185789 Assessing staff readiness to implement the “Ask, Advise, Refer” (AAR) tobacco cessation brief intervention at five public health centers

Tuesday, October 28, 2008

Tony Kuo, MD, MSHS , County of Los Angeles, Department of Public Health, Office of Senior Health, Los Angeles, CA
Jennifer Piron, MPH , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Lisa V. Smith, MS, DrPH , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Donna Sze, MPH , Tobacco Control & Prevention Program, County of Los Angeles Department of Public Health, Los Angeles, CA
Mark D. Weber, PhD , Tobacco Control & Prevention Program, County of Los Angeles County Department of Public Health, Los Angeles, CA
Linda Aragon, MPH , Tobacco Control & Prevention Program, County of Los Angeles County Department of Public Health, Los Angeles, CA
BACKGROUND: Successful implementation of the AAR intervention requires a high level of organizational functioning, a key component of which is staff readiness. Staff readiness often predicts whether mandated changes in practices at the organizational level can be implemented effectively and maintained over time. This analysis examines staff readiness to implement a brief tobacco cessation intervention, “Ask, Advise, Refer” (AAR), in the public health clinic setting. METHODOLOGY: As part of a larger study, we surveyed 90 staff members (e.g., front desk, nurses, physicians, etc.) from five public health centers using a self-administered questionnaire containing questions about staff readiness towards the implementation of the AAR brief intervention in 2007. This baseline survey was completed prior to implementation of the AAR intervention at these sites. RESULTS: The respondents were 70% female; 70% African American or Latino, 62% college graduates, 48% nurses; 61% in their current positions for 10 years or less; 81% employed in their profession for 10 years or more. Responses revealed that 86% of the staff was receptive to the AAR intervention; 82% felt the intervention strongly reflected the clinics' mission and goals; 61% felt they were included during the development and planning of the intervention's implementation. CONCLUSION: The findings indicate moderate to high levels of staff readiness to implement the AAR intervention at five public health clinics. These results are encouraging as research indicates that staff readiness is a critical factor in the successful implementation and maintenance of the AAR brief intervention.

Learning Objectives:
1. Describe the potential impact of staff readiness on the adoption and implementation of the AAR brief intervention for tobacco cessation in the public health clinic setting. 2. Discuss the implications of assessing staff readiness during the planning process of tobacco cessation interventions. 3. Create similar data collection procedures for evaluating and monitoring the feasibility, quality, and sustainability of this kind of clinic-based brief intervention.

Keywords: Tobacco Control, Organizational Change

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the planning, implementation, analysis, and interpretation process.
Any relevant financial relationships? No

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.