This American Journal of Preventive Medicine article presents findings from a cluster randomized controlled trial aimed at determining whether smoking cessation support in practices is enhanced by the use of telephone quitlines. The study found that a systems approach to identifying smokers, advising and assessing readiness to quit, combined with partnership with a quitline, increased delivery of cessation support for primary care patients by 12.5% beyond that accomplished by traditional tobacco-use vital sign screening alone. The increase in cessation was more pronounced with patients aged 35-54 years and with male and more experienced clinicians.

This American Journal of Preventive Medicine article presents a feasibility evaluation of an electronic linkage system (eLinkS) to automate and increase patient referrals for healthy behavior counseling at nine primary care practices. Patients were offered 9 months of free counseling for weight loss, smoking cessation, and problem drinking at a choice of venues: group counseling, telephone counseling, computer care, and usual care. The study found that eLinkS increased the rate at which patients were referred for intensive behavioral counseling compared to current practice norms.

This American Journal of Preventive Medicine article presents findings from a mixed-methods case study that examined how coverage affected utilization of intensive health behavior counseling. The study found that when counseling designed to help patients lose weight and quit smoking was available for free, approximately one in five patients with an unhealthy behavior was referred for such counseling. However, when patient charges were instituted, clinicians asked fewer patients about health behaviors (37% vs. 29%, p<0.001); clinicians offered fewer patients referrals (29% vs. 6%, p<0.001); and patients were less interested in accepting referrals (76% vs. 14%, p<0.001). In interviews, patients and clinicians cited cost as a major barrier.

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