What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?

Luck, Kerrie E.; Doucet, Shelley

doi:10.1177/2333393618756770

Cited by 3 publications

(4 citation statements)

References 46 publications

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“…There are a few key practices that can help to address perceived barriers to tobacco use disorder care and support providers to provide tobacco use screenings that may increase their consistent use, namely, programming a hard stop in the EHR that requires the input of patients’ tobacco use status, training providers to screen for tobacco use, and making a TUA template available to providers [ 24 , 84 , 86 , 87 , 88 ]. In the present study, mandated tobacco screenings were most common in health care settings where hard stops in EHRs for entry of tobacco use status were used than in settings in which they were not; likewise, screening was marginally more common in centers where provider tobacco training was readily available than in settings where training was not offered.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, until there is more work, the value of key practices that were not significantly or independently associated with mandated screenings should not be discounted as unimportant. Additionally, and although these were not the specific focus of this study, tobacco-free workplace policies have been found to help reduce tobacco use by enhancing physical cues in treatment center environments to facilitate a quit attempt; likewise, the presence of Certified Tobacco Treatment Specialists has been linked with evidence-based intervention provision [ 84 , 85 , 86 , 97 ]. Unfortunately, tobacco-free workplace policy implementation was reported at (marginally significant) lower rates in substance use treatment centers, both those in LMHAs and standalone centers, compared with the other types of surveyed centers, revealing a need to intervene to increase their uptake in these settings.…”

Section: Discussionmentioning

confidence: 99%

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Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment

Siddiqi

Britton

Chen

et al. 2022

IJERPH

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Tobacco use, and thus tobacco-related morbidity, is elevated amongst patients with behavioral health treatment needs. Consequently, it is important that centers providing health care to this group mandate providers’ use of tobacco screenings to inform the need for tobacco use disorder intervention. This study examined the prevalence of mandated tobacco screenings in 80 centers providing health care to Texans with behavioral health needs, examined key factors that could enhance screening conduct, and delineated providers’ perceived barriers to tobacco use intervention provision. The results indicated that 80% of surveyed centers mandated tobacco use screenings; those that did were significantly more likely than those that did not to have a hard stop for tobacco use status in health records and were marginally more likely to make training on tobacco screening available to providers. The most widespread barriers to tobacco use disorder care provision were relative perceived importance of competing diagnoses, lack of community resources to refer patients, perceived lack of time, lack of provider knowledge or confidence, and belief that patients do not comply with cessation treatment. Overall, the results suggest that there are opportunities for centers providing care to Texans with behavioral health needs to bolster their tobacco screening and intervention capacity to better address tobacco-related health disparities in this group. Health care centers can support their providers to intervene in tobacco use by mandating screenings, streamlining clinical workflows with hard stops in patient records, and educating providers about the importance of treating tobacco with brief evidence-based intervention strategies while providing accurate information about patients’ interest in quitting and providers’ potential impacts on a successful quit attempt.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment

Siddiqi

Britton

Chen

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Additionally, there may be other organizational-level interventions not part of this tobacco-free workplace intervention that might be used to complement educational and skill-building efforts to build a capacity for tobacco interventions. For example, programming a 'hard stop' in the electronic health record system that requires addressing the five A's may increases providers' provision of brief screening and intervention for smoking with their patients [70][71][72]. This factor was not included or evaluated in the present study; the authors' anecdotal experience was that many participating substance use treatment centers still used paper records and/or did not have the capability, funding, or interest to change their electronic health records in this regard.…”

Section: Future Directionsmentioning

confidence: 99%

Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance Use Treatment Centers

LoParco

Chen

Leal

et al. 2022

IJERPH

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Many adults with a substance use disorder smoke cigarettes. However, tobacco use is not commonly addressed in substance use treatment centers. This study examined how provider beliefs about addressing tobacco use during non-nicotine substance use treatment, provider self-efficacy in delivering tobacco use assessments, and perceived barriers to the routine provision of tobacco care were associated with changes in the delivery of the evidence-based five A’s for smoking intervention (asking, advising, assessing, assisting, and arranging) at the organizational level. The data were from 15 substance use treatment centers that implemented a tobacco-free workplace program; data were collected before and after the program’s implementation. Linear regression examined how center-level averages of provider factors (1) at pre-implementation and (2) post- minus pre-implementation were associated with changes in the use of the five A’s for smoking in substance use treatment patients. The results indicated that centers with providers endorsing less agreement that tobacco use should be addressed in non-nicotine substance use treatment and reporting lower self-efficacy for providing tobacco use assessments at pre-implementation were associated with significant increases in asking patients about smoking, assessing interest in quitting and assisting with a quit attempt by post-implementation. Centers reporting more barriers at pre-implementation and centers that had greater reductions in reported barriers to treatment over time had greater increases in assessing patients’ interest in quitting smoking and assisting with a quit attempt by post-implementation. Overall, the centers that had the most to learn regarding addressing patients’ tobacco use had greater changes in their use of the five A’s compared to centers whose personnel were already better informed and trained. Findings from this study advance implementation science and contribute information relevant to reducing the research-to-practice translational gap in tobacco control for a patient group that suffers tobacco-related health disparities.

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“…Trustworthiness of the study. In order to ensure the trustworthiness and to reduce the influence of researcher, four basic criteria were applied during all stages of the study including: credibility, transferability, dependability and confirmability [38]. The credibility was achieved during prolonged engagement in the field, triangulation by using more than one data source, frequent debriefing session, peer review and member check.…”

Section: Discussionmentioning

confidence: 99%

Barriers to managing and delivery of care to war-injured survivors or patients with non-communicable disease: a qualitative study of Palestinian patients’ and policy-makers’ perspectives

Mosleh

Jeesh

Dalal

et al. 2020

BMC Health Serv Res

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Background: Improving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality of care is essential in developing an effective healthcare intervention for patient with non-communicable disease (NCD) or war-injured survivors. Methods: Qualitative interviews were performed using a purposive sampling strategy of 18 political-key informants, 10 patients with NCD and 7 war-injured survivors from different health facilities in Gaza Strip. A semi-structured interview guide was developed for data collection. The interviews were audio recorded and transcribed verbatim. Important field notes of the individual interviews were also reported. Thematic-driven analytic approach was used to identify key themes and patterns. Results: From the policy maker's perspective, the following important barriers to accessing optimal healthcare for patients with NCD or war-injured survivors' treatment were identified; 1) organizational/structural 2) availability 3) communication 4) personnel/lack of staff 5) financial and political barriers. Patient with NCD or war-injury had similar experiences of barriers as the policy makers. In addition, they also identified socioeconomic, physical and psychological barriers for accessing optimal healthcare and treatment. Conclusions: The main perceived barriers explored through this study will be very interesting and useful if they are considered seriously and handled carefully, in order to ensure efficient, productive, cost-effective intervention and delivery of a high-standard quality of care and better disease management.

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What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?

Cited by 3 publications

References 46 publications

Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment

Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment

Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance Use Treatment Centers

Barriers to managing and delivery of care to war-injured survivors or patients with non-communicable disease: a qualitative study of Palestinian patients’ and policy-makers’ perspectives

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