163719 Training healthcare providers to deliver evidence-based brief interventions for tobacco use and dependence

Tuesday, November 6, 2007

Michael Anders, PhD, MPH, RRT , University of Arkansas for Medical Sciences, Little Rock, AR
Claudia Barone, EdD, RN , University of Arkansas for Medical Sciences, Little Rock, AR
Christine E. Sheffer, PhD , College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
Tobacco use is the leading cause of preventable death and disease in the U.S. with cessation causing major health benefits. Healthcare providers are vital to the delivery of tobacco cessation services. The evidence-based Public Health Service (PHS) Clinical Practice Guideline for the Treatment of Tobacco Use and Dependence (Fiore, 2000) provides recommendations that can be implemented with minimal demands on providers, can increase patient quit rates, are cost-effective, and should be part of the routine care of every patient at every visit; however, healthcare providers are poor at implementation. Providers report a number of barriers, including lack of knowledge, awareness, self-efficacy, and positive outcome expectancies. In Arkansas, a training program was developed to address these barriers. From 1-2006 to 1-2007, 807 providers completed a 1-hour CE-approved training delivered by doctoral-level faculty. Tests were administered prior to and immediately after training with responses reported on a scale of 0-10 with 0 =“None” and 10 = “Most Ever.” Paired-samples t-tests compared pre- and post-test responses. Training resulted in significant increases in factors known the affect intervention performance including a) motivation, b) knowledge, and c) confidence, as well as perceived d) importance, e) effectiveness, f) importance of barriers, and g) preparedness (all p.s <.01). Because tobacco use is the most deadly and the costliest public health problem in the U.S. and this very brief training is likely to increase the frequency with which patients are offered assistance with cessation, this minimal 1-hour training should be broadly disseminated among all healthcare providers.

Learning Objectives:
Idenitfy the essential components of the Public Health Service Clinical Practice Guideline for treating tobacco use and dependence. Describe barriers to implementation experienced by healthcare providers. Describe how barriers can be addressed in a brief training. Describe how to attract healthcare providers to training.

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.