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Wee LH, West R, Tee GH, Yeap L, Chan CMH, Ho BK, Perialathan K, Nik Mohamed MH, Michie S, Jackson SE. Effectiveness of training stop-smoking advisers to deliver cessation support to the UK national proposed standard versus usual care in Malaysia: a two-arm cluster-randomized controlled trial. Addiction 2021; 116:2150-2161. [PMID: 33220115 PMCID: PMC8359305 DOI: 10.1111/add.15346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/29/2020] [Accepted: 11/17/2020] [Indexed: 01/29/2023]
Abstract
AIMS To assess the effectiveness of training stop smoking services providers in Malaysia to deliver support for smoking cessation based on the UK National Centre for Smoking Cessation and Training (NCSCT) standard treatment programme compared with usual care. DESIGN Two-arm cluster-randomized controlled effectiveness trial across 19 sites with follow-up at 4-week, 3-month, and 6-month. SETTING Stop smoking services operating in public hospitals in Malaysia. PARTICIPANTS Five hundred and two smokers [mean ± standard deviation (SD), age 45.6 (13.4) years; 97.4% male] attending stop smoking services in hospital settings in Malaysia: 330 in 10 hospitals in the intervention condition and 172 in nine hospitals in the control condition. INTERVENTION AND COMPARATOR The intervention consisted of training stop-smoking practitioners to deliver support and follow-up according to the NCSCT Standard Treatment Programme. The comparator was usual care (brief support and follow-up). MEASUREMENTS The primary outcome was continuous tobacco smoking abstinence up to 6 months in smokers who received smoking cessation treatment, verified by expired-air carbon monoxide (CO) concentration. Secondary outcomes were continuous CO-verified tobacco smoking abstinence up to 4 weeks and 3 months. RESULTS Follow-up rates at 4 weeks, 3 months and 6 months were 80.0, 70.6 and 53.3%, respectively, in the intervention group and 48.8, 30.8 and 23.3%, respectively, in the control group. At 6-month follow-up, 93 participants in the intervention group and 19 participants in the control group were abstinent from smoking, representing 28.2 versus 11.0% in an intention-to-treat (ITT) analysis assuming that participants with missing data had resumed smoking, and 52.8 versus 47.5% in a follow-up-only (FUO) analysis. Unadjusted odds ratios (accounting for clustering) were 5.04, (95% confidence interval (CI) = 1.22-20.77, P = 0.025) and 1.70, (95% CI = 0.25-11.53, P = 0.589) in the ITT and FUO analyses, respectively. Abstinence rates at 4 week and 3 month follow-ups were significantly higher in the intervention versus control group in the ITT but not the FUO analysis. CONCLUSIONS On an intention-to-treat analysis with missing-equals-smoking imputation, training Malaysian stop smoking service providers in the UK National Centre for Smoking Cessation and Training standard treatment programme appeared to increase 6 month continuous abstinence rates in smokers seeking help with stopping compared with usual care. However, the effect may have been due to increasing follow-up rates.
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Affiliation(s)
- Lei Hum Wee
- Universiti Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Robert West
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | | | | | | | - Bee Kiau Ho
- Ministry of HealthBandar Botanic Health CentreMalaysia
| | | | | | - Susan Michie
- Centre for Behaviour ChangeUniversity College LondonLondonUK
| | - Sarah E. Jackson
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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Ivanova A, Baliunas D, Ahad S, Tanzini E, Dragonetti R, Fahim M, Selby P. Performance Change in Treating Tobacco Addiction: An Online, Interprofessional, Facilitated Continuing Education Course (TEACH) Evaluation at Moore's Level 5. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:31-38. [PMID: 33433131 DOI: 10.1097/ceh.0000000000000328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Continuing education is essential to build capacity among health care providers (HCPs) to treat people with tobacco addiction. Online, interprofessional training programs are valuable; however, interpretation and comparison of outcomes remain challenging because of inconsistent use of evaluation frameworks. In this study, we used level 5 of Moore's evaluation framework to examine whether an online training program in intensive tobacco cessation counseling achieved sustained performance change among HCPs across multiple health disciplines. METHODS The evaluation sample included 62 HCPs with direct clinical duties, who completed the online Training Enhancement in Applied Counseling and Health (TEACH) Core Course in 2015 and 2016. We compared self-reported changes in cessation counseling and clinical practices across eight core competencies from baseline to 6-month follow-up using McNemar's tests and descriptive analyses. RESULTS Compared with baseline, significantly more HCPs reported providing cessation counseling at 6-month follow-up (44% versus 81%, P < .001). HCPs also reported significant increases in engagement in six of the eight core competencies. DISCUSSION Online training in intensive tobacco cessation treatment can result in sustained performance improvement at 6 months. However, availability of resources and clinical context may influence the extent to which HCPs are able to implement their learned skills. Furthermore, continuing education programs should consider the use of consistent evaluation frameworks to promote cross program comparisons.
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Affiliation(s)
- Anna Ivanova
- Ms. Anna Ivanova: Research Coordinator, Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.Dr. Dolly Baliunas: Collaborator Scientist, Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Assistant Professor, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.Ms. Sheleza Ahad: Project Coordinator, Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.Ms. Elise Tanzini: Research Coordinator, Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Ms. Rosa Dragonetti: Project Director, Addictions Education and Research, Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and Assistant Professor, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.Ms. Myra Fahim: Clinic Manager, Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.Dr. Peter Selby: Senior Medical Consultant, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, Clinician Scientist, Addictions, Research Program, Clinical Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada, Clinician Scientist, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada, and Professor, Departments of Family and Community Medicine, Psychiatry, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Lorencatto F, Asif S, Francis JJ, Harper AM, Lawrenson JG. Seeing New Opportunities to Help Smokers Quit: A UK National Survey of Optometrist-Delivered Smoking Cessation Behavioral Support Interventions. Nicotine Tob Res 2020; 21:655-662. [PMID: 29660046 DOI: 10.1093/ntr/nty066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/04/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Smoking is a risk factor for various eye conditions. Brief smoking cessation interventions have demonstrated effectiveness when delivered by a range of health care professionals. Optometrists are well placed in the community to advise otherwise healthy smokers to quit, yet remain relatively neglected in smoking cessation research and policy. In a national survey, this study investigated self-reported practices of UK optometrists for delivering brief tobacco smoking cessation interventions to patients. METHODS A randomly selected sample of 1200 optometrists out of the 9000 optometrists registered on the UK College of Optometrists database were invited to complete a 40-item, web-based survey assessing: training related to smoking cessation, current practice (ie, the proportion of patients to which components of very brief advice [Ask, Advise, Assist] and other evidence-based smoking cessation behavior change techniques were delivered), and barriers/enablers to intervention delivery. RESULTS In total, 408 (34%) responses were received. Most (83%) optometrists received no training in practical skills for delivering smoking cessation support. A third (34%) routinely assessed smoking status. Fewer self-reported advising smokers to quit (22%), offering assistance (via referral to dedicated services) (3%), or advice on smoking cessation medications (2%). Perceived barriers included insufficient knowledge/training (81%) and time (65%). Optometrists were more likely to assess and advise on smoking cessation if they practiced in Scotland, χ2(2) = 32.95, p < .001; an independent optometry practice, χ2(1) = 4.27, p = .39; or had received smoking cessation training, χ2(1) = 13.1, p < .001. CONCLUSIONS Substantial gaps exist in UK optometrists' current smoking cessation training and practice. Evidence-based training resources are needed to support the implementation of smoking cessation interventions into routine optometry practice. IMPLICATIONS Optometrists are well placed in the community to deliver brief advice interventions to a large population of smokers. This survey provides a comprehensive description of current UK optometry practice related to the provision of evidence-based brief tobacco smoking cessation interventions to patients. Although optometrists perceive advising on smoking cessation as part of their role, numerous substantial gaps in current practice and training remain, which need to be addressed through targeted interventions to increase implementation.
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Affiliation(s)
- Fabiana Lorencatto
- Centre for Behaviour Change, University College London, London, UK.,Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK
| | | | - Jill J Francis
- Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK
| | - Alice M Harper
- Centre for Health Services Research, School of Health Sciences, City, University of London, London, UK
| | - John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
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Hasan SI, Mohd Hairi F, Ahmad Tajuddin NA, Amer Nordin AS. Empowering healthcare providers through smoking cessation training in Malaysia: a preintervention and postintervention evaluation on the improvement of knowledge, attitude and self-efficacy. BMJ Open 2019; 9:e030670. [PMID: 31562154 PMCID: PMC6773327 DOI: 10.1136/bmjopen-2019-030670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/15/2019] [Accepted: 09/03/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Healthcare providers are ideally positioned to advise their patients to quit smoking by providing effective smoking cessation intervention. Thus, we evaluate the effectiveness of a 1-day training programme in changing the knowledge, attitude and self-efficacy of healthcare providers in smoking cessation intervention. METHODS A prepost study design was conducted in 2017. The 8-hour Smoking Cessation Organising, Planning and Execution (SCOPE) training comprised lectures, practical sessions and role-play sessions to 218 healthcare providers. A validated evaluation tool, Providers' Smoking Cessation Training Evaluation, was administered to assess the impact of training on knowledge, attitude and self-efficacy on smoking cessation intervention. RESULTS After SCOPE training, the knowledge score increased significantly from 7.96±2.34 to 10.35±1.57 (p<0.001). Attitude and self-efficacy in smoking cessation intervention also increased significantly from 34.32±4.12 to 37.04±3.92 (p<0.001) and 40.31±8.61 to 54.67±7.45 (p<0.001) respectively. Pretraining and post-training scores improved significantly for all professions, and each measure, particularly self-efficacy. CONCLUSION This study demonstrates that SCOPE training could improve healthcare providers' knowledge, attitude and self-efficacy on smoking cessation intervention. Future training is recommended to equip healthcare providers with current knowledge, positive attitude and high self-efficacy to integrate what they have learned into practice successfully.
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Affiliation(s)
- Siti Idayu Hasan
- Social & Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Nicotine Addiction Research & Collaboration, UMCAS, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Social & Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Nicotine Addiction Research & Collaboration, UMCAS, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Amani Ahmad Tajuddin
- Nicotine Addiction Research & Collaboration, UMCAS, University of Malaya, Kuala Lumpur, Malaysia
- Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research & Collaboration, UMCAS, University of Malaya, Kuala Lumpur, Malaysia
- Psychological Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Jumbe S, James WY, Madurasinghe V, Steed L, Sohanpal R, Yau TK, Taylor S, Eldridge S, Griffiths C, Walton R. Evaluating NHS Stop Smoking Service engagement in community pharmacies using simulated smokers: fidelity assessment of a theory-based intervention. BMJ Open 2019; 9:e026841. [PMID: 31110097 PMCID: PMC6530322 DOI: 10.1136/bmjopen-2018-026841] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Smokers are more likely to quit if they use the National Health Service (NHS) Stop Smoking Service (SSS). However, community pharmacies experience low service uptake. The Smoking Treatment Optimisation in Pharmacies (STOP) programme aims to address this problem by enhancing staff training using a theory-based intervention. In this study, we evaluated intervention fidelity using simulated smokers (actors) to assess smoker engagement and enactment of key intervention components by STOP trained staff. DESIGN An observational pilot study. SETTINGS Five community pharmacies in North East London with an NHS SSS. METHODS Six actors, representative of East London's population, were recruited and trained to complete intervention fidelity assessments. Consenting pharmacy staff from five participating pharmacies received STOP Intervention training. Four weeks after the staff training, the actors visited the participating pharmacies posing as smokers eligible for smoking cessation support. Engagement behaviour by pharmacy staff and enactment of intervention components was assessed using a scoring tool derived from the STOP logic model (scoring range of 0-36), and contemporaneous field notes taken by actors. RESULTS 18 of 30 completed assessments were with STOP trained staff (10/18 were counter assistants). Mean score for smoker engagement was 24.4 (SD 9.0) points for trained and 16.9 (SD 7.8) for untrained staff, respectively. NHS SSS leaflets (27/30) were the most common smoking cessation materials seen on pharmacy visits. Most trained counter staff engaged with smokers using leaflets and a few proactively offered appointments with their cessation advisors. Appropriate use of body language was reported on 26/30 occasions alongside the use of key phrases from the STOP training session (n=8). Very few pharmacy staff wore STOP promotional badges (4/30). CONCLUSIONS STOP training may change client engagement behaviour in pharmacy staff and could improve the uptake of the NHS SSS. A cluster randomised controlled trial is currently in progress to evaluate its effectiveness and cost-effectiveness. TRIAL REGISTRATION NUMBER ISRCTN16351033.
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Affiliation(s)
- Sandra Jumbe
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, UK
- Queen Mary University of London, London, UK
| | - Wai Y James
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, UK
| | | | - Liz Steed
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, UK
| | - Ratna Sohanpal
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Tammy K Yau
- Department of Medicine, California Northstate University, Elk Grove, California, USA
| | - Stephanie Taylor
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Sandra Eldridge
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Chris Griffiths
- Barts and The London School of Medicine and Dentistry, London, UK
| | - Robert Walton
- Centre for Health Sciences, Barts and The London School of Medicine and Dentistry, London, UK
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Hagimoto A, Nakamura M, Masui S, Bai Y, Oshima A. Effects of Trained Health Professionals' Behavioral Counseling Skills on Smoking Cessation Outcomes. Ann Behav Med 2018; 52:752-761. [PMID: 30124760 DOI: 10.1093/abm/kax049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background There is evidence that training health professionals in behavioral counseling skills can lead to greater success in helping their smokers to quit. However, it is still unknown how counseling skills relate to counseling effects. Purpose We established a method of skills evaluation of health professionals for smoking cessation counseling based on videotaped counseling sessions with a standardized smoker, and examined the relationship between skill levels and smoking cessation outcomes. Methods Twenty-three health professionals at Japanese workplaces underwent a training program. Their counseling skills were evaluated before and after the program using a structured evaluation form-based analysis of videotaped interactions between participants and a standardized smoker. A total of 858 smokers then received individual smoking cessation counseling by the trained health professionals at an annual health checkup. These patients were followed-up through surveys after 1 year. Results On a scale from 0 to 24, Total skill scores, which ranged from 0 to 24, were significantly higher after the training than before the training (p < .001). Multiple two-level logistic regression analysis adjusted for smokers' characteristics showed that the odds ratios of skill scores after the training for point prevalence and sustained abstinence rates among smokers who received counseling were 1.21 (95% confidence interval: 1.03-1.42) and 1.26 (1.05-1.50), respectively. Conclusions This study demonstrates that higher behavioral counseling skills were associated with better smoking cessation outcomes. This research is of clinical importance in that it provides a tool for assessing counselling skills in a way that is demonstrably relevant to outcomes.
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Affiliation(s)
- Akiko Hagimoto
- Faculty of Nursing, Doshisha Woman's College of Liberal Arts, Kyotanabe-shi, Kyoto, Japan
| | - Masakazu Nakamura
- Health Promotion Research Center, Institute of Community Medicine, Japan Association for Development of Community Medicine, Kyoto/Tokyo, Japan
| | - Shizuko Masui
- Health Promotion Research Center, Institute of Community Medicine, Japan Association for Development of Community Medicine, Kyoto/Tokyo, Japan
| | - Yoshiko Bai
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Akira Oshima
- Osaka International Cancer Institute, Osaka, Japan
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Jackson CB, Quetsch LB, Brabson LA, Herschell AD. Web-Based Training Methods for Behavioral Health Providers: A Systematic Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 45:587-610. [PMID: 29352459 PMCID: PMC6002894 DOI: 10.1007/s10488-018-0847-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There has been an increase in the use of web-based training methods to train behavioral health providers in evidence-based practices. This systematic review focuses solely on the efficacy of web-based training methods for training behavioral health providers. A literature search yielded 45 articles meeting inclusion criteria. Results indicated that the serial instruction training method was the most commonly studied web-based training method. While the current review has several notable limitations, findings indicate that participating in a web-based training may result in greater post-training knowledge and skill, in comparison to baseline scores. Implications and recommendations for future research on web-based training methods are discussed.
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Affiliation(s)
- Carrie B Jackson
- West Virginia University, Morgantown, WV, USA.
- Department of Psychology, West Virginia University, Life Sciences Building, 65 Campus Drive, Morgantown, WV, 26505, USA.
| | | | | | - Amy D Herschell
- West Virginia University, Morgantown, WV, USA
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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West R, Coyle K, Owen L, Coyle D, Pokhrel S. Estimates of effectiveness and reach for 'return on investment' modelling of smoking cessation interventions using data from England. Addiction 2018; 113 Suppl 1:19-31. [PMID: 28833834 PMCID: PMC6032933 DOI: 10.1111/add.14006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/10/2017] [Accepted: 08/09/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Estimating 'return on investment' (ROI) from smoking cessation interventions requires reach and effectiveness parameters for interventions for use in economic models such as the EQUIPT ROI tool (http://roi.equipt.eu). This paper describes the derivation of these parameter estimates for England that can be adapted to create ROI models for use by other countries. METHODS Estimates were derived for interventions in terms of their reach and effectiveness in: (1) promoting quit attempts and (2) improving the success of quit attempts (abstinence for at least 12 months). The sources were systematic reviews of efficacy supplemented by individual effectiveness evaluations and national surveys. FINDINGS Quit attempt rates were estimated to be increased by the following percentages (with reach in parentheses): 20% by tax increases raising the cost of smoking 5% above the cost of living index (100%); 10% by enforced comprehensive indoor public smoking bans (100%); 3% by mass media campaigns achieving 400 gross rating points (100%); 40% by brief opportunistic physician advice (21%); and 110% by use of a licensed nicotine product to reduce cigarette consumption (12%). Quit success rates were estimated to be increased by the following ratios: 60% by single-form nicotine replacement therapy (NRT) (5%); 114% by NRT patch plus a faster-acting NRT (2%);124% by prescribed varenicline (5%); 60% by bupropion (1%); 100% by nortriptyline (0%), 10) 298% by cytisine (0%); 40% by individual face-to-face behavioural support (2%); 37% by telephone support (0.5%); 88% by group behavioural support (1%); 63% by text messaging (0.5%); and 19% by printed self-help materials (1%). There was insufficient evidence to obtain reliable, country-specific estimates for interventions such as websites, smartphone applications and e-cigarettes. CONCLUSIONS Tax increases, indoor smoking bans, brief opportunistic physician advice and use of nicotine replacement therapy (NRT) for smoking reduction can all increase population quit attempt rates. Quit success rates can be increased by provision of NRT, varenicline, bupropion, nortriptyline, cytisine and behavioural support delivered through a variety of modalities. Parameter estimates for the effectiveness and reach of these interventions can contribute to return on investment estimates in support of national or regional policy decisions.
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Affiliation(s)
- Robert West
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Kathryn Coyle
- Health Economics Research Group (HERG), Institute of Environment, Health and SocietyBrunel University LondonUxbridgeUK
| | - Lesley Owen
- Centre for GuidelinesNational Institute for Health and Care ExcellenceLondonUK
| | - Doug Coyle
- Health Economics Research Group (HERG), Institute of Environment, Health and SocietyBrunel University LondonUxbridgeUK
- School of Epidemiology and Public HealthUniversity of OttawaOttawaCanada
| | - Subhash Pokhrel
- Health Economics Research Group (HERG), Institute of Environment, Health and SocietyBrunel University LondonUxbridgeUK
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Ye L, Goldie C, Sharma T, John S, Bamford M, Smith PM, Selby P, Schultz ASH. Tobacco-Nicotine Education and Training for Health-Care Professional Students and Practitioners: A Systematic Review. Nicotine Tob Res 2018; 20:531-542. [PMID: 28371888 DOI: 10.1093/ntr/ntx072] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/28/2017] [Indexed: 11/12/2022]
Abstract
Introduction The objective of this systematic review was to investigate what education and training characteristics prepares and supports health-care professionals (HCPs) in the delivery of competent and effective care to clients who use tobacco-nicotine. Aims and Methods A search of eight bibliographic databases for English-language peer-reviewed publications from January 2006 to March 2015. Studies were included if they met the a priori inclusion criteria, which consisted of: (1) quantitative study design and (2) focus on tobacco-nicotine education or training for HCP students and practitioners. All studies were independently screened for inclusion by two reviewers. Data from included studies were extracted for study characteristics and key outcomes then critically appraised for methodological quality. Results Fifty-nine studies were included for narrative synthesis. Two categories emerged: (1) curriculum characteristics (n = 10) and (2) education and training interventions (n = 49). Included curriculum studies identified the following themes: content, intensity, competencies evaluation, and barriers. Study findings about education and training interventions were grouped by level of education (prelicensure, post-licensure, and faculty training), teaching modality, health discipline, and the associated HCP and client outcomes. Conclusions This comprehensive review suggests that there is a lack of consistency in HCP tobacco-nicotine education and training characteristics. This paper provides valuable categorization of the most frequently utilized components of academic curriculum and discusses the interventions in relation to HCP and client outcomes. Gaps in the literature are highlighted, and the need for standardization of tobacco-nicotine training competencies and evaluation is discussed. Future research investigating the most effective approaches to training is needed. Implications This systematic review summarizes existing tobacco-related curriculum components (content, intensity, competency evaluation, and barriers) and training interventions for health-care professionals worldwide and demonstrates that they are associated with positive health-care professional outcomes (knowledge, attitudes, behaviors, and skills) and client outcomes (quit attempts and smoking abstinence).
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Affiliation(s)
- Lisa Ye
- International Affairs and Best Practice Guidelines, Registered Nurses' Association of Ontario, Toronto, ON, Canada
| | - Catherine Goldie
- Faculty of Health Sciences, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Tanvi Sharma
- International Affairs and Best Practice Guidelines, Registered Nurses' Association of Ontario, Toronto, ON, Canada
| | - Sheila John
- International Affairs and Best Practice Guidelines, Registered Nurses' Association of Ontario, Toronto, ON, Canada
| | - Megan Bamford
- International Affairs and Best Practice Guidelines, Registered Nurses' Association of Ontario, Toronto, ON, Canada
| | - Patricia M Smith
- Human Science Division, Northern Ontario School of Medicine, ON, Canada
| | - Peter Selby
- Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Asper Clinical Research Institute, Winnipeg, MB, Canada
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Forman J, Harris JM, Lorencatto F, McEwen A, Duaso MJ. National Survey of Smoking and Smoking Cessation Education Within UK Midwifery School Curricula. Nicotine Tob Res 2017; 19:591-596. [DOI: 10.1093/ntr/ntw230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/04/2016] [Indexed: 11/13/2022]
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Proportion of Time Spent Delivering Support Predicts Stop Smoking Advisor Quit Rate Independently of Training, Experience, and Education. J Smok Cessat 2017. [DOI: 10.1017/jsc.2016.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Despite a downwards trend in smoking prevalence, smoking remains the UK's biggest preventable cause of premature mortality. Specialist stop smoking support programmes provided by the NHS have helped to reduce smoking prevalence and whilst there has been a vast amount of research investigating the most effective behavioural and pharmacological support models, little is known about the impact of smoking cessation advisor's smoking status and clinical effectiveness on quit rates. This study aimed to identify factors that contribute to NHS stop smoking advisor performance using a quantitative cross-sectional design via an online survey that was completed by 159 participants in 24 London boroughs. Multiple regression analyses revealed that level of training, years practiced, level of advisor education, number of patients supported in a given year, and smoking status had no significant impact on NHS stop smoking advisor quit rate in this sample. However, the model revealed that proportion of time spent delivering smoking cessation support was significantly associated with quit rate. It is imperative that this finding is considered when recruiting, commissioning, and training new smoking cessation advisors or provider organisations.
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Scott KM, Baur L, Barrett J. Evidence-Based Principles for Using Technology-Enhanced Learning in the Continuing Professional Development of Health Professionals. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2017; 37:61-66. [PMID: 28252469 DOI: 10.1097/ceh.0000000000000146] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Increasingly, health professional training involves the use of educational technologies through what is broadly termed "Technology-Enhanced Learning" (TEL). TEL includes hardware, such as computers and mobile devices, and software, such as software applications (apps), learning management systems, and discussion boards. For many years, TEL has formed an integral part of health professional programs and is growing in acceptance, if not expectation, in postgraduate training and continuing education. TEL generally aims to be flexible, engaging, learner focused and interactive, and may involve collaboration and communication. It offers many benefits for learning and teaching, whether used on its own or in conjunction with face-to-face teaching through blended learning. The ubiquity of mobile devices in clinical settings means TEL is ideal for busy clinicians, both as learners and teachers. TEL enables participants to learn at a time and place that is convenient to them, so learners living in geographically dispersed locations can access standardized courses. To realize these potential benefits, we recommend that those developing TEL programs for health professionals take a systematic approach to planning, development, implementation, and evaluation. To that end, we propose 10 principles: clarify purpose and conduct a needs assessment; allocate adequate time and technology; incorporate proven approaches to improve learning; consider the need for a skills component; enable interaction between learners and with others; create different resources for different groups; pilot before implementing; incorporate measures to retain learners; provide opportunities for revision to aid retention; and evaluate learning outcomes, not just satisfaction.
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Affiliation(s)
- Karen M Scott
- Dr. Scott: Senior Lecturer, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia. Dr. Baur: Professor of Child and Adolescent Health, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia, and The Children's Hospital at Westmead, Sydney, Australia. Dr. Barrett: Honorary Research Fellow, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Shen N, Yufe S, Saadatfard O, Sockalingam S, Wiljer D. Rebooting Kirkpatrick: Integrating Information System Theory Into the Evaluation of Web-based Continuing Professional Development Interventions for Interprofessional Education. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2017; 37:137-146. [PMID: 28562503 DOI: 10.1097/ceh.0000000000000154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Information system research has stressed the importance of theory in understanding how user perceptions can motivate the use and adoption of technology such as web-based continuing professional development programs for interprofessional education (WCPD-IPE). A systematic review was conducted to provide an information system perspective on the current state of WCPD-IPE program evaluation and how current evaluations capture essential theoretical constructs in promoting technology adoption. METHODS Six databases were searched to identify studies evaluating WCPD-IPE. Three investigators determined eligibility of the articles. Evaluation items extracted from the studies were assessed using the Kirkpatrick-Barr framework and mapped to the Benefits Evaluation Framework. RESULTS Thirty-seven eligible studies yielded 362 evaluation items for analysis. Most items (n = 252) were assessed as Kirkpatrick-Barr level 1 (reaction) and were mainly focused on the quality (information, service, and quality) and satisfaction dimensions of the Benefits Evaluation. System quality was the least evaluated quality dimension, accounting for 26 items across 13 studies. WCPD-IPE use was reported in 17 studies and its antecedent factors were evaluated in varying degrees of comprehensiveness. DISCUSSION Although user reactions were commonly evaluated, greater focus on user perceptions of system quality (ie, functionality and performance), usefulness, and usability of the web-based platform is required. Surprisingly, WCPD-IPE use was reported in less than half of the studies. This is problematic as use is a prerequisite to realizing any individual, organizational, or societal benefit of WCPD-IPE. This review proposes an integrated framework which accounts for these factors and provides a theoretically grounded guide for future evaluations.
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Affiliation(s)
- Nelson Shen
- Mr. Shen: PhD Candidate, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. Ms. Yufe: MA Candidate, Department of Psychology, York University, Toronto, Ontario, Canada. Mr. Saadatfard: Researcher, Norwegian Centre for E-health, Tromsø, Norway. Dr. Sockalingam: Associate Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Deputy Psychiatrist-in-Chief, Centre for Mental Health, University Health Network, Toronto, Ontario, Canada. Dr. Wiljer: Associate Professor, Institute of Health Policy, Management and Evaluation, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada, and Executive Director, Education, Technology & Innovation, University Health Network, Toronto, Ontario, Canada
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Lorencatto F, Harper AM, Francis JJ, Lawrenson JG. A survey of
UK
optometry trainees’ smoking cessation training. Ophthalmic Physiol Opt 2016; 36:494-502. [DOI: 10.1111/opo.12290] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Fabiana Lorencatto
- Centre for Health Services Research, School of Health Sciences City University London London UK
| | - Alice M. Harper
- Centre for Health Services Research, School of Health Sciences City University London London UK
| | - Jill J. Francis
- Centre for Health Services Research, School of Health Sciences City University London London UK
| | - John G. Lawrenson
- Centre for Public Health Research, School of Health Sciences City University London London UK
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Brose LS, McEwen A, Michie S, West R, Chew XY, Lorencatto F. Treatment manuals, training and successful provision of stop smoking behavioural support. Behav Res Ther 2015; 71:34-9. [PMID: 26057438 DOI: 10.1016/j.brat.2015.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 05/15/2015] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Translating evidence-based behaviour change interventions into practice is aided by use of treatment manuals specifying the recommended content and format of interventions, and evidence-based training. This study examined whether outcomes of stop smoking behavioural support differed with practitioner's use and evaluation of treatment manuals, or practitioner's training. METHODS English stop smoking practitioners were invited to complete an online survey including questions on: practitioners' training, availability, use and perceived utility of manuals, and annual biochemically-validated success rates of quit attempts supported (practitioner-reported). Mean success rates were compared between practitioners with/without access to manuals, those using/not using manuals, perceived utility ratings of manuals, and consecutive levels of training completed. RESULTS Success rates were higher if practitioners had a manual (Mean (SD) = 54.0 (24.0) versus 48.0 (25.3), t(838) = 2.48, p = 0.013; n = 840), used a manual (F(2,8237) = 4.78, p = 0.009, n = 840), perceived manuals as more useful (F(3,834) = 2.90, p = 0.034, n = 840), and had completed training (F(3,709) = 4.81, p = 0.002, n = 713). Differences were diminished when adjusting for professional and demographic characteristics and no longer reached statistical significance using a conventional alpha for perceived utility of manuals and training status (both p = 0.1). CONCLUSIONS Practitioners' performance in supporting smokers to quit varied with availability and use of treatment manuals. Evidence was weaker for perceived utility of manuals and practitioners' evidence-based training. Ensuring practitioners have access to treatment manuals within their service, promoting manual use, and training practitioners to competently apply manuals is likely to contribute to higher success rates in clinical practice.
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Affiliation(s)
- Leonie S Brose
- National Addictions Centre, UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Andy McEwen
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
| | - Susan Michie
- Centre for Outcomes Research and Effectiveness, University College London, London, UK.
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
| | - Xie Yin Chew
- Department of Psychology and Language Sciences, University College London, London, UK.
| | - Fabiana Lorencatto
- Health Services Research and Management, School of Health Sciences, City University London, London, UK.
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Brose LS, West R, Michie S, McEwen A. Changes in success rates of smoking cessation treatment associated with take up of a national evidencebased training programme. Prev Med 2014; 69:1-4. [PMID: 25152508 DOI: 10.1016/j.ypmed.2014.08.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/26/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The English 'stop smoking services' provide behavioural support to some 700,000 smokers annually. Success rates of the services varied considerably before 2010 and had been in slight decline so, to improve performance, a national programme of evidence-based practitioner training was developed to improve knowledge and skills-based competences. This study evaluated whether uptake of the training was associated with improvements in success rates of services. METHODS Mean 4-week biochemically verified abstinence rates were compared for 146 (of 151) stop smoking services between 2008-10 (before roll-out of training) and 2011-13 (after roll-out), and the change in success rates for each service was regressed on to the number of practitioners per service trained in a) knowledge (online) and b) skills (face-to-face). RESULTS Success rate across all services improved between the two periods (34.1% to 36.5%, p=0.01 1-tailed; 95% CI for difference 0.44-4.48). The magnitude of improvement for each service was associated with the number of practitioners who completed the knowledge and skills training (beta=0.22, p=0.005 1-tailed), and marginally with the number who completed the knowledge training (beta=0.14, p=0.047 1-tailed). CONCLUSION English stop smoking services that have greater uptake of a national evidence-based training programme showed greater improvements in success rates.
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Affiliation(s)
- Leonie S Brose
- UK Centre for Tobacco and Alcohol Studies, Addictions, Institute of Psychiatry, King's College London, UK.
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, University College London, UK; National Centre for Smoking Cessation and Training (NCSCT), UK
| | - Susan Michie
- Clinical, Educational and Health Psychology, University College London, UK; National Centre for Smoking Cessation and Training (NCSCT), UK
| | - Andy McEwen
- Cancer Research UK Health Behaviour Research Centre, University College London, UK; National Centre for Smoking Cessation and Training (NCSCT), UK
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McDermott MS, Beard E, Brose LS, West R, McEwen A. Factors Associated With Differences in Quit Rates Between “Specialist” and “Community” Stop-Smoking Practitioners in the English Stop-Smoking Services. Nicotine Tob Res 2012; 15:1239-47. [DOI: 10.1093/ntr/nts262] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Brose LS, West R, Michie S, McEwen A. Validation of content of an online knowledge training program. Nicotine Tob Res 2012. [PMID: 23197766 DOI: 10.1093/ntr/nts258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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