Jintana Yunibhand, RN, PhD
Day 4, October 13, 2011, Session 19
Reporting:
09/14/2011
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 Center
To: Thailand National Quitline
Jintana Yunibhand
09/14/2011
2
ศูนย์บริการเลิกบุหรี่ทางโทรศัพท์แห่งชาติ Thailand National Quitline
ศูนย์บริการเลิกบุหรี่ทางโทรศัพท์แห่งชาติ
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 Foundation
4/8/2015
Jintana Yunibhand
3
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
09/14/2011
4
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
09/14/2011
5
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
4/8/2015
09/14/2011
6
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
4/8/2015
09/14/2011
7
Thailand National Quitline
Goal: High effectiveness then high reach
(Impacts and Accessibility)
Specific Objectives:
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
Jintana Yunibhand
09/14/2011
8
Looking
Dec 2009
back
Start2008-2011
Internet
services
24 Feb 2011
database
system
Become
the
Paper recorded
Proj. Funded
National Quitline
Establishing the -Personnel
organization
-Data base
-Service model
Full scale operation
system
-Space location
installation
-telephone lines
Sept
Aug
Oct
-protocolsSept Jan
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
09/14/2011
9
Framework: Counseling Stage of changes,
Evidences, Experiences- No Medication
1600 Quitline--Curative Factors
Intention
(Readiness to
Quit)
– Motivation/Intention after
explore Pro & Con of Quitting
and set Quit-date
Confidence to – Self-efficacy/confidence to
action of quitting smoking
Quit
Quit with
help/supports – Maintenance of Quitting with
supports (1600 Quitline and
self/family/social support)
Jintana Yunihand
4/8/2015
Jintana Yunibhand
09/14/2011
10
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 ยูนิพนั ธุ์
4/8/2015
09/14/2011
11
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
09/14/2011
12
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
Jintana Yunibhand
09/14/2011
13
09/14/2011
Thailand Quitline: Organization Changes
Sept-Dec08
Jan-Aug09
Sep09-Aug10
Sept10-Sept11
Phone lines
0
10
18
22**
No.-Quit*
Counselors
0
9
16
27
No.2
5
9
8
Supporting
staff
*Health professionals, Nurses, clinical psychologists
or Medical social workers (Full-time + Part-time)
**TOTAL = 32 (Training and Screening = 8 lines)
Jintana Yunibhand
09/14/2011
15
Log-in
password protected
Active,
Inactive
lines
09/14/2011
Reports
by agents
Inbound calls
summary
Outbound
calls summary
09/14/2011
Data base
1st page
Summary
09/14/2011
Data entry for follow up
Follow up
summary
09/14/2011
FAX or WWW (U-Refer) system
Networks
Cessation Clinics
-Individual
counseling
-Group counseling
-Medication
•Hospitals
•Health
professional
clinics
•PHC
•Schools
•Industries
•Others
ARRANGE
ASK
ADVISE
REFER
Quitline
ASSESS
Quitline
Reactive and
ASSIST
proactive
Counseling
Jintana Yunibhand
09/14/2011
20
Reporting: Thailand Quitline experiences
Jintana Yunibhand
09/14/2011
21
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
Jintana Yunibhand
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.
09/14/2011
22
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
09/14/2011
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Data Collection and Analysis
Jintana Yunibhand
09/14/2011
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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
09/14/2011
25
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
09/14/2011
26
TNQ:
Call volume
1600 Services
Outbound calls
Inbound calls
Proactive services
Callback service
(Internet clients &
U-Refer)
Reactive services
1600 Quitline
Callers
Proxy &
interest
individuals
Brief
intervention
Proactive phone
support, after QD
#1 : 1-7 days
# 2: 14 days
# 3: 1 month
# 4: 3 months
# 5: 6 months
# 6: 12 months
Smokers
Giving
Information
Quit
Counseling
Brief
intervention
Protocol-based
No
Quit Date
Protocol-based
Set
Quit Date
Agree for
-Free packages
-Follow-up calls
Proactive calls/callback
services for Relapse
prevention
No interest in
Future services
Unable to
callback
Protocol-based
Jintana Yunibhand
09/14/2011
27
Completed + Outgoing Calls yearly, Monthly
January 2009 – September 2011
Year
2009
Completed
22,756
Outgoing
All calls
8,380
62,272
Average/
Month
(1,896/m)
(698/m)
(5,189/m)
Average/
Month
37,385
(3,115/m)
48,411
85,796
2010
2011
Jan-Sept
Average/
Month
Jintana Yunihand
49,408
(5,489/m)
(4,134/m)
(7,150/m)
68,988
118,396
(7,665/m)
09/14/2011
(13,155/m)
28
Callers: Call-in clients, call-out services & total services
delivery in 3 month time and average/month (Oct10-Sep11)
Month
Completed
Outgoing
Services Delivery
4,303.33
5,913.67
10,220.00
5,435.00
7,810.33
13,245.33
5,569.00
6,654.00
12,223.00
5465.33
8531.67
13997.00
Oct-Dec 10
Average/Mo
Jan-Mar 11
Average/Mo
Apr-Jun 11
Average/Mo
Jul-Sep 11
Average/Mo
09/14/2011
Number of calls Jan 2009 – Sept 2011
Completed Calls
2552
2009
2553
2010
8,000
2554
2011
7,098
7,000
6,560
6,000
5,000
4,872
4,000
5,313
4,335
1,000
0
4,269
1,598
715
2,161
455 666
5,383
4,481 4,524
3,674
3,914
2,924
2,832
2,793
2,854
2,712
2,365
2,559 2,392
2,194 2,050
2,239
1,661
3,562
3,000
2,000
4,834
5,185
5,828
547
09/14/2011
Number of calls Jan 2009 – Sept 2011
Outgoing Calls
2552
2553
2554
12,000
10,341
10,000
10,168
9,172
8,000
6,000
4,000
6,505 6,585
3,692 3,798 3,585
2,000
0
6,850
6,4926,620
6,255
3,870
4,269
2,518
75
411
472
7,708
389
303
2,239
894
330
09/14/2011
5,212
4,698 4,821
2,001
1,185 1,280
1,761
559
721
Service delivery Jan 2009 - Sept 2011
Completed + Outgoing Calls
20,000
18,000
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2,000
0
2552
2009
2553
2010
17,439
15,000
13,410
15,551
11,805
11,377
11,454
10,920
5,9597,147
5,290
790
2554
2011
866
12,189
11,440
7,530 8,735
6,429
4,910
1,138 936 1,964
6,508
7,123
3,818
4,240
4,859
3,992
3,123
09/14/2011
9,736
4,126
2,753 2,771
Callers at times of the day
Jintana Yunihand
4/8/2015
09/14/2011
33
Numbers and percentage of calls made by smokers or proxy
Jan 2010
Quitline
Month
Number
On packs
Oct-Dec 10
Proxy
Smokers
No
%
2,852
28.00
Average/Mo 950.67
Jan-Mar 11
1,618
1,305
16.59
625
Average/Mo 312.50
7,332 72.00
13.79
3,251.33
8,160 86.21
2,720
11.19
3,394.67
8,136 83.41
2,712
Average/Mo 435.00
Jul-Aug 11
%
2,444
Average/Mo 539.33
Apr-Jun 11
No
Total
3,155.00
4,958 88.81
2,479
09/14/2011
2,791.50
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
1600
Smokers received
Service provided
(Protocol)
-counseling as in prot
-set quit date
to Smokers (%)
09/14/2011
1600 Quitline promotion
09/14/2011
Achievements, constraints and
challenges
According to current action plan
and future action plan
09/14/2011
Monthly/Quarterly/Yearly report
• U-Refer = 646 cases
• U-Quit = 73 cases
• Live Chat = 11 cases
www. visits
12,000
10,000
Visit
Unique Visitor
New Visitor
Return Visitor
8,000
6,000
4,000
2,000
0
ต.ค.-ธ.ค.
ม.ค.-มี.ค.
เม.ย.-มิ.ย.
09/14/2011
ก.ค.-ส.ค.
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.
Jintana Yunibhand
09/14/2011
51
49
90
39
TNQ Challenges
Call Screening)
Quitline Quality Monitoring)
Module Learning for quit counselor
Model/Protocol for specific populations
Model/Protocol for integrated to PHC
setting
09/14/2011
www.thailandquitline.or.th
09/14/2011
Thank You
Jintana Yunibhand
09/14/2011
42