Computer-Facilitated 5A’s for Smoking Cessation: A Randomized Trial of Technology to Promote Provider Adherence

Satterfield, Jason M.; Gregorich, Steven E.; Kalkhoran, Sara; Lum, Paula J.; Bloome, Jessica; Alvarado, Nicholas; Muñoz, Ricardo F.; Vijayaraghavan, Maya

doi:10.1016/j.amepre.2018.04.009

Cited by 14 publications

(14 citation statements)

References 45 publications

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“…All patient participants were given a $20 gift card after completing a post-visit interview. Additional details on the trial and primary outcomes are presented elsewhere (Satterfield et al, 2018).…”

Section: Procedures and Participantsmentioning

confidence: 99%

Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014–2015

Thrul

Vijayaraghavan

Kalkhoran

et al. 2020

Addictive Behaviors

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Background: Poly-use of tobacco, cannabis, and electronic cigarettes (e-cigarettes) is an emerging problem in the general population. The current study investigated poly-use of these products and receipt of smoking cessation counseling in a primary care setting. Methods:We conducted a cross-sectional secondary data analysis from a trial of a tablet intervention to increase provider delivery of the 5As (Ask, Advise, Assess, Assist, Arrange followup), a brief counseling intervention for smoking cessation, in 3 diverse primary care clinics in San Francisco, CA from 2014 to 2015. Participants were currently smoking cigarettes (N=601; mean age = 50.8; 38.1% female) and reported information on past 30-day cigarette and e-cigarette use and past 3-month cannabis use. We classified participants into 4 groups: (1) cigarette-only, (2) dual-use of cigarettes and e-cigarettes, (3) dual-use of cigarettes and cannabis, (4) poly-use of cigarettes, e-cigarettes, and cannabis, and examined correlates of use. Results:Only cigarette smoking was reported by 48.6% of participants, 30.4% reported use of cigarettes and cannabis, 10.5% reported use of cigarettes and e-cigarettes, and 10.5% reported use of cigarettes, e-cigarettes, and cannabis. Cigarette-only smokers did not differ from other groups by cigarette smoking behavior and motivation to quit. Patients reporting dual-use of cigarettes and e-cigarettes had a higher likelihood of receiving the Arrange step and all 5As compared to cigarette-only smokers.

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Section: Procedures and Participantsmentioning

confidence: 99%

Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014–2015

Thrul

Vijayaraghavan

Kalkhoran

et al. 2020

Addictive Behaviors

Self Cite

View full text Add to dashboard Cite

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“…Smoking cessation intervention programs— such as the 5A approach—Ask, Advise, Assess, Assist, and Arrange 2 , 3 , the motivational interviews 4 , 5 and brief advice —have shown efficacy, but among specific populations or in specialized clinical settings 6 , 7 . Professional support and cessation interventions or medications increase significantly the chance of successful quitting, while without support 95% of attempts to quit will fail 1 .…”

Section: Introductionmentioning

confidence: 99%

When primary care providers and smokers meet: a systematic review and metasynthesis

Manolios

Sibéoni

Teixeira

et al. 2021

npj Prim. Care Respir. Med.

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Primary Care Providers (PCPs) often deal with patients on daily clinical practice without knowing anything about their smoking status and willingness to quit. The aim of this metasynthesis is to explore the PCPs and patients who are smokers perspectives regarding the issue of smoking cessation within primary care settings. It relies on the model of meta-ethnography and follows thematic synthesis procedures. Twenty-two studies are included, reporting on the view of 580 participants. Three main themes emerge: (i) What lacks, (ii) Some expectations but no request, and (iii) How to address the issue and induce patients’ motivation. Our results reveal a global feeling of a lack of legitimacy among PCPs when it comes to addressing the issue of tobacco and smoking cessation with their patients, even though they have developed creative strategies based on what is at the core of their practice, that is proximity, continuity, long-term and trustworthy relationship.

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“…The present project sought to create a package of implementation strategies designed to facilitate uptake and sustainment of an evidence-based, technology-assisted tobacco cessation tool at the FQHC. In consultation with clinician and researcher colleagues, the CEDI leadership team selected computer-facilitated delivery of evidence-based 5A's due to its known impact increasing delivery of tobacco cessation treatment in medical settings (16,17).…”

Section: Setting: Federally Qualified Health Centermentioning

confidence: 99%

Implementation mapping for tobacco cessation in a federally qualified health center

Domlyn

Crowder

Eisenson

et al. 2022

Front. Public Health

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BackgroundImplementation mapping (IM) is a promising five-step method for guiding planning, execution, and maintenance of an innovation. Case examples are valuable for implementation practitioners to understand considerations for applying IM. This pilot study aimed to determine the feasibility of using IM within a federally qualified health center (FQHC) with limited funds and a 1-year timeline.MethodsAn urban FQHC partnered with an academic team to employ IM for implementing a computerized strategy of tobacco cessation: the 5A's (Ask, Advise, Assess, Assist, Arrange). Each step of IM was supplemented with theory-driven methods and frameworks. Data collection included surveys and interviews with clinic staff, analyzed via rapid data analysis.ResultsMedical assistants and clinicians were identified as primary implementers of the 5A's intervention. Salient determinants of change included the perceived compatibility and relative priority of 5A's. Performance objectives and change objectives were derived to address these determinants, along with a suite of implementation strategies. Despite indicators of adoptability and acceptability of the 5A's, reductions in willingness to adopt the implementation package occurred over time and the intervention was not adopted by the FQHC within the study timeframe. This is likely due to the strain of the COVID-19 pandemic altering health clinic priorities.ConclusionsAdministratively, the five IM steps are feasible to conduct with FQHC staff within 1 year. However, this study did not obtain its intended outcomes. Lessons learned include the importance of re-assessing barriers over time and ensuring a longer timeframe to observe implementation outcomes.

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Computer-Facilitated 5A’s for Smoking Cessation: A Randomized Trial of Technology to Promote Provider Adherence

Abstract: This study is registered at www.clinicaltrials.gov NCT02046408.

Cited by 14 publications

References 45 publications

Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014–2015

Patterns of cigarette, e-cigarette, and cannabis use among adult smokers in primary care 2014–2015

When primary care providers and smokers meet: a systematic review and metasynthesis

Implementation mapping for tobacco cessation in a federally qualified health center

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