RECRUITINGPhase 3INTERVENTIONAL

Intervention to Increase Intention to Change Alcohol/Tobacco Use in Veterans With Chronic Disease

A Low-Cost, High-Access Intervention to Increase Intention to Change Alcohol/Tobacco Use Among Reticent Veterans Who Are Non-Responders to Brief Advice at High Risk Due to Chronic Conditions

About This Trial

Many Veterans who have chronic conditions like cardiovascular disease or diabetes smoke or drink too much alcohol, which can worsen the condition. Veterans are asked yearly about drinking/smoking and providers provide a brief advice discussion focused on behavior change. However, many Veterans continue to drink or smoke, and are often not interested in higher-intensity, change-based referrals. The investigators recently piloted MINDSET, an intervention that fills this gap. MINDSET is a proactive, population-based intervention that uses a mailed packet with tailored education about how drinking/smoking relate to the Veteran's condition (heart conditions and/or diabetes), followed by a brief motivational call. The investigators will test MINDSET's effectiveness versus usual primary care on outcomes including intention to change and substance use and evaluate the relationships between these and other variables over time.

Who May Be Eligible (Plain English)

Who May Qualify: - an active diagnosis of diabetes, cardiovascular disease (CVD), or a cardiovascular risk factor (hypertension {HTN}, hyperlipidemia {HLD}) AND signs of reticence to change their smoking and/or alcohol use as evidenced by the two consecutive prior screens being positive for hazardous (e.g., Alcohol Use Disorders Test-Consumption \[AUDC\], and/or smoking (I.e., whether they are a current smoker or not). - Confirmation of smoking and/or drinking status during telephone screening (e.g., Alcohol Use Disorders Test-Consumption \[AUDC\], and/or smoking (I.e., whether they are a current smoker or not). - Veteran - Age 18 years - utilize VA for medical care more than 1 time per year - are due to complete their smoking/alcohol use screen in approximately 3 months (to ensure they will likely receive UC during intervention period) - a scheduled PC appointment within the intervention period. Who Should NOT Join This Trial: - dementia or severe cognitive impairment per Problem List - significant visual impairment per Problem List - Other Exclusion criteria assessed by study staff during screening/self-report are: - inability to communicate or read in English; - Hearing impairment; and - cognitive impairment or screening for cognitive impairment (\>=weighted score of 10 on Blessed screener). Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language

Inclusion Criteria: * an active diagnosis of diabetes, cardiovascular disease (CVD), or a cardiovascular risk factor (hypertension {HTN}, hyperlipidemia {HLD}) AND signs of reticence to change their smoking and/or alcohol use as evidenced by the two consecutive prior screens being positive for hazardous (e.g., Alcohol Use Disorders Test-Consumption \[AUDC\], and/or smoking (I.e., whether they are a current smoker or not). * Confirmation of smoking and/or drinking status during telephone screening (e.g., Alcohol Use Disorders Test-Consumption \[AUDC\], and/or smoking (I.e., whether they are a current smoker or not). * Veteran * Age 18 years * utilize VA for medical care more than 1 time per year * are due to complete their smoking/alcohol use screen in approximately 3 months (to ensure they will likely receive UC during intervention period) * a scheduled PC appointment within the intervention period. Exclusion Criteria: * dementia or severe cognitive impairment per Problem List * significant visual impairment per Problem List * Other Exclusion criteria assessed by study staff during screening/self-report are: * inability to communicate or read in English; * Hearing impairment; and * cognitive impairment or screening for cognitive impairment (\>=weighted score of 10 on Blessed screener).

Treatments Being Tested

BEHAVIORAL

MINDSET

A behavior-change model informed mailed informational packet with tailored health information regarding the impacts of smoking/drinking on chronic disease and the benefits of stopping, followed by a brief motivational telephone booster call from a behavioral health provider.

OTHER

Usual Care

All Veterans involved in this study will have a standard primary care (PC) appointment, which may include conversations/interventions related to drinking and smoking. This appointment is not controlled by the study team and we cannot comment on the extent to which smoking/drinking will or will not be discussed in the primary care appointment but we imagine this can range from no discussion/intervention at all to extensive conversations with the provision of medications, brief advice, etc.

Locations (1)

VA Western New York Healthcare System, Buffalo, NY

Buffalo, New York, United States