Utilizing telephone interviewers as counselors: Lessons learned from a smoking reduction study

A randomized trial is currently underway to assess an intervention that seeks to help smokers scheduled for an outpatient procedure, reduce daily cigarette consumption by 50% or more. The study integrates 4 telephone counseling sessions with 5 tailored newsletters. This presentation describes our experience using interviewers who do not have training in clinical services or counseling to assist study participants in reducing the number of cigarettes they smoke daily. In-depth, semi-structured assessments of the telephone interviewers were conducted to explore techniques and methods used while interacting with study participants. Interviewers' self-assessment and end of call summary notes were also reviewed and coded. In addition, participant satisfaction with interviewer interaction was analyzed. Qualitative data revealed the interviewers were able to establish rapport with participants who were motivated to work on smoking reduction. Continuity of interviewers over all telephone counseling calls proved to be favored by study participants. Patient satisfaction data show positive responses toward the telephone interviewers. Eighty-six percent felt their assigned interviewer was knowledgeable, and 84% said their interviewer was credible. Overall 3 month reduction results will also be discussed in the context of interviewers' abilities. The program was well-received by outpatients who were not ready to quit smoking and was proven feasible and successful to implement by telephone staff that had no previous counseling experience. Despite this lack of prior training, interviewers were able to learn and successfully employ rapport-building skills and actively engage a majority of the individuals who participated in this smoking reduction study.