Tsoh JY, Hessler D, Parra JR, Bowyer V, Lugtu K, Potter MB. Addressing tobacco use in the context of complex social needs: A new conceptual framework and approach to address smoking cessation in community health centers.
PEC INNOVATION 2021;
1:100011. [PMCID:
PMC10194343 DOI:
10.1016/j.pecinn.2021.100011]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 06/07/2023]
Abstract
Objective
This article presents a new conceptual framework “Connection to Health for Smokers” (CTHS), its application to address smoking cessation, and its acceptability in community health centers (CHCs).
Methods
CTHS, an online interactive patient educational tool comprehensively implements the “5 A's” (ask, advise, assess, assist, and arrange) within the context of patients' social and behavioral health needs. Semi-structured interviews were conducted with five health educators (nurses) who administered CTHS with 62 patients to evaluate the acceptability of the program. Thematic analyses were conducted with interview transcripts.
Results
CHC health educators viewed CTHS has enhanced patient-centered communication, was able to identify patients' needs beyond tobacco use, and individualize action planning to integrate social and behavioral health needs.
Conclusion
CTHS received enthusiasm from CHC health educators as a helpful tool to address tobacco use among their patients. Comprehensive on-site smoking cessation programs at CHCs that provide a structured evidence-based approach informed by an understanding of each patient's coexisting social and behavioral health needs may play an important role in reducing tobacco use disparities in the United States.
Innovation
CTHS offers a new promising framework to comprehensively integrate the 5A's within the context of social and behavioral determinants of health for smoking cessation.
Social and behavioral health challenges may interfere smoking cessation
CTHS implements “5A's” while addressing coexisting social and behavioral needs
Integrate patients' needs in tobacco treatment optimizes cessation outcomes
Nurses viewed addressing complex needs helpful to motivate smokers to quit smoking
Comprehensive patient-centered approach may reduce tobacco use disparities
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