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09/14/2011
Jintana Yunibhand, RN, PhD
Day 4, October 13, 2011, Session 19Reporting:
09/14/2011
09/14/201109/14/2011
Overview Reporting:
1) How the Thai QL has evolved its internal and external reporting as it has grown dramatically over the past 3 years?
2) How reporting stakeholders (internal and external) has changed during this period of growth?
3) How data collection needs have changed during this same period?
From: Thailand Quitline CenterTo: Thailand National Quitline
Jintana Yunibhand 2
ศู�นย์�บริ�การิเลิ�กบ หริ��ทางโทริศู�พท�แห�งชาติ� Thailand National Quitline
ศู�นย์�บริ�การิเลิ�กบ หริ��ทางโทริศู�พท�แห�งชาติ� Thailand National Quitline
Initiated by Thai Wellbeing Foundation under the Tri-parties
Commitment :1. Ministry of Public Health, 2. National Health Security Office,
and 3. Thai Health Promotion
Foundation04/10/23
Jintana Yunibhand 3
09/14/201109/14/2011Jintana Yunibhand 4
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
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Thailand Smoking rate: 1991 - 2009
Male adolescentsage 15 and over
Female adolescentsage 15 and over
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.
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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
04/10/23Jintana Yunibhand 6
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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
04/10/23Jintana Yunibhand 7
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Thailand National Quitline
1. Provide proactive and reactive telephone and internet counseling services
2. Sharing information and knowledge development, nationally and internationally on the topic of quitline
3. Train quit counselors, and volunteers for quitline services
4. 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
Goal: High effectiveness then high reach (Impacts and Accessibility) Specific Objectives:
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Looking back 2008-2011
Paper recorded database system
Jintana Yunibhand 9
Sept Jan Sept Aug Oct 2009 2009 2009 2010 2011 Operation period
Full scale operation
Proj. FundedEstablishing the organization-Service model-Space location-telephone lines-protocols
-Personnel-Data base system installation
Mar 2009 Callback services and follow-up calls
Mar 2009 Callback services and follow-up calls
Jan 2010 Quitline Number on cigarette pack
Jan 2010 Quitline Number on cigarette pack
24 Feb 2011 Become the
National Quitline
24 Feb 2011 Become the
National Quitline
Dec 2009 Start Internet
services
Dec 2009 Start Internet
services
Promotion + Creating Demand Promotion + Creating Demand
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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)
04/10/23
Intention (Readiness to Quit)
Confidence to Quit
Quit with help/supports
Jintana Yunibhand 10Jintana Yunihand
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จิ�นตนา ยู�น�พันธุ์� 11
36 items
Quality Monitoring System : (Scale used in training and monitoring
Ask & Assess
Advise & Assist
Agree to all services
Telephone service behaviors
Telephone counseling behaviors
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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 12
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Callers pay 3 baht/call using land-line from anywhere in the Kingdom of Thailand
Will 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
13Jintana Yunibhand
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Thailand Quitline: Organization Changes
Jintana Yunibhand 15
Sept-Dec08 Jan-Aug09 Sep09-Aug10 Sept10-Sept11
Phone lines 0 10 18 22**
No.-Quit* Counselors
0 9 16 27
No.-Supporting staff
2 5 9 8
*Health professionals, Nurses, clinical psychologists or Medical social workers (Full-time + Part-time)**TOTAL = 32 (Training and Screening = 8 lines)
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Log-inpassword protected
Active, Inactive lines
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Reportsby agents
Inbound calls summaryInbound calls summaryOutbound calls summary
Outbound calls summary
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Data base1st page
Summary
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Data entry for follow up
Follow upsummary
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FAX or WWW (U-Refer) system
ADVISE
ASK
ASSESS
ARRANGE
ASSIST
•Hospitals•Health professionalclinics •PHC •Schools •Industries•Others
Reactive and proactive
Counseling
Networks
Quitline
Quitline
20Jintana Yunibhand
REFER
09/14/2011Jintana Yunibhand 21
Reporting: Thailand Quitline experiences
09/14/2011
Why reporting?
Purposes• 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
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.
Jintana Yunibhand 22
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Reporting time-line:
Jintana Yunibhand 23
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
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Data Collection and Analysis
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• MDS (Paper recorded and Data base system• Researches by external researchers
Jintana Yunibhand 25
Data Sources:
Types of Reporting: -Working reports -Budget reports -Annual reports -Project reports -Books/Case studies about Quitlines -Others as requested
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Focus and IndicatorsFocus: 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 26
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TNQ:Call volume1600 Services
Proxy & interest
individuals
Smokers
Brief
intervention
Giving Information
Quit Counseling
Protocol-based
Brief intervention
Protocol-based
No Quit Date
Set Quit Date
Agree for -Free
packages-Follow-up
calls
No interest in Future
services
Proactive calls/callback
services for Relapse prevention
Protocol-based
Unable to callback
Inbound calls
Reactive services 160
0 Quitline Callers
Outbound calls Proactive services Callback service
(Internet clients & U-Refer)
Proactive phone support, after QD #1 : 1-7 days# 2: 14 days# 3: 1 month # 4: 3 months # 5: 6 months # 6: 12 months
27Jintana Yunibhand
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Completed + Outgoing Calls yearly, Monthly January 2009 – September 2011
Jintana Yunihand 28
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Month Completed Outgoing Services Delivery
Oct-Dec 10
Average/Mo 4,303.33 5,913.67 10,220.00Jan-Mar 11
Average/Mo 5,435.00 7,810.33 13,245.33Apr-Jun 11
Average/Mo 5,569.00 6,654.00 12,223.00Jul-Sep 11
Average/Mo 5465.33 8531.67 13997.00
Callers: Call-in clients, call-out services & total Callers: Call-in clients, call-out services & total services services delivery in 3 month time and average/month delivery in 3 month time and average/month (Oct10-(Oct10-Sep11)Sep11)
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Number of calls Jan 2009 – Sept 2011
2009 20102011
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Number of calls Jan 2009 – Sept 2011
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Service delivery Jan 2009 - Sept 2011
2009 20102011
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Callers at times of the day
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Numbers and percentage of calls made by smokers or proxy
Month Proxy SmokersTotal
No % No %Oct-Dec 10 2,852 28.00 7,332 72.00
Average/Mo 950.67 2,444 3,394.67
Jan-Mar 11 1,618 16.59 8,136 83.41
Average/Mo 539.33 2,712 3,251.33
Apr-Jun 11 1,305 13.79 8,160 86.21
Average/Mo 435.00 2,720 3,155.00
Jul-Aug 11 625 11.19 4,958 88.81
Average/Mo 312.50 2,479 2,791.50
Jan 2010
Quitline
Number
On packs
Jan 2010
Quitline
Number
On packs
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Quitline callers (percentage) by age group
15 yrs -15-18 yrs19-24 yrs25-40 yrs41-59 yrs 60 yrs+
Oct-Dec Jan-Mar Apr-June July-Aug
1600 Service provided
(Protocol) to Smokers (%)
Smokers received
-counseling as in protocol
-set quit date
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1600 Quitline promotion
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According to current action plan and future action plan
Achievements, constraints and challenges
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• U-Refer = 646 cases
• U-Quit = 73 cases
• Live Chat = 11 cases
Monthly/Quarterly/Yearly report
www. visits
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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 39
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Call Screening) Quitline Quality Monitoring) Module Learning for quit counselor Model/Protocol for specific populationsModel/Protocol for integrated to PHC
setting
TNQ Challenges
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www.thailandquitline.or.th
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Thank You
Jintana Yunibhand 42