摘要：Objectives. This study was designed to better understand how the network of quitlines in the North American Quitline Consortium (NAQC) interact and share new knowledge on quitline practices. Methods. Network relationship data were collected from all 63 publicly funded quitlines in North America, including information sharing, partner trust, and reputation. Results. There was a strong tendency for US and Canadian quitlines to seek information from other quitlines in the same country, with few seeking information from quitlines from the other country. Quitlines with the highest reputation tended to more centrally located in the network, but the NAQC coordinating organization is highly central to the quitline network—thus demonstrating their role as a broker of quitline information. Conclusions. This first “snapshot” of US and Canadian quitlines demonstrated that smoking cessation quitlines in North America are not isolated, but are part of an interconnected network, with some organizations more central than others. As quitline use expands with the inclusion of national toll-free numbers on cigarette packs, how quitlines share information to improve practice will become increasingly important. In the early 1990s, California became the first state to implement a quitline as a result of funding from a new state tobacco tax. Within a few years, Massachusetts, Arizona, and other states added state quitlines, and now every state in the United States and every province in Canada has a toll-free tobacco quitline to treat tobacco dependence. 1 Moreover, there is now an organization, the North American Quitline Consortium (NAQC), which seeks to foster communication between quitlines with the objective to improve access to, and the quality of, quitline services for residents of the 53 state and territorial and 10 provincial entities that participate in the consortium. Thus, there now exists a system of tobacco treatment in the United States and Canada that is linked functionally, which is recognized by their respective governments, as they prepare to place toll-free national quitline numbers on cigarette packs to refer smokers to those quitlines. However, there are no data on how the quitlines function as an organizational network to foster the adoption and implementation of evidence-based practices, or whether NAQC is functioning to foster that collaboration as intended. Although extensive research has been conducted on organizational networks over the past 20 years, most of the work focused on the impact of network involvement on individual members. Thus, except in isolated cases, 2–4 the “systemness” of the network was typically ignored. More specifically, only recently has greater emphasis been placed on the processes by which research is translated into practice and back again, and it is clear that considerable research is needed to further explicate those processes. 5,6 For example, Valente 7 actively explored the role of social networks in the diffusion of innovations to better understand how knowledge and decision-making impact changing health practices. Analyzing network structure and function in areas such as obesity, 8 tobacco control, 6,9–11 and HIV/AIDS 12 has become increasingly recognized as critical to improving public health. However, much more work is needed to understand the impact of the structure of network relationships (e.g., central roles, cliques, etc.) on the adoption and implementation of practices. Given the complexity of the quitline system of funders and service providers, and the lack of clarity regarding the communication characteristics of the network, the goal of this study was to provide the first snapshots of the NAQC network, including information on the interactions among quitlines, between quitlines and the NAQC coordinating organization (called the network administrative organization [NAO]), 13 and the relationship between quitlines with high positive reputation and other quitlines.
