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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.
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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
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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.
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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
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Andrés A, Castellano Y, Fu M, Feliu A, Ballbè M, Antón L, Baena A, Fernández E, Martínez C. Exploring individual and contextual factors contributing to tobacco cessation intervention implementation. Addict Behav 2019; 88:163-168. [PMID: 30205255 DOI: 10.1016/j.addbeh.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous research suggests that smoking cessation interventions are poorly implemented. This study reports the development and testing of a questionnaire including knowledge, attitude, behavioral, and organizational (KABO) factors affecting the implementation of smoking cessation practices in hospitals by health care providers and organizations. METHODS An initial pool of 44 items was developed to assess the individual knowledge, attitudes, and beliefs of health professionals towards smoking cessation practices according to the 5 A's intervention model, as well as organizational barriers and opportunities for its implementation. Items were measured in a scale from 0="Not at all/Never" to 10 = "Completely/Always". Data were collected from health workers (n = 702) in Catalonia. The validity of the instrument was measured by: (a) analyzing the items, (b) assessing the internal structure, (c) estimating the internal consistency, and (d) analyzing the relationship between this tool and the 5 A's intervention model. RESULTS Seven domains were extracted: individual skills, positive organizational support, attitudes and beliefs, individual commitment, organizational resources, beliefs about patient desire/readiness to quit, and organizational endorsement. These domains explained 69.7% of the variance, and allowed for the development of a refined 26-item version of the questionnaire. Both the seven domains and the total scale showed adequate internal consistency. CONCLUSIONS Psychometric testing indicates that the KABO questionnaire is a reliable and valid instrument for assessing the main barriers and facilitators to smoking cessation intervention implementation. Individual factors better explained the implementation of smoking cessation interventions in hospitals, and the seven identified domains can be used for further investigations into how the implementation of evidence-based practices impacts smoking cessation performance.
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Martínez C, Fu M, Castellano Y, Riccobene A, Fernández P, Cabrera S, Gavilan E, Feliu A, Puig-Llobet M, Fuster P, Martínez-Sánchez JM, Montes J, Estrada JM, Moreno C, Falcó-Pegueroles A, Galimany J, Brando C, Suñer-Soler R, Capsada A, Fernández E. Smoking among hospitalized patients: A multi-hospital cross-sectional study of a widely neglected problem. Tob Induc Dis 2018; 16:34. [PMID: 31516433 PMCID: PMC6659490 DOI: 10.18332/tid/92927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION A comprehensive smoking ban was recently enacted for acute-care hospital campuses in Spain. The aim of this study was to assess the prevalence and patterns of smoking among inpatients before and during hospitalization. METHODS Multi-center cross-sectional study was conducted in 13 hospitals in the province of Barcelona, Spain from May 2014 to May 2015. Participants were adults who provided informed consent. The sample size was calculated to be representative of each hospital (prevalence 29.4%, precision ± 5%, error 5%). We approached 1228 subjects, 888 accepted to participate and 170 were replaced (were not available or declined to participate). Final sample comprised 1047 subjects. We used a computer-assisted personal interview system to collect data, including sociodemographic variables and use of tobacco before and during hospitalization. Smoking status was validated with exhaled carbon monoxide. We calculated overall tobacco prevalence and investigated associations with participant and center characteristics. We performed multiple polytomous and multilevel logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustments for potential confounders. RESULTS In all, 20.5% (95% CI: 18.1–23.0) of hospitalized patients were smokers. Smoking was most common among men (aOR=7.47; 95% CI: 4.88–11.43), young age groups (18–64 years), and individuals with primary or less than primary education (aOR=2.76; 95% CI: 1.44–5.28). Of the smokers, 97.2% were daily consumers of whom 44.9% had medium nicotine dependence. Of all smokers, three-quarters expressed a wish to quit, and one-quarter admitted to consuming tobacco during hospitalization. CONCLUSIONS Our findings indicate the need to offer smoking cessation interventions among hospitalized patients in all units and service areas, to avoid infringements and increase patient safety, hospital efficiency, and improve clinical outcomes. Hospitalization represents a promising window for initiating smoking interventions addressed to all patients admitted to smoke-free hospitals, specially after applying a smoke-free campus ban.
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Affiliation(s)
- Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain.,Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain.,Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Nursing Science, Gimbernat School, Barcelona, Spain.,Department of Nursing Science, University of Girona, Girona, Spain.,Fundació Althaia, Barcelona, Spain
| | - Anna Riccobene
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain
| | - Paz Fernández
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Sandra Cabrera
- Nursing Research Unit, Institut Català d'Oncologia-ICO, Barcelona, Spain
| | - Eva Gavilan
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Montse Puig-Llobet
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Pilar Fuster
- Medicine and Health Sciences School, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Javier Montes
- Department of Nursing Science, Gimbernat School, Barcelona, Spain
| | - Joan Maria Estrada
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Carmen Moreno
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anna Falcó-Pegueroles
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jordi Galimany
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Cecilia Brando
- Department of Nursing Science, Gimbernat School, Barcelona, Spain
| | - Rosa Suñer-Soler
- Department of Nursing Science, University of Girona, Girona, Spain
| | | | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO-IDIBELL, Barcelona, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
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Martínez C, Castellano Y, Andrés A, Fu M, Antón L, Ballbè M, Fernández P, Cabrera S, Riccobene A, Gavilan E, Feliu A, Baena A, Margalef M, Fernández E. Factors associated with implementation of the 5A's smoking cessation model. Tob Induc Dis 2017; 15:41. [PMID: 29142531 PMCID: PMC5669025 DOI: 10.1186/s12971-017-0146-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/23/2017] [Indexed: 12/04/2022] Open
Abstract
Background Several health organizations have adopted the 5A’s brief intervention model (Ask, Advise, Assess, Assist, Arrange), based on evidence-based guidelines for smoking cessation. We examine individual, cognitive, behavioral, and organizational factors associated with the 5A’s performance among clinical healthcare workers in Catalonia. We also investigate how these factors interact and potentially predict the implementation of each component of the 5A’s. Methods A cross-sectional survey was conducted among clinical health workers enrolled in an online smoking cessation training course (n = 580). The survey included questions about individual characteristics as well as cognitive, behavioral, and organizational factors previously identified in research. We assessed self-reported performance of the 5A’s, assessed on a scale from 0 to 10, and used Multivariate regression to examine factors associated with its performance. Results The performance means (standard deviation) were moderate for the first 3A’s [Ask: 6.4 (3.1); Advise: 7.1 (2.7); Assess: 6.3 (2.8)] and low for the last 2A’s [Assist: 4.4 (2.9); Arrange: 3.2 (3.3)]. We observed a high correlation between Assist and Arrange (r = 0.704, p < 0.001). Having positive experiences and feeling competent were positively associated with performing the 5A’s model and having organizational support with Assist and Arrange. Personal tobacco use among healthcare workers was negatively associated with Advice and Arrange. Conclusions Our study found that clinical healthcare workers do not perform the 5A’s completely. The main barriers identified suggest the need of training and making available practical guidelines in healthcare services. Organizational support is essential for moving towards the implementation of Assist and Arrange. Electronic supplementary material The online version of this article (10.1186/s12971-017-0146-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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.,Medicine and Health Sciences School, C. Josep Trueta s/n, 08915 Sant Cugat del Valles, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - Y Castellano
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Andrés
- National Institute of Physical Education of Catalonia (INEFC), Av. de l'Estadi, 12-22, 08038 Barcelona, Spain
| | - M Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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.,Medicine and Health Sciences School, C. Josep Trueta s/n, 08915 Sant Cugat del Valles, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - L Antón
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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
| | - M Ballbè
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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.,Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036 Barcelona, Spain
| | - P Fernández
- Nursing Research Unit, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Cabrera
- Nursing Research Unit, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Riccobene
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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
| | - E Gavilan
- Medicine and Health Sciences School, C. Josep Trueta s/n, 08915 Sant Cugat del Valles, Barcelona, Spain
| | - A Feliu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa llarga s/n, 08907 L'Hospitalet del Llobregat, Barcelona, Spain
| | - A Baena
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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
| | - M Margalef
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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
| | - E Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Av. Granvia de L'Hospitalet, 199-203, E-08908 L'Hospitalet de Llobregat, Barcelona, Spain.,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 L'Hospitalet del Llobregat, Barcelona, Spain
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Martínez C, Company A, Guillen O, Margalef M, Arrien MA, Sánchez C, Cáceres de León P, Fernández E. Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study. JMIR Res Protoc 2017; 6:e7. [PMID: 28128731 PMCID: PMC5303198 DOI: 10.2196/resprot.6487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 10/21/2016] [Accepted: 11/23/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tobacco cessation training programs to treat tobacco dependence have measureable effects on patients' smoking. Tobacco consumption in low- and middle-income countries (LMICs) is high and slowly decreasing, but these countries usually lack measures to face the epidemic, including tobacco cessation training programs for health professionals and organizations. Based on a previous online smoking cessation training program for hospital workers in Spain, the Fruitful Study aims to increase smoking cessation knowledge, attitudes, self-confidence, and performance interventions among health care professionals of three Spanish-speaking low- and middle-income Latin American and Caribbean (LAC) countries. OBJECTIVE The purpose of this paper is to describe the methodology and evaluation strategy of the Fruitful Study intended to adapt, implement, and test the effectiveness of an online, evidence-based tobacco cessation training program addressed to health professionals from Bolivia, Guatemala, and Paraguay. METHODS This study will use a mixed-methods design with a pre-post evaluation (quantitative approach) and in-depth interviews and focus groups (qualitative approach). The main outcomes will be (1) participants' attitudes, knowledge, and behaviors before and after the training; and (2) the level of implementation of tobacco control policies within the hospitals before and after the training. RESULTS To date, adaptation of the materials, study enrollment, and training activities have been completed. During the adaptation, the main mismatches were language background and content adaptation. Several aids were developed to enable students' training enrollment, including access to computers, support from technicians, and reminders to correctly complete the course. Follow-up data collection is in progress. We have enrolled 281 hospital workers. Results are expected at the beginning of 2017 and will be reported in two follow-up papers: one about the formative evaluation and the other about the summative evaluation. CONCLUSIONS There is a need to learn more about the cultural and content elements that should be modified when an online tobacco cessation training program is adapted to new contexts. Special attention should be given to the personal and material resources that could make the implementation possible. Results from the Fruitful Study may offer a new approach to adapting programs to LMICs in order to offer education solutions with the use of emerging and growing communication technologies. CLINICALTRIAL Clinicaltrials.gov NCT02718872; https://clinicaltrials.gov/ct2/show/NCT02718872 (Archived by WebCite at http://www.webcitation.org/6mjihsgE2).
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Affiliation(s)
- Cristina Martínez
- Institut Català d'Oncologia-ICO, Tobacco Control Unit, Cancer Control and Prevention Programme, L'Hospitalet del Llobregat, Spain.,Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain.,Universitat Internacional de Catalunya, Medicine and Health Sciences School, Sant Cugat del Vallés, Spain
| | - Assumpta Company
- Institut Català d'Oncologia-ICO, Training Unit, L'Hospitalet de Llobregat, Spain
| | - Olga Guillen
- Institut Català d'Oncologia-ICO, Training Unit, L'Hospitalet de Llobregat, Spain
| | - Mercè Margalef
- Institut Català d'Oncologia-ICO, Tobacco Control Unit, Cancer Control and Prevention Programme, L'Hospitalet de Llobregat, Spain
| | - Martha Alicia Arrien
- Management Department, Instituto Oncologico del Oriente Boliviano de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia
| | - Claudia Sánchez
- Public Health Department, Ministerio de Salud y Pública y Bienestar Social, Asuncion, Paraguay
| | - Paula Cáceres de León
- Radiation Oncology Department, Instituto de Cancerología y Hospital Dr. Bernardo, Guatemala, Guatemala
| | - Esteve Fernández
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain.,Institut Català d'Oncologia-ICO, Tobacco Control Unit, Cancer Control and Prevention Programme, L'Hospitalet de Llobregat, Spain.,School of Medicine, Department of Clinical Sciences, Universitat de Barcelona, L'Hospitalet del Llobregat, Spain
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- Management Department, Instituto Oncologico del Oriente Boliviano de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia.,Public Health Department, Ministerio de Salud y Pública y Bienestar Social, Asuncion, Paraguay.,Radiation Oncology Department, Instituto de Cancerología y Hospital Dr. Bernardo, Guatemala, Guatemala
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Lally RM, Chalmers KI, Johnson J, Kojima M, Endo E, Suzuki S, Lai YH, Yang YH, Degner L, Anderson E, Molassiotis A. Smoking behavior and patient education practices of oncology nurses in six countries. Eur J Oncol Nurs 2008; 12:372-9. [DOI: 10.1016/j.ejon.2008.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 04/25/2008] [Accepted: 04/25/2008] [Indexed: 11/25/2022]
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8
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Freund MAG, Campbell EM, Paul CL, Wiggers JH, Knight JJ, Mitchell EN. Provision of smoking care in NSW hospitals: opportunities for further enhancement. NEW SOUTH WALES PUBLIC HEALTH BULLETIN 2008; 19:50-55. [PMID: 18507966 DOI: 10.1071/nb07102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The provision of smoking care, including the management of nicotine withdrawal and assistance with a quitting attempt, is identified as an important part of the overall care of hospitalised patients. Levels of smoking care delivery in hospitals have been less than optimal. Increasing this care across multiple facilities and units within NSW Health represents a significant challenge. This article examines levels of smoking care delivery in NSW hospitals, and research evidence and best practice recommendations to inform potential strategies to increase such care. It also reviews statewide initiatives implemented by NSW Health to enhance the delivery of smoking care and suggests further strategies that could facilitate this.
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Affiliation(s)
- Megan A G Freund
- Hunter New England Population Health, Hunter New England Area Health Service, Australia.
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