Neil Maizlish, PhD, MPH¹, Jodie Ruland, MDiv², Marishka Rosinski, RN¹, and Khati Hendry, MD¹. (1) Community Health Center Network, 1320 Harbor Bay Parkway, Suite 250, Alameda, CA 94502, (2) Alameda Health Consortium, 1320 Harbor Bay Parkway, Suite 250, Alameda, CA 94502, 212-304-7184, Jodier@chcn-eb.org

The study objective was to describe the frequency of asking adult patients about tobacco use and advising smokers to quit after an intervention that educated health center staff on smoking as a vital sign (SVS) and provided technical support. The setting was a network of 7 urban, ethnically diverse, community health centers. The educational program included written materials and an oral presentation on the tobacco-related health risks, clinical guidelines, and cessation pharmacotherapies. Technical support included the revision of forms and vital sign stamps. A random sample of medical charts of approximately 1800 adults who had >=1 encounters up to 2 years after implementation were abstracted for SVS information. In the first year after implementation, 71% (± 6%, 95% CI) of patients had been asked about tobacco use, and 59% (± 6%) had been asked during the most recent encounter. In multivariate analyses, clinic and gender were significantly related to asking at the last encounter, but not age, ethnicity, insurance status, or month post-implementation. The prevalence of smoking was 19% (± 4%) and varied by gender and ethnicity. During the first year, 47% of smokers had been given advice to quit, and 26% were advised at their last encounter. Advice to quit varied by clinic, but not by age, gender, ethnicity, or month post-implementation. The first year of data analysis provided a baseline and insights on the redesign of forms and retargeting of training. The second year of analysis will allow an evaluation of whether these changes led to sustainable improvements.

Learning Objectives:

• Identify components of an educational intervention for providers to assist patients stop smoking
• Recognize how tools for clinical quality improvement assist behavioral change in providers
• Describe difficulties in measuring smoking as a vital sign in a primary care setting

Keywords: Community Health Centers, Smoking Cessation

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.