Implementing tobacco interventions in the real world of managed care

Hollis, Jack F.; Bills, Richard E.; Whitlock, Evelyn P; Stevens, Victor J.; Mullooly, John P.; Lichtenstein, E

doi:10.1136/tc.9.suppl_1.i18

Cited by 62 publications

(54 citation statements)

References 13 publications

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“…Whereas the effect we found on treatment rates was modest, Hollis et al 31 found that access to an on-site nurse smoking counselor nearly doubled the rate of smoking cessation. In another study, Hollis et al 32 implemented a tobacco counseling model in primary care, and, similar to our results, found a modest increase in treatment rates with the benefit disappearing postintervention. In terms of educational outreach, our efforts do not appear to have produced any lasting impact on providers' treatment of smokers; the literature on educational outreach for smoking cessation is similarly inconclusive.…”

Section: Discussionsupporting

confidence: 77%

Effectiveness of an On-Call Counselor at Increasing Smoking Treatment

et al. 2007

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BACKGROUND: Smoking cessation programs are very effective, but little is known about how to get smokers to attend these programs. OBJECTIVE:To evaluate whether an "on-call" counselor increased smoking cessation program referrals and attendance. DESIGN:We randomly assigned 1 of 2 primary care teams at the Sepulveda VA Ambulatory Care Center to intervention and the other to usual care. The intervention team had access to an on-call counselor who provided counseling and care coordination. Social marketing efforts included educational outreach, provider feedback, and financial incentives. MEASUREMENTS:Baseline telephone interviews with a sample of 482 smokers were conducted, covering smoking history, health status, and smoking cessation treatments. Follow-up surveys were conducted at midintervention (n=251) and post-intervention (n=251).RESULTS: Two hundred ninety-six patients were referred to the on-call counselor, who counseled each patient in person and provided follow-up calls. The counselor referred 45% to the on-site program, and 27% to telephone counseling; of these, half followed through on the referral; 28% declined referral. Patients on the intervention team were more likely to report being counseled about smoking (68% vs 56%; odds ratio [OR] 1.7, CI 1.0-2.9) and referred to a cessation program (38% vs 23%; OR 2.1, CI 1.2-3.6); having attended the program (11% vs 4%; OR 3.6, CI 1.2-10.5); and receiving a prescription for bupropion (17% vs 8%) (OR 2.3, CI 1.1-5.1). The effect was not sustained after the case management period. CONCLUSIONS:Having access to an on-call counselor with case management increased rates of smoking cessation counseling, referral, and treatment. The intervention could be reproduced by other health care systems.

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Section: Discussionsupporting

confidence: 77%

Effectiveness of an On-Call Counselor at Increasing Smoking Treatment

et al. 2007

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“…nurses, social workers, etc.) (Hollis et al, 2000); subsidized NRT (Cohen et al, 1987); chart reminders on how to move patients not ready to quit smoking through the stages of the Stages of Change model (Cohen et al) and obtaining reimbursement for smoking cessation services (Solberg, Davidson, Alesci, Boyle, & Magnan, 2002). For those desiring more information, a comprehensive clinical practice guideline for treating tobacco use and dependence has been published by the Public Health Service (Fiore et al, 2000).…”

Section: Discussionmentioning

confidence: 98%

Psychiatrists’ Smoking Cessation Activities with Ohio Community Mental Health Center Patients

Price

Ambrosetti

Sidani

et al. 2007

Community Ment Health J

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This study describes a survey of Ohio community mental health center psychiatrists' perceptions and practices regarding smoking cessation activities using the 5A's method of smoking cessation. Of the 150 psychiatrists surveyed, 80 (53%) were returned. The majority of psychiatrists reported asking their patients about cigarette smoking status as well as giving advice to quit. However, the practice of actually facilitating quit attempts (i.e. with social support, nicotine replacement therapy, referrals, and follow-up visits) was lacking. This demonstrates that although cigarette smoking in individuals with mental illness is recognized as a major problem by adult psychiatrists, too little is being done to adequately address the issue.

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“…We further hypothesized that perception of organizational support would change as a function of training, and be positively related to greater implementation of nurse counseling. Lack of organizational support has been shown to be a barrier to counseling among physicians (Cabana et al, 1999;Hollis et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses

Borrelli

Lee

Novak

2008

Preventive Medicine

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Objective-We prospectively examined whether training home health care nurses is associated with changes in attitudes towards smoking cessation counseling and counseling behaviors.Methods-We trained 98 home health care nurses to deliver cessation counseling to their patients. Measures were administered at pre-training, post-training, and six months later. This was part of a larger study conducted in Providence, RI, USA (1998-2002.Results-Compared with pre-training, at post-training, nurses reported significantly higher levels of self-efficacy to counsel, positive outcome expectations, optimism that patients would follow their advice, perceived worth of smoking counseling, perceived importance of quitting smoking, and perceived organizational support. These training effects were maintained six-months later. Between the end of training and the six-month follow-up, nurses reported significant increases in their perceived effectiveness to counsel smokers and confidence to encourage behavior change. Compared with pre-training, at six month follow-up, nurses were significantly more likely to ask about smoking status, assess readiness to quit, advise to quit, assist with quitting, and arrange follow-up. Nurses spent significantly more time counseling smokers at 6 months than at pre-training, and were less likely to selectively counsel.Conclusions-Brief training facilitates both short-and long-term changes in nurse attitudes and behaviors regarding smoking cessation counseling.

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Implementing tobacco interventions in the real world of managed care

Cited by 62 publications

References 13 publications

Effectiveness of an On-Call Counselor at Increasing Smoking Treatment

Effectiveness of an On-Call Counselor at Increasing Smoking Treatment

Psychiatrists’ Smoking Cessation Activities with Ohio Community Mental Health Center Patients

Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses

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