1
|
Abufarsakh B, Otachi JK, Wang T, Al-Mrayat Y, Okoli CTC. The Impact of a Nurse-Led Service on Tobacco Treatment Provision Within a Psychiatric Hospital: A Time Series Study. J Am Psychiatr Nurses Assoc 2024; 30:434-440. [PMID: 35549464 DOI: 10.1177/10783903221093582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Psychiatric hospitalization is an opportunity to provide evidence-based tobacco treatment to optimize cessation efforts among people living with mental illnesses (MI). The purpose of this study was to examine the effectiveness of nurse-driven initiatives to enhance tobacco treatment within an inpatient psychiatric setting. AIMS We assessed the 4-year impact of implementing a nurse-led tobacco treatment service offered to 11,314 inpatients at admissions in a tobacco-free psychiatric facility in Kentucky. METHOD Through a time-series design, we compared the differences in rates of screening for tobacco use and providing treatment from September to December 2015 (prior to implementing the nurse-led tobacco treatment services) to each subsequent year in a 4-year period (2016-2019). RESULTS Approximately 60.0% of inpatients were persons using tobacco during the assessment period. Although there were no changes in tobacco use prevalence over the 4-year evaluation duration, there were significant increases in the provision of practical counseling and Food and Drug Administration-approved nicotine replacement therapies for persons using tobacco. CONCLUSIONS Our findings support the effectiveness of implementing tobacco treatment programs at the organizational level. Psychiatric hospitalizations provide an opportunity to optimize nurse-driven efforts to deliver tobacco treatment to people with MI. Similar models of nurse-led tobacco treatment services can be adopted within inpatient and other mental and behavioral health settings.
Collapse
Affiliation(s)
- Bassema Abufarsakh
- Bassema Abufarsakh, PhD candidate, MSN, BSN, University of Kentucky College of Nursing, Lexington, KY, USA
| | - Janet K Otachi
- Janet K. Otachi, PhD, MSW, MA, University of Kentucky College of Social Work, Lexington, KY, USA
| | - Tianyi Wang
- Tianyi Wang, MS, BS, University of Kentucky College of Arts and Sciences, Lexington, KY, USA
| | - Yazan Al-Mrayat
- Yazan Al-Mrayat, PhD, MSN, RN, University of Kentucky College of Nursing, Lexington, KY, USA
| | - Chizimuzo T C Okoli
- Chizimuzo T. C. Okoli, PhD, MPH, MSN, PMHNP-BC, APRN, FAAN, Professor, University of Kentucky College of Nursing, Lexington, KY, USA
| |
Collapse
|
2
|
Zhang G, Zhou J, Luk TT, Lam VSF, Yao Z, Wang MP, Cheung YTD. The learning outcomes of smoking cessation training in undergraduate nursing students: A systematic review. Nurse Educ Pract 2024; 75:103907. [PMID: 38308947 DOI: 10.1016/j.nepr.2024.103907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
AIM To systematically evaluate the effect of smoking cessation training on nursing students' learning outcomes. DESIGN This systematic review followed the PRISMA guidelines and was registered with PROSPERO (CRD42022373280). METHODS Ten electronic English and Chinese databases were searched to identify articles on nursing students' smoking cessation training from inception to October 2022. Medical Education Research Study Quality Instrument was used to assess the methodological quality of eligible studies. RESULTS Twelve moderate methodological quality studies (three randomized controlled trials and nine quasi-experimental studies) with 2114 undergraduate nursing students were included. Teaching strategies included didactic lectures, collaborative learning, blended learning and the service-learning approach. Eight studies showed that the training significantly increased nursing students' knowledge of smoking cessation (p < 0.05) and three of them showed a large effect size (Cohen's d: 0.83-1.31). Seven studies showed that training enhanced students' attitudes/motivation towards smoking cessation interventions significantly (p < 0.05) and two of them showed a large effect size (Cohen's d: 1.11-1.84). Nine studies reported that students' self-efficacy improved significantly after training (p < 0.05) and six of them showed a large effect size (Cohen's d: 0.98-2.18). Two one-group pre-post studies showed training significantly improved students' practice of 5 A's behavior (p < 0.05), with a small effect size (Cohen's d < 0.50). CONCLUSIONS This review showed that smoking cessation training had a positive and large effect on undergraduate nursing students' knowledge, attitudes/motivation and self-efficacy towards smoking cessation intervention, but the effect of changing the practice of 5 A's was modest. We noted that very few RCTs were done and most studies only used subjective measures. More robust experimental studies with long-term follow-up are warranted in evaluating nursing students' practice/behavior of smoking cessation intervention and patients' quitting outcomes. Blended and collaborative learning are recommended in smoking cessation education.
Collapse
Affiliation(s)
- Guowen Zhang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jie Zhou
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Tzu Tsun Luk
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Veronica Suk Fun Lam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Zhuangyan Yao
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Man Ping Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yee Tak Derek Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
3
|
Melzer AC, Reese ZA, Mascarhenas L, Clancy CB, Deepak J, Gogineni H, Gesthalter Y, Hart JL. Education for Tobacco Use Disorder Treatment: Current State, Evidence, and Unmet Needs. ATS Sch 2023; 4:546-566. [PMID: 38196686 PMCID: PMC10773493 DOI: 10.34197/ats-scholar.2022-0131re] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/20/2023] [Indexed: 01/11/2024] Open
Abstract
Background Tobacco use is undertreated in the medical setting. One driver may be inadequate tobacco use disorder treatment (TUDT) training for clinicians in specialties treating tobacco-dependent patients. Objective We sought to evaluate the current state of TUDT training for diverse professionals and how these skills are assessed in credentialing exams. Methods We performed a focused review of current educational practices, evidence-based strategies, and accreditation exam contents focused on TUDT. Results Among medical students, participants in reviewed studies reported anywhere from 45 minutes to 3 hours of TUDT training throughout their 4-year programs, most often in the form of didactic sessions. Similarly, little TUDT training was reported at the post-graduate (residency, fellowship, continuing medical education) levels, and reported training was typically delivered as time-based (expected hours of instruction) rather than competency-based (demonstration of mastery) learning. Multiple studies evaluated effective TUDT curricula at varied stages of training. More effective curricula incorporated longitudinal sessions and active learning, such as standardized patient encounters or proctored patient visits. Knowledge of TUDT is minimally evaluated on certification exams. For example, the American Board of Internal Medicine blueprint lists TUDT as <2% of one subtopic on both the internal medicine and pulmonary exams. Conclusion TUDT training for most clinicians is minimal, does not assess competency, and is minimally evaluated on certification exams. Effective, evidence-based TUDT training incorporating active learning should be integrated into medical education at all levels, with attention paid to inclusion on subsequent certifying exams.
Collapse
Affiliation(s)
- Anne C. Melzer
- Center for Care Delivery and Outcomes
Research, Minneapolis VA Health Care System, Minneapolis, Minnesota
- Division of Pulmonary, Allergy, Critical
Care, and Sleep, and
| | - Zachary A. Reese
- Division of Pulmonary, Allergy, and
Critical Care, Department of Medicine
| | - Lorraine Mascarhenas
- Department of Internal Medicine,
University of Minnesota Medical School, Minneapolis, Minnesota
| | - Caitlin B. Clancy
- Division of Pulmonary, Allergy, and
Critical Care, Department of Medicine
| | - Janaki Deepak
- Division of Pulmonary and Critical Care,
Department of Medicine, University of Maryland School of Medicine, Baltimore,
Maryland
| | - Hyma Gogineni
- Department of Pharmacy, Western University
of Health Sciences, Pomona, California
| | - Yaron Gesthalter
- Department of Pulmonary and Critical Care,
University of California San Francisco, San Francisco, California; and
| | - Joanna L. Hart
- Division of Pulmonary, Allergy, and
Critical Care, Department of Medicine
- Palliative and Advanced Illness Research
Center, and
- Department of Medical Ethics and Health
Policy, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Medicine, Corporal Michael
J. Crescenz Department of Veterans Affairs Medical Center, Philadelphia,
Pennsylvania
| |
Collapse
|
4
|
Marciniak ET, LaRocco AM, Deepak J. Promoting Training and Education in Tobacco Dependence Treatment. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
5
|
Essenmacher C, Baird C, Houfek J, Spielmann MR, Adams S. Developing Competency-Based Nursing Treatment for Persons With Tobacco Use Disorder. J Am Psychiatr Nurses Assoc 2022; 28:23-36. [PMID: 34763557 DOI: 10.1177/10783903211058785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Tobacco continues to have a deleterious impact on health outcomes in the United States. Professional nurses at all levels of practice have an opportunity to be a part of the solution. The development of nurse-specific competencies for treating tobacco use disorder (TUD) disorder is long overdue. A task force of American Psychiatric Nurses Association (APNA) subject matter experts was assembled to engage in the process of reviewing the available peer-reviewed literature and additional evidence-based resources (e.g., professional organization position statement, toolkits, national survey results) to create the Nursing Competencies for Treating Tobacco Use Disorders. OBJECTIVE The aim of this article is ultimately to improve patient access to quality, evidence-based TUD nursing care by all nurses who are competent, full partners in TUD multidisciplinary care. METHOD Search terms were defined and a scoping search and review of the TUD literature and resources was performed from November 2018 to November 2020. RESULTS Over 300 articles and evidence-based resources (e.g., professional organization position statements, toolkits, etc.) were discovered. Thirteen competencies were developed and were internally and externally reviewed prior to APNA Board of Director's approval. CONCLUSION TUD competencies have the potential to guide nursing education, practice, and research, allowing nurses to be full partners in the design, development, and implementation of effective TUD treatment.
Collapse
Affiliation(s)
- Carol Essenmacher
- Carol Essenmacher, PMHCNS-BC, DNP, Saginaw Valley State University, University Center, MI, USA
| | - Carolyn Baird
- Carolyn Baird, DNP, MBA, RN-BC, CARN-AP, CAADC, FIAAN, Meredith Counseling and Consulting, McMurray, PA, USA
| | - Julia Houfek
- Julia Houfek, PhD, APRN-CNS, University of Nebraska, Omaha, NE, USA
| | - M Rene Spielmann
- M. Rene Spielmann, DNP, ARNP, FNP-BC, PMHNP-BC, Gonzaga University, Spokane, WA, USA
| | - Sara Adams
- Sara Adams, PhD, RN, CNE, Rush University, Chicago, IL, USA
| |
Collapse
|
6
|
Tan MM, Veluz-Wilkins A, Styrczula P, McBrayer S. Gaps in Knowledge and Practice in Treating Tobacco Use Among Non-physician Healthcare Professionals and Lay Health Workers in Chicago, Illinois. Cancer Control 2022; 29:10732748221105310. [PMID: 35632990 PMCID: PMC9150222 DOI: 10.1177/10732748221105310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/15/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To conduct a needs assessment for lay health workers and non-physician healthcare professionals [i.e., community health workers (CHW) and lung health professionals who spend more time face-to-face with tobacco-related disparity populations] to describe current gaps in tobacco cessation practices and knowledge. METHODS A 46-item needs assessment survey was developed to understand knowledge, practices, and confidence about tobacco cessation among non-physician health professionals in a large, urban city in the U.S. Participants, recruited from local community-based organizations and email listservs, completed the online or paper survey, which included a 10-item investigator-initiated tobacco knowledge questionnaire. RESULTS About 61.5% of participants (N = 53) asked each client/patient about tobacco use at initial visit, 41.8% reported extreme likelihood of discussing tobacco during a visit, and 43.1% reported addressing tobacco use directly. Despite assisting with cessation, tobacco-related knowledge and confidence was low, with respondents scoring an average of 4.08 out of 10 (SD = 2.21) on the tobacco knowledge questionnaire. CONCLUSION There was a clear lack of knowledge about tobacco cessation in the U.S. among non-physician healthcare professionals. These professionals could benefit from trainings that are relevant to their model of care and better equip them to assist the disparity populations that they serve.
Collapse
Affiliation(s)
- Marcia M. Tan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anna Veluz-Wilkins
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Paulina Styrczula
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Shambreia McBrayer
- American Lung Association in Illinois, Greater Chicago, Chicago, IL, USA
| |
Collapse
|
7
|
Liu X, Shi J, Mol BW, Bai H. Impact of maternal education level on live birth rate after in vitro fertilization in China: a retrospective cohort study. J Assist Reprod Genet 2021; 38:3077-3082. [PMID: 34694541 DOI: 10.1007/s10815-021-02345-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/15/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To assess the association between maternal education level and live birth after in vitro fertilization (IVF). METHODS We studied women who underwent the first cycle of fresh or frozen-thawed embryo transfer between 2014 and 2019. Women were divided into four educational categories according to the level of education received (elementary school graduate or less, middle school graduate, high school graduate, college graduate or higher). The live birth rate was compared between different education level groups. We used logistic regression to analyze the association between maternal education level and live birth after IVF. RESULTS We studied 41,546 women, who were grouped by maternal educational level: elementary school graduate or less (n = 1590), middle school graduate (n = 10,996), high school graduate (n = 8354), and college graduate or higher (n = 20,606). In multivariable logistic regression analysis, we did not demonstrate a statistically significant relationship between educational level and live birth in middle school graduate (adjusted odds ratio [AOR] 0.96; 95% confidence interval [CI], 0.84-1.09), high school graduate (AOR 1.01; 95% CI, 0.87-1.14) or college graduate or higher (AOR 1.01; 95% CI, 0.88-1.14) patients, with elementary school graduate or less as the reference group. CONCLUSIONS Maternal educational level was not associated with the likelihood of live birth in patients undergoing fresh or frozen embryo transfer.
Collapse
Affiliation(s)
- Xitong Liu
- The Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Juanzi Shi
- The Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Melbourne, VIC, Australia
| | - Haiyan Bai
- The Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China.
| |
Collapse
|
8
|
Martínez C, Castellano Y, Laroussy K, Fu M, Baena A, Margalef M, Feliu A, Aldazabal J, Tigova O, Galimany J, Puig-Llobet M, Moreno C, Bueno A, López A, Guydish J, Fernández E. Knowledge, Attitudes, and Training in Tobacco Dependence and Cessation Treatment Among Nursing Students in Catalonia (ECTEC Study): Cross-Sectional Study. Int J Ment Health Addict 2021. [PMID: 37261115 PMCID: PMC10229109 DOI: 10.1007/s11469-021-00640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Nursing students are part of the future health labor force; thus, knowing their knowledge and participation in tobacco control is of importance. Multicentre cross-sectional study conducted to assess nursing students' knowledge, attitudes, and training in tobacco dependence and treatment at 15 nursing schools in Catalonia. We employed a self-administered questionnaire. 4,381 students participated. Few respondents (21.1%) knew how to assess smokers' nicotine dependence, and less than half (41.4%) knew about the smoking cessation therapies. Most (80%) had been educated on the health risks of smoking, 50% about the reasons why people smoke and, one third on how to provide cessation aid. Students in the last years of training were more likely to have received these two contents. Nursing students lack sufficient knowledge to assess and treat tobacco dependence and are rarely trained in such subjects. Nursing curricula in tobacco dependence and treatment should be strengthened to tackle the first preventable cause of disease worldwide.
Collapse
|
9
|
Vides-Porras A, Cáceres P, Company A, Guillen O, Arrien MA, Castellano Y, Margalef M, Yantuche W, Fernández E, Martínez C. Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries. Health Promot Int 2021; 36:349-362. [PMID: 32594125 DOI: 10.1093/heapro/daaa054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Continuous medical education focused on health problems emerging in low- and middle-income countries (LMICs) is scarce. Although tobacco consumption is increasing in LMICs, there is a lack of tobacco cessation training programs in these countries. To promote smoking cessation interventions in Bolivia, Guatemala and Paraguay, we adapted an e-learning program developed in Catalonia (Spain). This process evaluation study reports on reach, dose and satisfaction of participants with the course, as well as the contextual factors of its application. We conducted a multiple method evaluation, which included a survey and several focus groups, each one specific to the same type of healthcare professional (nurses, doctors, other professionals). Two hundred and ninety-two participants registered into the online course. The motivation for undertaking the course was different between doctors and nurses. The main sources of difficulty in enrolling and finishing the course were the technical problems experienced when accessing the platform, and lack of acquaintance with computers and the Internet in general. Our results show that implementing e-learning education in hospitals from LMICs is feasible, especially when there are similarities between participating countries and the country in which the original program was developed. However, several elements such as strong organizational commitment, technical support and resources and adequate communication channels should be provided to facilitate enrollment and training completion. Efforts to improve Internet access should be made to avoid jeopardizing students' motivation to enroll and complete online training.
Collapse
Affiliation(s)
- Ana Vides-Porras
- School of Social Sciences, Universidad del Valle de Guatemala, 18 Av. 11-95 zona 15 Vista Hermosa III, Guatemala 01015, Guatemala
| | - Paula Cáceres
- Radiation Oncology Department, Instituto de Cancerología y Hospital Dr. Bernardo del Valle S., 6 Av 6-58 Z-11, Guatemala
| | - Assumpta Company
- E-oncologia Unit, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olga Guillen
- E-oncologia Unit, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Martha Alicia Arrien
- Instituto Oncologico del Oriente Boliviano de Santa Cruz de la Sierra Av. Marcelo Terceros Bánzer, Santa Cruz de la Sierra, Bolivia
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mercè Margalef
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Wendy Yantuche
- Oncologic Surgery, Instituto de Cancerología y Hospital Dr. Bernardo del Valle S, Guatemala
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa llarga s/n, 08907.,Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO 08907.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain.,Department of Nursing: Public Health, Mental Health and Maternal and Child Health, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, USA
| | | |
Collapse
|
10
|
Grech J. Impact of a nurse-led brief tobacco cessation training program for healthcare professionals. Public Health Nurs 2021; 38:869-878. [PMID: 34043822 DOI: 10.1111/phn.12925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the impact of a tobacco cessation training program on healthcare professionals' smoking cessation practices, counseling-related opinions, and attitudes about their role in tobacco control. DESIGN A single group pre- and post-design. SAMPLE Eligible participants (n = 133) were health professionals who attended a training program between September 2018 and June 2019 at specific training sites in Malta. MEASUREMENTS An already established questionnaire was used to compare healthcare professionals' practices, opinions, and attitudes before the training program, and at 3-month follow-up. INTERVENTION A public health nurse-led, 3-hr training intervention addressing tobacco use and tobacco cessation with emphasis on the 5As (Ask, Advise, Assess, Assist and Arrange) framework. RESULTS Healthcare professionals were favorably disposed towards counseling patients to stop. While participants still found it difficult to get clients to quit and lacked the time to counsel patients, they were more likely to deliver tobacco cessation interventions frequently at follow-up. CONCLUSION Despite these challenges, this training program was found useful by the participants, who took a more comprehensive approach to address tobacco use. Public health nurses are encouraged to take a leading role in tobacco cessation training initiatives as part of their efforts to improve population health.
Collapse
Affiliation(s)
- Joseph Grech
- Institute of Applied Sciences, Malta College of Arts, Science & Technology, Paola, Malta.,Health Promotion and Disease Prevention Directorate, Department for Health Regulation, Ministry for Health, Pietà, Malta
| |
Collapse
|
11
|
Bialous S, Freeman B. Communication challenges of a tobacco addictiveness reduction policy. Tob Induc Dis 2021; 19:38. [PMID: 34017232 PMCID: PMC8114736 DOI: 10.18332/tid/134747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/25/2021] [Accepted: 03/22/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Stella Bialous
- Social and Behavioral Sciences Department, School of Nursing, University of California, San Francisco, United States
| | - Becky Freeman
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| |
Collapse
|
12
|
Meijer E, Chavannes NH. Lacking willpower? A latent class analysis of healthcare providers' perceptions of smokers' responsibility for smoking. PATIENT EDUCATION AND COUNSELING 2021; 104:620-626. [PMID: 32943247 DOI: 10.1016/j.pec.2020.08.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/29/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Healthcare providers' (HCPs) perceptions of smokers' responsibility for smoking may affect implementation of smoking cessation care (SCC), but are understudied. This study examined Dutch HCPs' perceptions of smokers' responsibility for smoking, and how many and which subgroups exist with regard to these perceptions. METHODS Observational cross-sectional study among physicians and other HCPs (N = 570). Latent class analysis was used to analyse data. RESULTS Results showed two latent classes of HCPs: a majority (77 %) that appeared to hold smokers themselves more accountable for their smoking, and a minority (23 %) that seemed more inclined to believe that people smoked as a consequence of factors such as addiction, and smoking initiation when people were young and could not foresee consequences. The two-class model showed excellent certainty in classification. Class membership was associated with age, working experience, and smoking status. The majority class experienced more barriers to SCC than the minority class and provided SCC tasks to fewer patients. CONCLUSIONS HCPs' perceptions of smokers' responsibility for smoking relate to HCP background characteristics, barriers to SCC and implementation of SCC. PRACTICE IMPLICATIONS New approaches to improving SCC might be needed that take HCP's perceptions of smokers' responsibility into account.
Collapse
Affiliation(s)
- E Meijer
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - N H Chavannes
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands.
| |
Collapse
|
13
|
Lauerer E, Tiedemann E, Polak T, Simmenroth A. Can smoking cessation be taught online? A prospective study comparing e-learning and role-playing in medical education. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:12-21. [PMID: 33507877 PMCID: PMC7883797 DOI: 10.5116/ijme.5ff9.bccc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 01/09/2021] [Indexed: 05/10/2023]
Abstract
OBJECTIVES We compared the effect of different didactic formats - e - learning and role-playing - on medical students' knowledge and counselling skills in smoking cessation training. METHODS At a German medical school, 145 third-year students were randomly allocated to attend an online course with video examples or an attendance course with role-playing. Students were trained in smoking cessation counselling according to the 5A's (ask, advise, assess, assist, arrange) for approximately 90 minutes. Practical skills were measured in an objective structured clinical examination (OSCE) and represent the primary endpoint of this prospective comparative study. Additionally, changes in theoretic knowledge were assessed by pre - and post - interventional questionnaires and a final written exam. RESULTS In the OSCE, overall scores were higher in the attendance group (Mdn=70.8 % vs. 62.8 %; U=119; p=.087, n=36), but a statistical advantage was only found in one single counselling sequence ("Assist": Mdn=66.7 % vs. 51.4 %; p = .049) and the rating of the standardised patients (M=4.7 vs. 4.2 out of 5 points, t(27.836)=2.0, p=.028). Students' results (n=130) from self-assessment and written exams suggest that both approaches are equally well suited to increase theoretical knowledge. The online course was more time efficient (90 vs. 73 minutes). CONCLUSIONS Seminar and web-based training seem equally well suited for transferring knowledge and skills on tobacco cessation counselling. Considering their particular strengths, these two teaching approaches could be combined.
Collapse
Affiliation(s)
- Elias Lauerer
- Department of General Practice, University Medical Centre Würzburg, Germany
| | - Elena Tiedemann
- Department of General Practice, University Medical Centre Würzburg, Germany
| | - Thomas Polak
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Medical Centre Würzburg, Germany
| | - Anne Simmenroth
- Department of General Practice, University Medical Centre Würzburg, Germany
| |
Collapse
|
14
|
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.
Collapse
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
| | | | | | | | | | | | | |
Collapse
|
15
|
Okoli CTC, Otachi JK, Seng S. Assessing opinions and barriers to providing evidence-based tobacco treatment among health care providers within an in-patient psychiatric facility. J Ment Health 2020; 29:631-641. [PMID: 30862266 DOI: 10.1080/09638237.2019.1581328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 10/17/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
Background: Tobacco-related morbidity and mortality is high among people with mental illnesses (PMI); yet tobacco treatment (TT) is often not provided by mental health care providers (MHPs). Studies that examine barriers to TT for people with MI are critical in addressing this disparity.Aims: To determine factors associated with MHPs' opinions of, self-efficacy in, barriers to and training needs for providing TT by job role.Methods: 205 MHPs in a psychiatric facility were surveyed using a standardized questionnaire on demographics and opinions, self-efficacy, barriers and needs to providing TT. Descriptive and multivariate regression analyses examined factors associated with the main outcomes.Results: MHP's gave high ratings to both the appropriateness of delivering evidence-based TT and their confidence in providing TT medications. In regards to perceived barriers to providing TT, MHP's further endorsed that patients should be provided nicotine replacement therapy and be motivated to engage in TT. Key needs were for training in cessation counseling, cessation materials and community support for TT.Conclusions: Based on our findings, future studies are needed to address providers' biases and concerns, eliminate system-barriers and determine effective provider training. Moreover, these findings may guide research, practice and policies toward enhancing TT in PMI.
Collapse
Affiliation(s)
| | - Janet K Otachi
- Center for Health Services Research, University of Kentucky, Lexington, KY, USA
| | - Sarret Seng
- College of Nursing, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
16
|
Martínez C, Feliu A, Castellano Y, Fu M, Fernández P, Cabrera-Jaime S, Puig-Llobet M, Galimany J, Guydish J, Fernández E. Factors associated with receipt of the 5As model of brief intervention for smoking cessation among hospitalized patients. Addiction 2020; 115:2098-2112. [PMID: 32297373 DOI: 10.1111/add.15076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/18/2019] [Accepted: 04/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Guidelines recommend the 5As model of brief intervention for providing smoking cessation support in clinical settings. This study assessed patient and hospital characteristics associated with self-reported receipt of the 5As (ask, advise, assess, assist and arrange). DESIGN Multi-center cross-sectional study. SETTING AND PARTICIPANTS Adult inpatients (n = 1047) were randomly selected from 13 hospitals in the Barcelona province of Spain in 2014-2015. MEASUREMENTS We explored participants' receipt of the 5As through a questionnaire. Given the progressiveness of the 5As, we recoded the fulfillment of the intervention as: A0 : no intervention; A1 : ask; A2 : ask and advise; A3 : A2 and assess; A4 : A3 and assist; and A5 : A4 and arrange a follow-up. We explored patient (e.g. age, sex, comorbidities) and hospital (e.g. type of hospital, unit) characteristics. We adjusted multi-level robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of the association between the recoded 5As intervention received. FINDINGS A total of 60.4% (n = 624) of patients had been asked (A1 ) about their smoking status. Among smokers, 46.5% (n = 90) were advised (A2 ), 26.6% (n = 48) assessed (A3 ) and 4.6% (n = 10) received all the components of the 5As (A5 ). Middle-aged smokers [aPR = 3.63; 95% confidence interval (CI) = 1.69-7.79] with a respiratory disease (aPR = 2.19; 95% CI = 1.11-4.34) were most likely to have been asked, advised and assessed (A3 ). The cessation intervention was most frequently performed by physicians. CONCLUSIONS In the Barcelona province of Spain, it appears that fewer than half of hospitalized patients who smoke were advised to quit and few received the full 'five As' brief intervention for smoking cessation.
Collapse
Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Ariadna Feliu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Paz Fernández
- School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Sandra Cabrera-Jaime
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Montse Puig-Llobet
- School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Jordi Galimany
- School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Esteve Fernández
- Tobacco Control Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, Campus of Bellvitge. University of Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | | |
Collapse
|
17
|
Halas G, Schultz ASH, Rothney J, Wener P, Holmqvist M, Cohen B, Kosowan L, Enns JE, Katz A. A Scoping Review of Foci, Trends, and Gaps in Reviews of Tobacco Control Research. Nicotine Tob Res 2020; 22:599-612. [PMID: 30715468 DOI: 10.1093/ntr/nty269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/17/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The burden of disease associated with tobacco use has prompted a substantial increase in tobacco-related research, but the breadth of this literature has not been comprehensively examined. This review examines the nature of the research addressing the action areas in World Health Organization's Framework Convention on Tobacco Control (FCTC), the populations targeted and how equity-related concepts are integrated. METHOD A scoping review of published reviews addressing tobacco control within the primary prevention domain. We searched PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Educational Resources Information Centre, and PsycInfo from 2004 to 2018. RESULTS The scoping review of reviews offered a "birds-eye-view" of the tobacco control literature. Within the 681 reviews meeting inclusion criteria, there was a strong focus on smoking cessation targeting individuals; less attention has been given to product regulation, packaging, and labeling or sales to minors. Equity-related concepts were addressed in 167/681 (24.5%); few were focused on addressing inequity through structural and systemic root causes. CONCLUSION This analysis of foci, trends, and gaps in the research pursuant to the FCTC illustrated the particular action areas and populations most frequently addressed in tobacco control research. Further research is needed to address: (1) underlying social influences, (2) particular action areas and with specific populations, and (3) sustained tobacco use through the influence of novel marketing and product innovations by tobacco industry. IMPLICATIONS This scoping review of the breadth of tobacco control research reviews enables a better understanding of which action areas and target populations have been addressed in the research. Our findings alongside recommendations from other reviews suggest prioritizing further research to support policymaking and considering the role of the tobacco industry in circumventing tobacco control efforts. The large amount of research targeting individual cessation would suggest there is a need to move beyond a focus on individual choice and decontextualized behaviors. Also, given the majority of reviews that simply recognize or describe disparity, further research that integrates equity and targets various forms of social exclusion and discrimination is needed and may benefit from working in collaboration with communities where programs can be tailored to need and context.
Collapse
Affiliation(s)
- Gayle Halas
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Janet Rothney
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Wener
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Maxine Holmqvist
- Department of Clinical Health Psychology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Benita Cohen
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leanne Kosowan
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer E Enns
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
18
|
Baliunas D, Ivanova A, Tanzini E, Dragonetti R, Selby P. Impact of comprehensive smoking cessation training of practitioners on patients' 6-month quit outcome. Canadian Journal of Public Health 2020; 111:766-774. [PMID: 32441021 DOI: 10.17269/s41997-020-00318-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/31/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Smoking remains a leading public health issue and health care practitioners (HCPs), who play an important role in supporting and promoting patients' cessation efforts, need educational initiatives that improve their ability to provide effective clinical care. The objective of this study was to compare patient-reported abstinence from smoking following treatment by HCPs trained in an intensive tobacco cessation program and those trained in less intensive programs. METHODS A secondary data analysis of two overlapping samples of patients who received most of their treatment from one identifiable HCP (n = 26,590) or all of their treatment from one identifiable HCP (n = 20,986) was assessed. Patients were residents of Ontario, Canada, who enrolled in a publicly funded smoking cessation treatment program between 01 May 2014 and 31 October 2016 and completed the 7-day point prevalence of smoking question at 6-month follow-up. Treatment was provided by HCPs who engaged in the intensive Training Enhancement in Applied Counselling and Health (TEACH) Core course, or those who engaged in one or more other training programs. Generalized estimating equation (GEE) logistic regression was used to compare smoking abstinence between groups. RESULTS After adjustment for both patient- and practice-level covariates, a significant association was found between being treated by a TEACH-trained HCP and the likelihood of smoking abstinence at 6-month follow-up in both analytic samples (most care sample: OR = 1.10, 95% CI = 1.01, 1.20; all care sample: OR = 1.12, 95% CI = 1.02, 1.24). CONCLUSION Implementation of comprehensive cessation training to support HCP delivery of smoking cessation treatment should be considered to improve patient outcomes.
Collapse
Affiliation(s)
- Dolly Baliunas
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anna Ivanova
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Elise Tanzini
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rosa Dragonetti
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. .,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. .,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
19
|
Hyndman K, Thomas RE, Schira HR, Bradley J, Chachula K, Patterson SK, Compton SM. The Effectiveness of Tobacco Dependence Education in Health Professional Students' Practice: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214158. [PMID: 31661922 PMCID: PMC6862178 DOI: 10.3390/ijerph16214158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/20/2019] [Accepted: 10/24/2019] [Indexed: 01/18/2023]
Abstract
The objective of this study was to perform a systematic review to examine the effectiveness of tobacco dependence education versus usual or no tobacco dependence education on entry-level health professional student practice and client smoking cessation. Sixteen published databases, seven grey literature databases/websites, publishers’ websites, books, and pertinent reference lists were searched. Studies from 16 health professional programs yielded 28 RCTs with data on 4343 healthcare students and 3122 patients. Two researchers independently assessed articles and abstracted data about student knowledge, self-efficacy, performance of tobacco cessation interventions, and patient smoking cessation. All forms of tobacco were included. We did not find separate interventions for different kinds of tobacco such as pipes or flavoured tobacco. We computed effect sizes using a random-effects model and applied meta-analytic procedures to 13 RCTs that provided data for meta-analysis. Students’ counseling skills increased significantly following the 5As model (SMD = 1.03; 95% CI 0.07, 1.98; p < 0.00001, I2 94%; p = 0.04) or motivational interviewing approach (SMD = 0.90, 95% CI 0.59, 1.21; p = 0.68, I2 0%; p < 0.00001). With tobacco dependence counseling, 78 more patients per 1000 (than control) reported quitting at 6 months (OR 2.02; 95% CI 1.49, 2.74, I2 = 0%, p = 0.76; p < 0.00001), although the strength of evidence was moderate or low. Student tobacco cessation counseling improved guided by the above models, active learning strategies, and practice with standardized patients.
Collapse
Affiliation(s)
- Kathryn Hyndman
- Faculty of Health Studies, Brandon University, Brandon, Manitoba R7A 6A9, Canada.
| | - Roger E Thomas
- School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1, Canada.
| | - H Rainer Schira
- John E. Robbins Library, Brandon University, Manitoba R7A 6A9, Canada.
| | - Jenifer Bradley
- Department of National Defence, Petawawa, Ontario K8H 2X3, Canada.
| | - Kathryn Chachula
- Faculty of Health Studies, Brandon University, Brandon, Manitoba R7A 6A9, Canada.
| | - Steven K Patterson
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta T6G 1C9, Canada.
| | - Sharon M Compton
- Dental Hygiene Program, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta T6G 1C9, Canada.
| |
Collapse
|
20
|
Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers. BMC Health Serv Res 2019; 19:750. [PMID: 31653215 PMCID: PMC6815021 DOI: 10.1186/s12913-019-4527-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 09/11/2019] [Indexed: 01/10/2023] Open
Abstract
Background Although healthcare providers are well placed to help smokers quit, implementation of smoking cessation care is still suboptimal. The Ask-Advise-Refer tasks are important aspects of smoking cessation care. We examined to which extent a large and diverse sample of healthcare providers expressed the intention to implement smoking cessation care and which barriers they encountered. We moreover examined to which extent the Ask-Advise-Refer tasks were implemented as intended, and which determinants (in interaction) influenced intentions and the implementation of Ask-Advise-Refer. Methods Cross-sectional survey among addiction specialists, anaesthesiologists, cardiologists, general practitioners, internists, neurologists, paediatricians, pulmonologists, ophthalmologists, surgeons, youth specialists, dental hygienists, dentists, and midwives (N = 883). Data were analysed using multivariate linear and logistic regression analyses and regression tree analyses. Results The Ask-Advice-Refer tasks were best implemented among general practitioners, pulmonologists, midwives, and addiction specialists. Overall we found a large discrepancy between asking patients about smoking status and advising smokers to quit. Participants mentioned lack of time, lack of training, lack of motivation to quit in patients, and smoking being a sensitive subject as barriers to smoking cessation care. Regression analyses showed that the most important determinants of intentions and implementation of Ask-Advise-Refer were profession, role identity, skills, guideline familiarity and collaboration agreements for smoking cessation care with primary care. Determinants interacted in explaining outcomes. Conclusions There is much to be gained in smoking cessation care, given that implementation of Ask-Advise-Refer is still relatively low. In order to improve smoking cessation care, changes are needed at the level of the healthcare provider (i.e., facilitate role identity and skills) and the organization (i.e., facilitate collaboration agreements and guideline familiarity). Change efforts should be directed towards the specific barriers encountered by healthcare providers, the contexts that they work in, and the patients that they work with.
Collapse
|
21
|
Tobari H, Takahashi Y, Yamagishi K, Sugiura M. Tobacco cessation training in 6-year pharmacy schools in Japan: a cross-sectional survey. BMJ Open 2019; 9:e027971. [PMID: 31300498 PMCID: PMC6629421 DOI: 10.1136/bmjopen-2018-027971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study aimed to identify the extent of tobacco cessation training content, including the introduction of a comprehensive programme; and the presence of tobacco-related topics, including new tobacco products, school years and course of training, educators, and attitudes and policies relevant to tobacco education in pharmacy schools in Japan. DESIGN A cross-sectional survey. SETTING All pharmacy schools in Japan with a 6-year course of training were invited to participate. METHODS Pharmacy schools in Japan that agreed to participate in a web-based survey asking about tobacco cessation training, and attitudes and policies relevant to tobacco education. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the number of pharmacy schools that introduced comprehensive tobacco cessation training in their curriculum. The secondary outcome was to clarify the curriculum coverage of 9 basic knowledge and 10 tobacco cessation-specific topics, including new tobacco products. RESULTS Of the 75 pharmacy schools with a 6-year course in Japan, 52 (74%) responded to the survey. While 27 (52%) schools reported that comprehensive tobacco cessation training would be beneficial, only 1 school had introduced it as a one-credit elective course in the fifth year. Basic knowledge topics for tobacco cessation listed in or related to the Model Core Curriculum were covered by 44%-65% of the schools, while practical skills were covered in 10%-19% of the schools. Only seven schools (14%) introduced the topic of new tobacco products in their curriculum. CONCLUSIONS This study revealed that comprehensive tobacco cessation training is not generally offered in pharmacy schools in Japan. The Model Core Curriculum should revise its standards to implement updated tobacco cessation training programmes to keep up with new tobacco products and to train pharmacy students on counselling users of such products. TRIAL REGISTRATION NUMBER Tokyo University of Pharmacy and Life Sciences No. 17 - 14.
Collapse
Affiliation(s)
- Hiroko Tobari
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Yuji Takahashi
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Munetoshi Sugiura
- School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
| |
Collapse
|
22
|
Meijer E, van der Kleij R, Segaar D, Chavannes N. Determinants of providing smoking cessation care in five groups of healthcare professionals: A cross-sectional comparison. PATIENT EDUCATION AND COUNSELING 2019; 102:1140-1149. [PMID: 30718091 DOI: 10.1016/j.pec.2019.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
Objective To investigate implementation of a tobacco dependence treatment guideline among five groups of healthcare professionals. Methods Data collected in The Netherlands (2016-2017) were compared among gynaecologists (N = 49), midwives (N = 68), respiratory nurses (N = 72), practice nurses (N = 84) and paediatricians (N = 38). Intentions to use the guideline, satisfaction with own implementation, and dosage delivered of quit-advice and assisting in quitting were predicted using linear regression analyses and regression tree analyses. Results Implementation of smoking cessation care (SCC) and barriers differed between the groups, with nurses reporting better implementation and fewer barriers. Main barriers were lacking training (gynecologists, pediatricians) and time (midwives). Regression tree analyses showed that self-efficacy and training interacted; participants with weaker self-efficacy provided more quit advice if they had participated in SCC training. Training was positively related to intentions to use the guideline, satisfaction, providing quit-advice, and assisting smokers in quitting. Conclusion Implementation of SCC is suboptimal, such that patients who smoke do not receive the highest quality of care. Profession and training in SCC are important determinants of implementation of SCC. Practice implications Efforts to improve implementation should be targeted at profession. Training is indicated, and may focus on skills for nurses, and knowledge for gynecologists, midwives and pediatricians.
Collapse
Affiliation(s)
- Eline Meijer
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
| | - Rianne van der Kleij
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Dewi Segaar
- Dutch Alliance for a Smokefree Society, Utrecht, the Netherlands
| | - Niels Chavannes
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
23
|
Almahdi HM, Ali RW, Åstrøm AN, Nasir EF. Perception of health professions students of their role model status in Toombak cessation: A cross-sectional study from Sudan. PLoS One 2019; 14:e0210837. [PMID: 30730905 PMCID: PMC6366877 DOI: 10.1371/journal.pone.0210837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/02/2019] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Health professionals are to play an essential and effective role in tobacco control. Toombak is a popular form of smokeless tobacco, locally made and used among Sudanese. It is associated with oral and systemic health hazards, particularly oral cancer. This study was set out to assess health professions students' perception of their status as future role models for their patients and the public regarding Toombak use cessation and to explore socio-cognitive covariates of perceived role model status. MATERIALS AND METHODS A cross-sectional study was conducted in 2013-2014 using a self-administered questionnaire among health professions students enrolled in Medicine, Pharmacy, Dentistry and Nursing colleges in Khartoum state, Sudan. A total of 1530 participants were recruited from colleges using a cluster stratified sampling procedure. RESULTS The majority of the participants (88.2%) were 19-22 year old, females showed predominance (66.1%). Most of the participants (69.7%) scored good knowledge of Toombak-related therapies. The majority (97%) had a positive attitude towards banning Toombak use in public. Half of the participants (50.4%) confirmed availability of Toombak control policy in their college, while 66% reported receiving training in Toombak cessation. Only 9.2% of the participants reported that they have ever used Toombak; among them, 69.5% were current daily users. Less than half (47.8%) reported a positive perception of their status as a role model. Logistic regression model revealed that tobacco cessation training, availability of college policy and positive attitudes towards banning Toombak use in public were strong predictors of with a positive perception of role model status. CONCLUSION Imposing Toombak control policies within colleges combined with formal training in cessation methods, would reinforce the positive perception of health professions students as a role model, particularly the students themselves seem to be ready for such systematic training.
Collapse
Affiliation(s)
- Hatim Mohammed Almahdi
- University of Science and Technology, Faculty of Dentistry, Omdurman, Sudan
- King Faisal University, College of Dentistry, AlAhsa, Saudi Arabia
| | - Raouf Wahab Ali
- University of Science and Technology, Faculty of Dentistry, Omdurman, Sudan
- King Faisal University, College of Dentistry, AlAhsa, Saudi Arabia
| | - Anne Nordrehaug Åstrøm
- Centre for International Health, University of Bergen, Bergen, Norway
- Department of Clinical Dentistry, Faculty of Medicine and Odontology, University of Bergen, Bergen, Norway
| | - Elwalid Fadul Nasir
- University of Science and Technology, Faculty of Dentistry, Omdurman, Sudan
- King Faisal University, College of Dentistry, AlAhsa, Saudi Arabia
| |
Collapse
|
24
|
El Hajj MS, Awaisu A, Kheir N, Mohamed MHN, Haddad RS, Saleh RA, Alhamad NM, Almulla AM, Mahfoud ZR. Evaluation of an intensive education program on the treatment of tobacco-use disorder for pharmacists: a study protocol for a randomized controlled trial. Trials 2019; 20:25. [PMID: 30621772 PMCID: PMC6324165 DOI: 10.1186/s13063-018-3068-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 11/21/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Tobacco use is presently responsible for the death of over seven million people across the world. In Qatar, it is one of the main causes of premature deaths and preventable diseases. To reduce tobacco use, Qatar has ratified the World Health Organization (WHO)'s Framework Convention on Tobacco Control (FCTC) and has implemented many tobacco-control initiatives. In spite of these measures, tobacco use is still considered a public health threat in Qatar. Pharmacists practicing in retail/community pharmacy settings are often the first port of call for individuals requiring general health advice. Evidence has proven that they have a pivotal role in health promotion and disease prevention including tobacco cessation. However, pharmacists in Qatar are not actively involved in tobacco control and many have not received any education or training about smoking cessation counseling in the past. In an effort to build the capacity of pharmacists towards tobacco control in Qatar, the aim of the proposed study is to design, implement, and evaluate an intensive education program on tobacco dependence treatment for pharmacists in Qatar. METHODS/DESIGN The study will be a prospective randomized controlled trial comparing an intensive tobacco-related education program versus non-tobacco-related training on pharmacists' tobacco-use-related knowledge, attitudes, self-efficacy, and skills. Community pharmacists practicing in Qatar will be eligible for participation in the study. A random sample of pharmacists will be selected for participation. Consenting participants will be randomly allocated to intervention or control groups. Participants in the intervention group will receive an intensive education program delivered by a multi-disciplinary group of educators, researchers, and clinicians with expertise in tobacco cessation. A short didactic session on a non-tobacco-related topic will be delivered to pharmacists in the control group. The study has two primary outcomes: post-intervention tobacco-related knowledge and post-intervention skills for tobacco cessation assessed using a multiple-choice-based evaluation instrument and an Objective Structured Clinical Examination (OSCE), respectively. The secondary study outcomes are post-intervention attitudes towards tobacco cessation and self-efficacy in tobacco-cessation interventions assessed using a survey instrument. An additional secondary study outcome is the post-intervention performance difference in relation to tobacco-cessation skills in the practice setting assessed using the simulated client approach. DISCUSSION If demonstrated to be effective, this education program will be considered as a model that Qatar and the Middle East region can apply to overcome the burden of tobacco-use disorder. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03518476 . Registered on 8 May 2018. Version 1/22 June 2018.
Collapse
Affiliation(s)
| | - Ahmed Awaisu
- College of Pharmacy, Qatar University, Doha, 2713 Qatar
| | - Nadir Kheir
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | | | | | | | - Ahmad Mohd Almulla
- Tobacco Control Center-WHO Collaborating Center, Hamad Medical Corporation, Doha, Qatar
| | | |
Collapse
|
25
|
Meijer E, Chavannes N, Segaar D, Parlevliet J, Van Der Kleij R. Optimizing smoking cessation guideline implementation using text-messages and summary-sheets: A mixed-method evaluation. CLINICAL EHEALTH 2019. [DOI: 10.1016/j.ceh.2019.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
26
|
Langley TE. New Lessons for Addressing Article 12. Nicotine Tob Res 2018; 20:529-530. [DOI: 10.1093/ntr/nty023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Tessa E Langley
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Nottingham, UK
| |
Collapse
|