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Jintana Yunibhand, RN, PhD. Day 4, October 13, 2011, Session 19 Reporting:. 09/14/2011. Overview Reporting:. How the Thai QL has evolved its internal and external reporting as it has grown dramatically over the past 3 years?
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Jintana Yunibhand, RN, PhD Day 4, October 13, 2011, Session 19 Reporting: 09/14/2011
Overview Reporting: • How the Thai QL has evolved its internal and external reporting as it has grown dramatically over the past 3 years? • How reporting stakeholders (internal and external) has changed during this period of growth? • How data collection needs have changed during this same period? From: Thailand Quitline Center To: Thailand National Quitline Jintana Yunibhand
Initiated by Thai Wellbeing Foundation under the Tri-parties Commitment : Ministry of Public Health, National Health Security Office, and Thai Health Promotion Foundation Jintana Yunibhand
Thailand Smoking rate: 1991 - 2009 Current smoking rate Regular smoking rate Occasional smoking rate Numbers of Current Smokers: 1981 = 12.26 millions; 2009 = 10.91 millions Jintana Yunibhand
Thailand Smoking rate: 1991 - 2009 Numbers of Male Current Smokers: 1981 = 11.30 m.; 2009 = 10.36 m. Numbers of Female Current Smokers: 1981 = 9.53 m.; 2009 = 5.45 m. Male adolescents age 15 and over Female adolescents age 15 and over Jintana Yunibhand
Thailand National Quitline: • 1993: ASH Thailand Quitline (provide reactive service with 2 lines, 2 counselors) • September 2009: Funded available by the Thai Health Promotion Foundation to the Thai Wellbeing Foundation for the development of Thailand Quitline Project from • February 2011: Achieving the status as Thailand National Quitline Jintana Yunibhand
Thailand National Quitline: • As it’s become a key component of the National Tobacco Control Program, soon, will be funded by the National Health Security Fund • Main purpose: to provide a countrywide accessible telephone service for tobacco cessation, to promote healthy lives for Thais and control the country’s tobacco consumption Jintana Yunibhand
Thailand National Quitline Goal:High effectiveness then high reach (Impacts and Accessibility) Specific Objectives: • Provide proactive and reactive telephone and internet counseling services • Sharing information and knowledge development, nationally and internationally on the topic of quitline • Train quit counselors, and volunteers for quitline services • Networking among GOs and NGOs regarding smoking cessation activities (complimentary/extension of the health care delivery system) and coordinating activities for Thailand smoke-free society Jintana Yunibhand
Dec 2009 Start Internet services Looking back 2008-2011 24 Feb 2011 Become the National Quitline 1 2 Proj. Funded Establishing the organization -Service model -Space location -telephone lines -protocols Paper recorded database system -Personnel -Data base system installation 3 Full scale operation Sept Jan Sept Aug Oct 2009 2009 2009 2010 2011 Operation period Mar 2009 Callback services and follow-up calls Jan 2010 Quitline Number on cigarette pack Promotion + Creating Demand Jintana Yunibhand
Framework: Counseling Stage of changes,Evidences, Experiences- No Medication1600 Quitline--Curative Factors • Motivation/Intention after explore Pro & Con of Quitting and set Quit-date • Self-efficacy/confidence to action of quitting smoking • Maintenance of Quitting with supports (1600 Quitline and self/family/social support) Intention (Readiness to Quit) Confidence to Quit Quit with help/supports Jintana Yunibhand Jintana Yunihand
Quality Monitoring System : (Scale used in training and monitoring Ask & Assess Advise & Assist Agree to all services Telephone service behaviors Telephone counseling behaviors 36 items จินตนา ยูนิพันธุ์
Quitline Promotion and Creating Demand • Public education campaign + Increase tobacco tax + Smoke-free law • Mass media campaigns by Thai Health Promotion Office • Quitline number on Cigarette Pack • Networking with Thai Health Professionals Alliance for Tobacco-Free Society-Referral • Grassroots promotion Jintana Yunibhand
Callers pay 3 baht/call using land-line from anywhere in the Kingdom of ThailandWill be a free number, in Nov 2011 Hour of operation: Monday to Friday 730 am-800 pm Calls will be tape recorded for callback services on weekend, holidays and after hours Jintana Yunibhand
Thailand Quitline: Organization Changes *Health professionals, Nurses, clinical psychologists or Medical social workers (Full-time + Part-time) **TOTAL = 32 (Training and Screening = 8 lines) Jintana Yunibhand
Log-inpassword protected Active, Inactive lines
Reportsby agents Inbound calls summary Outbound calls summary
Data base1st page Summary
Data entry for follow up Follow upsummary
FAX or WWW (U-Refer) system Networks • Hospitals • Health • professional • clinics • PHC • Schools • Industries • Others ASK ADVISE Cessation Clinics -Individual counseling -Group counseling -Medication REFER ARRANGE Quitline ASSESS Quitline Reactive and proactive Counseling ASSIST Jintana Yunibhand
Reporting: Thailand Quitline experiences Jintana Yunibhand
Why reporting? Purposes Stakeholders TNQ +TWF Advisory boards Public Health professionals and policy makers at all level of health care delivery system National Tobacco Control Board Thai health promotion office MoPH National Health Security Off. • To gain public credibility: Quitline as a part of National Tobacco Cessation System and national tobacco control efforts • To achieve the status: Thailand National Quitline • To ensure continuation of fund Jintana Yunibhand
Reporting time-line: Internal Stakeholders: - Quit counselors and supporting staff: Monthly External Stakeholders: • The Thai Wellbeing Executive Board: every 4 months • The TNQ Advisory Board: every 4 months • The Thai Health Promotion Foundation: every 3 months • Public: When applicable Partners: • Thai Health Professionals Alliance for Tobacco-Free Society: Monthly • Working groups in National Tobacco Control Board and Other GOs + NGOs tobacco related groups: As often as applicable Jintana Yunibhand
Data Collection and Analysis Jintana Yunibhand
Data Sources: • MDS (Paper recorded and Data base system • Researches by external researchers Types of Reporting: -Working reports -Budget reports -Annual reports -Project reports -Books/Case studies about Quitlines -Others as requested Jintana Yunibhand
Focus and Indicators Focus: Quality and Accessibility Indicators: • Calls volume, • Callers’ demographic data • Impact:- -Quit attempts (7 day point prevalence), -QR 6 month follow up (30 day point prevalence) -CQR 6 month (Continuous abstinence for 6 mo.) -Working protocols, curricular, evidences, and etc. Jintana Yunibhand
Proxy & interest individuals Smokers Brief intervention Giving Information Quit Counseling Protocol-based Briefintervention Protocol-based No Quit Date Set Quit Date Agree for -Free packages -Follow-up calls No interest in Future services TNQ:Call volume1600 Services Outbound calls Proactive services Callback service (Internet clients & U-Refer) Inbound calls Reactive services 1600 Quitline Callers Proactive phone support, after QD #1: 1-7 days # 2: 14 days # 3: 1 month # 4: 3 months # 5: 6 months # 6: 12 months Proactive calls/callback services for Relapse prevention Protocol-based Unable to callback Jintana Yunibhand
Completed + Outgoing Calls yearly, Monthly January 2009 – September 2011 Jintana Yunihand
Callers: Call-in clients, call-out services & total services delivery in 3 month time and average/month (Oct10-Sep11)
Number of calls Jan 2009 – Sept 2011 2009 2010 2011
Service delivery Jan 2009 - Sept 2011 2009 2010 2011
Callers at times of the day Jintana Yunihand
Numbers and percentage of calls made by smokers or proxy Jan 2010 Quitline Number On packs
Quitline callers (percentage) by age group 15 yrs - 15-18 yrs 19-24 yrs 25-40 yrs 41-59 yrs 60 yrs+ Oct-Dec Jan-Mar Apr-June July-Aug Smokers received -counseling as in protocol -set quit date 1600 Service provided (Protocol) to Smokers (%)
Achievements, constraints and challenges According to current action plan and future action plan
Monthly/Quarterly/Yearly report • U-Refer= 646 cases • U-Quit =73 cases • Live Chat =11 cases www. visits
Impacts/Outcomes of ITT (Mar-Aug2011)(From Independent research team) • Quit attempts (7 day point prevalence), • QR 6 month follow up (30 day point prevalence) • CQR 6 month (Continuous abstinence for 6 mo.) • satisfaction • Working protocols, curricular, evidences, and etc. 51 49 - 90 Jintana Yunibhand
TNQ Challenges • Call Screening) • Quitline Quality Monitoring) • Module Learning forquit counselor • Model/Protocol for specific populations • Model/Protocol for integrated to PHC setting
Thank You Jintana Yunibhand