A Teachable Moment After Orthopaedic Fracture in the Smoking Patient: A Randomized, Controlled Trial

Baron, Matthew; DeFrancesco, Christopher J.; Liu, Tiffany C.; Leone, Frank T.; Ahn, Jaimo

doi:10.1097/bot.0000000000000841

Cited by 8 publications

(4 citation statements)

References 12 publications

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“…Furthermore, it is important to consider that within the behaviours included in the analysis, the models, or certain model constructs, might be more relevant to particular behaviours. For example, the TM model was developed in the context of smoking cessation and is therefore frequently used to understand this behaviour, above others (Baron et al, 2017 ; McBride et al, 2003 ; McBride, Blocklin, Lipkus, Klein, & Brandon 2017 ). Furthermore, the ability of the COM-B model to explain behaviour has been suggested to vary across behavioural contexts; in particular, it has been found to better explain physical activity than it has eating behaviour (Willmott, Pang, & Rundle-Thiele, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models

Rockliffe

Peters

Heazell

et al. 2021

Health Psychology and Behavioral Medicine

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Objectives Theoretical models have informed the understanding of pregnancy as a ‘teachable moment’ for health behaviour change. However, these models have not been developed specifically for, nor widely tested, in this population. Currently, no pregnancy-specific model of behaviour change exists, which is important given it is a unique yet common health event. This study aimed to assess the extent to which factors influencing antenatal behaviour change are accounted for by the COM-B model and Teachable Moments (TM) model and to identify which model is best used to understand behaviour change during pregnancy. Design Theoretical mapping exercise. Methods A deductive approach was adopted; nine sub-themes identified in a previous thematic synthesis of 92 studies were mapped to the constructs of the TM and COM-B models. The sub-themes reflected factors influencing antenatal health behaviour. Findings All sub-themes mapped to the COM-B model constructs, whereas the TM model failed to incorporate three sub-themes. Missed factors were non-psychological, including practical and environmental factors, social influences, and physical pregnancy symptoms. In contrast to the COM-B model, the TM model provided an enhanced conceptual understanding of pregnancy as a teachable moment for behaviour change, however, neither model accounted for the changeable salience of influencing factors throughout the pregnancy experience. Conclusions The TM and COM-B models are both limited when applied within the context of pregnancy. Nevertheless, both models offer valuable insight that should be drawn upon when developing a pregnancy-specific model of behaviour change.

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Section: Discussionmentioning

confidence: 99%

Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models

Rockliffe

Peters

Heazell

et al. 2021

Health Psychology and Behavioral Medicine

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“…Previous work has demonstrated that trauma represents a "teachable moment" which can be used to help influence behavior. 23,24,29 Orthopaedic patients require multiple interactions with the health care system, providing several opportunities to affect change. Simple education seems to be sufficient producing a short-term effect in smoking cessation.…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Trial on Smoking Cessation in Orthopaedic Trauma Patients: Results From the Let’s STOP (Smoking in Trauma Orthopaedic Patients) Now Trial

Matuszewski

Joseph

O’Hara

et al. 2021

Journal of Orthopaedic Trauma

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Intervention: Randomly assigned to control (no counseling), brief counseling (inpatient counseling), or extended counseling (brief counseling plus follow-up counseling) groups in a 1:3:3 ratio.Main Outcome Measurements: Smoking cessation confirmed by exhaled carbon monoxide at 3 and 6 months. Secondary outcomes are proportion accepting services from a nationally based quitline.Results: Overall, 266 patients participated, with 40, 111, and 115 patients in the control and 2 treatment groups, respectively. At 3 months, 17% of control patients versus 11% in the brief counseling and 10% in the extended counseling groups quit smoking, respectively (P = 0.45, 0.37). At 6 months, 15% of control, and 10% and 5% of the respective counseling groups quit (P = 0.45, 0.10). Extended counseling patients were 3 times more likely to accept referral to a quitline [odds ratio (OR), 3.1; 95% confidence interval (CI), 1.4-6.9], and brief counseling patients were more than 2 times as likely to accept referral (OR, 2.3; 95% CI, 1.0-5.1) than the control group. Extended counseling (OR, 8.2; 95% CI, 1.0-68.5) and brief counseling (OR, 5.3; 95% CI, 0.6-44.9) patients were more likely to use quitline services than the control group. Conclusion:Increasing levels of inpatient counseling can improve successful referral to a smoking quitline, but it does not seem to influence quit rates among orthopaedic trauma patients. Extended counseling does not appear to provide substantial benefit over brief counseling.

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“…However, the link between an injury and the willingness to quit smoking requires further exploration. The time of injury may represent an opportunity for attitudinal change and associated with a shift in the valuation of habits and well-being [59][60][61][62].…”

Section: Discussionmentioning

confidence: 99%

Can financial payments incentivize short-term smoking cessation in orthopaedic trauma patients? Evidence from a discrete choice experiment

et al. 2021

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Background Smoking increases the risk of complications and related costs after an orthopaedic fracture. Research in other populations suggests that a one-time payment may incentivize smoking cessation. However, little is known on fracture patients’ willingness to accept financial incentives to stop smoking; and the level of incentive required to motivate smoking cessation in this population. This study aimed to estimate the financial threshold required to motivate fracture patients to stop smoking after injury. Methods This cross-sectional study utilized a discrete choice experiment (DCE) to elicit patient preferences towards financial incentives and reduced complications associated with smoking cessation. We presented participants with 12 hypothetical options with several attributes with varying levels. The respondents’ data was used to determine the utility of each attribute level and the relative importance associated with each attribute. Results Of the 130 enrolled patients, 79% reported an interest in quitting smoking. We estimated the financial incentive to be of greater relative importance (ri) (45%) than any of the included clinical benefits of smoking cessations (deep infection (ri: 24%), bone healing complications (ri: 19%), and superficial infections (ri: 12%)). A one-time payment of $800 provided the greatest utility to the respondents (0.64, 95% CI: 0.36 to 0.93), surpassing the utility associated with a single $1000 financial incentive (0.36, 95% CI: 0.18 to 0.55). Conclusions Financial incentives may be an effective tool to promote smoking cessation in the orthopaedic trauma population. The findings of this study define optimal payment thresholds for smoking cessation programs.

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A Teachable Moment After Orthopaedic Fracture in the Smoking Patient: A Randomized, Controlled Trial

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 8 publications

References 12 publications

Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models

Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models

Prospective Randomized Trial on Smoking Cessation in Orthopaedic Trauma Patients: Results From the Let’s STOP (Smoking in Trauma Orthopaedic Patients) Now Trial

Can financial payments incentivize short-term smoking cessation in orthopaedic trauma patients? Evidence from a discrete choice experiment

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