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APHA Scientific Session and Event Listing

Sylvia Twersky-Bumgardner, MPH, Department of Public Health, Temple University, 1700 N. Broad St., Room 304, Philadelphia, PA 19122, 215-204-7213, sylviatb@temple.edu and Bethany Picker, MD, Sothern Regional Area Health Education Center, 1601 Owen Drive, Fayetteville, NC 28304.

Background: Reviews of implementation of best practices have shown that there are mixed results in the dissemination and adoption of practice guidelines at the clinical level. Statistically significant improvements in health quality have been demonstrated using these best practices to address population health issues, including tobacco use. The nature of the residency period in the development of physician practices makes it a unique teachable moment for addressing the use of tobacco best practices with patient populations.

Objectives: To develop, implement and assess the impact of a family medicine residency education program, based on the 2000 best practices guideline, on tobacco use outcomes at each obstetric visit for pregnant women at one family medicine center.

Methods: An active learning practice based educational curriculum and a clinical support system was put into place at a family medicine clinic. For outcome analysis an historical control and logistic regression was used to see if there was a change in smoking status at each OB visit while controlling for identified confounding factors. Results Compared with the historical control, the women seen during the intervention period were twice as likely to have a smoke free OB visit.

Conclusions: Residency education can have a significant impact on tobacco pregnancy outcomes. Residency directors should consider the health impact of continuous and critical active learning best practices instruction.

Learning Objectives: At the conclusion of the session participants will be able to

• Identify perceived barriers to best practices tobacco implementation in a clinical setting.
• Develop an understanding of the impact that brief behavioral interventions for smoking have in a clinical setting during pregnancy.
• Recognize the importance of best practices tobacco instruction and active use during residency.

Presenting author's disclosure statement:

Not Answered