Effect of training on community-based pharmacists' self-efficacy toward brief tobacco cessation counseling

Background: Despite consistent evidence of the effectiveness of pharmacist-led smoking cessation counseling and considerable promotion of the brief Ask-Advise-Refer counseling protocol (AAR), very few pharmacists provide AAR. Pharmacists' lack of confidence in implementing AAR has been documented as a key barrier. Objective: This randomized controlled trial evaluated the effect of training on pharmacists' self-efficacy toward counseling low SES smokers in Southern Wisconsin. Method: Sixteen community-based pharmacies were randomly assigned to a control or experimental group. Pharmacists in the experimental group pharmacies (n=16; 2 per pharmacy) were given on-site training in implementing AAR. All pharmacies were purposively sampled such that each belonged to a large chain, was located within 75 miles from Madison, WI, and was located in a low SES area. Based on Social Cognitive Theory, the one-time training (30-45 minutes) consisted of model videos, role playing, feedback and a presentation detailing how to implement AAR. Self-efficacy was measured using a self-administered survey containing a 10-item 7-point scale where ‘1' was ‘not at all confident' and ‘7' was ‘extremely confident'. This was completed by all pharmacists (n=32) prior to and following training. Results: The scale demonstrated good psychometric properties (Cronbach's á = 0.96; one factor explained 65% variance). At baseline, pharmacists were ‘somewhat confident' in their ability to implement AAR. The Mann Whitney-U test (1-tailed; á=0.05) yielded a significant result (change score Median: 1 vs.1.4; p<0.03), rejecting the null hypothesis that training will have no effect on pharmacists' self-efficacy. Conclusion: This training program increased pharmacists' self-efficacy to implement AAR counseling.