Trial Outcomes & Findings for eCEASE to Support Treatment for Parental Tobacco Use (NCT NCT04974736)

NCT ID: NCT04974736

Last Updated: 2025-04-15

Results Overview

Parental 7-day combusted tobacco quit rates, as assessed by validated surveys, biochemically confirmed at 12 months between the intervention \& usual care arms

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

817 participants

Primary outcome timeframe

12-months

Results posted on

2025-04-15

Participant Flow

Cluster randomized controlled trial, conducted from July 2021 to August 2023 in Twelve Philadelphia region pediatric primary care practices within the Children's Hospital of Philadephia network. Parents who used combusted tobacco in the past seven days and attended a child's preventive healthcare visit were enrolled in the study.

A two-arm parallel cluster randomized trial was conducted in 12 pediatric practices at Children's Hospital of Philadelphia. Practices were eligible if ≥10% of child patients had Medicaid and ≥40 daily visits. Eligible practices were paired based on size and estimated smoking rate, with six pairs selected to ensure sufficient size and representativeness. Within each pair, practices were randomly assigned to either the intervention or control group using computer-generated allocation.

Unit of analysis: Practices

Participant milestones

Participant milestones
Measure
eCEASE (iEHR + Navigator)
Parents in intervention practices were proactively offered eCEASE (automated delivery of Nicotine Replacement Therapy (NRT), enrollment in the quitline and SmokefreeTXT, and cessation support from a health navigator).
Usual Care Control
Usual care delivery in pediatric primary care offices.
Overall Study
STARTED
408 6
409 6
Overall Study
COMPLETED
367 6
368 6
Overall Study
NOT COMPLETED
41 0
41 0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

One participant chose to not share their sex.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
eCEASE (iEHR + Navigator)
n=408 Participants
iEHR + Navigator: The iEHR + Navigator intervention consists of an iEHR part of the intervention in the pediatric primary care setting which will include routine screening of families for tobacco use and treatment delivery to parents who smoke and will be linked to the child's electronic health record. The enrolled parents will also be offered support from Community Health Navigators, who will work with offices to provide customized cessation support to tobacco users, ensuring access to medications and services.
Usual Care Control
n=409 Participants
Usual care delivery in pediatric primary care offices.
Total
n=817 Participants
Total of all reporting groups
Age, Categorical
<=18 years
1 Participants
n=408 Participants
1 Participants
n=409 Participants
2 Participants
n=817 Participants
Age, Categorical
Between 18 and 65 years
401 Participants
n=408 Participants
405 Participants
n=409 Participants
806 Participants
n=817 Participants
Age, Categorical
>=65 years
6 Participants
n=408 Participants
3 Participants
n=409 Participants
9 Participants
n=817 Participants
Age, Continuous
36.4 years
STANDARD_DEVIATION 8.89 • n=408 Participants
35.9 years
STANDARD_DEVIATION 8.454 • n=409 Participants
36.17 years
STANDARD_DEVIATION 8.67 • n=817 Participants
Sex: Female, Male
Female
335 Participants
n=407 Participants • One participant chose to not share their sex.
337 Participants
n=409 Participants • One participant chose to not share their sex.
672 Participants
n=816 Participants • One participant chose to not share their sex.
Sex: Female, Male
Male
72 Participants
n=407 Participants • One participant chose to not share their sex.
72 Participants
n=409 Participants • One participant chose to not share their sex.
144 Participants
n=816 Participants • One participant chose to not share their sex.
Ethnicity (NIH/OMB)
Hispanic or Latino
40 Participants
n=408 Participants
28 Participants
n=409 Participants
68 Participants
n=817 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
368 Participants
n=408 Participants
381 Participants
n=409 Participants
749 Participants
n=817 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=408 Participants
0 Participants
n=409 Participants
0 Participants
n=817 Participants
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants
n=408 Participants
2 Participants
n=409 Participants
4 Participants
n=817 Participants
Race (NIH/OMB)
Asian
17 Participants
n=408 Participants
3 Participants
n=409 Participants
20 Participants
n=817 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
4 Participants
n=408 Participants
0 Participants
n=409 Participants
4 Participants
n=817 Participants
Race (NIH/OMB)
Black or African American
165 Participants
n=408 Participants
179 Participants
n=409 Participants
344 Participants
n=817 Participants
Race (NIH/OMB)
White
173 Participants
n=408 Participants
204 Participants
n=409 Participants
377 Participants
n=817 Participants
Race (NIH/OMB)
More than one race
46 Participants
n=408 Participants
21 Participants
n=409 Participants
67 Participants
n=817 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=408 Participants
0 Participants
n=409 Participants
1 Participants
n=817 Participants
Region of Enrollment
United States
408 participants
n=408 Participants
409 participants
n=409 Participants
817 participants
n=817 Participants

PRIMARY outcome

Timeframe: 12-months

Parental 7-day combusted tobacco quit rates, as assessed by validated surveys, biochemically confirmed at 12 months between the intervention \& usual care arms

Outcome measures

Outcome measures
Measure
eCEASE (iEHR + Navigator)
n=408 Participants
iEHR + Navigator: The iEHR + Navigator intervention consists of an iEHR part of the intervention in the pediatric primary care setting which will include routine screening of families for tobacco use and treatment delivery to parents who smoke and will be linked to the child's electronic health record. The enrolled parents will also be offered support from Community Health Navigators, who will work with offices to provide customized cessation support to tobacco users, ensuring access to medications and services.
Usual Care Control
n=409 Participants
Usual care delivery in pediatric primary care offices.
Parental Combusted Tobacco Quit Rate at 12 Months
34 Participants
26 Participants

SECONDARY outcome

Timeframe: 12-months

Population: Those parents who completed the follow-up survey and reported smoking a tobacco product in the last 7 days were used in the denominator.

Rates of parents' self-reported quit attempts between the intervention \& usual care control arms, assessed by validated surveys of parents

Outcome measures

Outcome measures
Measure
eCEASE (iEHR + Navigator)
n=278 Participants
iEHR + Navigator: The iEHR + Navigator intervention consists of an iEHR part of the intervention in the pediatric primary care setting which will include routine screening of families for tobacco use and treatment delivery to parents who smoke and will be linked to the child's electronic health record. The enrolled parents will also be offered support from Community Health Navigators, who will work with offices to provide customized cessation support to tobacco users, ensuring access to medications and services.
Usual Care Control
n=299 Participants
Usual care delivery in pediatric primary care offices.
Rates of Parental Quit Attempts
205 Participants
189 Participants

SECONDARY outcome

Timeframe: 12-months

Population: Participants who completed the 12 month follow up

Rates of parental use of pharmacotherapy and Quitlines between the intervention \& usual care arms, assessed by validated surveys of parents

Outcome measures

Outcome measures
Measure
eCEASE (iEHR + Navigator)
n=367 Participants
iEHR + Navigator: The iEHR + Navigator intervention consists of an iEHR part of the intervention in the pediatric primary care setting which will include routine screening of families for tobacco use and treatment delivery to parents who smoke and will be linked to the child's electronic health record. The enrolled parents will also be offered support from Community Health Navigators, who will work with offices to provide customized cessation support to tobacco users, ensuring access to medications and services.
Usual Care Control
n=368 Participants
Usual care delivery in pediatric primary care offices.
Rates of Parental Use of Pharmacotherapy or Services
Used Nicotine Replacement Therapy
177 Participants
59 Participants
Rates of Parental Use of Pharmacotherapy or Services
Enrolled in quitline
79 Participants
11 Participants
Rates of Parental Use of Pharmacotherapy or Services
Enrolled in SmokefreeTXT
71 Participants
9 Participants

SECONDARY outcome

Timeframe: 12-months

Population: Participants who completed follow-up

Rates of parental institution of smoking and vaping bans in their homes and cars between the intervention \& usual care arms, assessed by validated surveys of parents

Outcome measures

Outcome measures
Measure
eCEASE (iEHR + Navigator)
n=367 Participants
iEHR + Navigator: The iEHR + Navigator intervention consists of an iEHR part of the intervention in the pediatric primary care setting which will include routine screening of families for tobacco use and treatment delivery to parents who smoke and will be linked to the child's electronic health record. The enrolled parents will also be offered support from Community Health Navigators, who will work with offices to provide customized cessation support to tobacco users, ensuring access to medications and services.
Usual Care Control
n=368 Participants
Usual care delivery in pediatric primary care offices.
Rates of Parental Institution of Smoking and Vaping Bans in Their Homes and Cars
Anyone smoked at home in the past 3 months
95 Participants
101 Participants
Rates of Parental Institution of Smoking and Vaping Bans in Their Homes and Cars
Anyone smoked in the car in the past 3 months
117 Participants
125 Participants

SECONDARY outcome

Timeframe: 12-months

Establish the incremental cost per quit of the iEHR + Navigator vs. usual care arms

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 36 months

Assess the rates of tobacco treatment delivery (NRT prescription and quitline referrals) in the iEHR + Navigator arm vs. usual care, assessed by validated surveys of parents and EHR documentation

Outcome measures

Outcome data not reported

Adverse Events

eCEASE (iEHR + Navigator)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Usual Care Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Jonathan P. WInickoff

Massachusetts General Hospital

Phone: (617) 726-2728

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place