A survey of tobacco‐related knowledge, attitudes and behaviours of primary care providers in Mississippi

Applegate, Bradford W.; Sheffer, Christine E.; Crews, Karen M.; Payne, Thomas J.; Smith, Patrick O.

doi:10.1111/j.1365-2753.2007.00910.x

Cited by 63 publications

(85 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This likely reflects physicians’ lack of training and skill in advanced motivational counseling techniques [7,25,26] that would go beyond simply providing information. It likely also reflects systemic constraints such as lack of time for engaging in more extended dialogues [27-29].…”

Section: Discussionmentioning

confidence: 99%

Physician smoking cessation counseling and adherence to the Clinical Practice Guideline

Champassak¹,

Catley²,

Finocchario-Kessler³

et al. 2014

EJPCH

View full text Add to dashboard Cite

Objective The U.S. Public Health Service Clinical Practice Guideline recommends that physicians provide tobacco cessation interventions to their patients at every visit. While many studies have examined the extent to which physicians implement the guideline's “5 A's”, few studies have examined the extent to which physicians implement the guideline's “5 R's” which are to be used in a Motivational Interviewing (MI) consistent style with smokers not ready to quit. This study examined the extent to which physicians in usual practice and without specific training administered the 5 R's including the use of an MI style. Methods Thirty-eight physicians were audio recorded during their routine clinical practice conversations with smokers.Recordings were coded by independent raters on the implementation of each of the 5 A's, 5 R's and MI counseling style. Results Results revealed that for patients not ready to quit smoking, physicians most frequently discussed the patient's personal relevance for quitting and the risks of smoking. Roadblocks and rewards were discussed relatively infrequently. MI skill code analyses revealed that physicians, on average, had moderate scores for acceptance and autonomy support, a low to moderate score for collaboration and low scores for empathy and evocation. Conclusion Results suggest that for the Clinical Guideline to be implemented appropriately physicians will need specialized training or will need to be able to refer patients to counselors with the necessary expertise. Counseling efforts could increase providers’ willingness to implement guideline recommendations and therefore to enhance the person-centeredness of clinical care.

show abstract

Section: Discussionmentioning

confidence: 99%

Physician smoking cessation counseling and adherence to the Clinical Practice Guideline

Champassak¹,

Catley²,

Finocchario-Kessler³

et al. 2014

EJPCH

View full text Add to dashboard Cite

show abstract

“…23, 25, 32 Items included provider demographics, tobacco use history and training, work setting, percent of patients who pay for services with Medicare, Medicaid, or self-pay, and 19 content items listed in Table 1. Tobacco training history was assessed with three questions, “Have you had formal training for treating tobacco use?” (yes/no), followed by “If yes, how did you receive this training?” with three options, “Workshop or seminar,” “Online or self-study,” and a fill-in the blank, “Other.” All content items were assessed on a Likert-type, discrete analogue scale of 0 to 10 with 0 being “none or not at all” and 10 being “the most possible.”…”

Section: Methodsmentioning

confidence: 99%

“…21, 22 Physicians with formal training in treating tobacco dependence are more likely to provide assistance than those without training and physicians who are familiar with treatment services are more likely to refer than those who are not. 20, 23–27 Paying for performance of specific tobacco intervention services is also associated with significant increases in the frequency of physician tobacco-related interventions. 28 However, it is unknown whether these and other factors function similarly when a high proportion of the patient population is of lower SES and clearly in greater need of the preventative services.…”

Section: Introductionmentioning

confidence: 99%

Tobacco Intervention Practices of Primary Care Physicians Treating Lower Socioeconomic Status Patients

Sheffer

Brackman

Anders

et al. 2012

The American Journal of the Medical Sciences

Self Cite

View full text Add to dashboard Cite

Tobacco use greatly contributes to overall socioeconomic health disparities and physicians are a major source of information about effective methods for tobacco cessation. This study examined the tobacco intervention practices of primary care physicians in Arkansas who treat a high proportion of lower SES patients. Greater than 70% of respondents’ patients were covered by Medicaid and/or Medicare or paid for primary care services without health insurance. Although physicians were highly motivated and considered cessation to be very important, 74% had no training of any kind in the treatment of tobacco dependence and familiarity with the free treatment services in Arkansas was low. Younger and non-white physicians and physicians with any type of training in treating tobacco dependence reported more positive attitudes, more frequent intervention behaviors, and more familiarity with treatment services. More frequently seeing the effects of tobacco use on the health of patients as well as increased knowledge, preparedness, and perceived effectiveness of treatments was related to a higher frequency of providing cessation assistance. More frequently seeing the effects of tobacco use on patients, as well as increased familiarity with treatment services was related to a higher frequency of referring patients to treatment services. These findings suggest that training experiences that increase physician awareness of the multiplicity of consequences of tobacco use as well as increase knowledge, preparedness, perceived effectiveness of treatments, and familiarity with treatment services will increase the frequency with which physicians assist and refer this important patient population.

show abstract

“…Sufficient availability of highly proficient practitioners is necessary to train practitioners who deliver brief, low-intensity interventions. At present, the vast majority of health care practitioners have not received even the minimal training needed to effectively deliver a brief, low-intensity evidence-based treatment (Applegate et al, 2008;Sheffer et al, 2012;Steinberg et al, 2006). Sufficient availability of highly proficient TTSs is also necessary to support the efforts of health care providers who identify tobacco users in need of higher intensity treatment, to support innovative chronic care models such as the Ask-Advise-Connect (Vidrine et al, 2013), and to treat tobacco users with complex presentations who do not respond to lower intensity treatment.…”

Section: Training Health Care Providers To Provide Brief Treatment Fomentioning

confidence: 99%

“…Given the opportunities provided by a significant reach into the smoking population, the clinical practice guidelines in many countries strongly recommend that health care practitioners briefly discuss evidence-based treatment options with all tobacco users at every visit (CAN-ADAPTT, 2011;Fiore et al, 2008;Health, 2007;NICE, 2013;). Practitioners, however, are generally unprepared to effectively discuss treatment options and are unfamiliar with the high intensity of treatment provided by TTSs (Applegate, Sheffer, Crews, Payne, & Smith, 2008;Payne et al, 2014;Sheffer, Anders, Brackman, Steinberg, & Barone, 2012;Steinberg, Alvarez, Delnevo, Kaufman, & Cantor, 2006).…”

mentioning

confidence: 99%

Increasing the Quality and Availability of Evidence-based Treatment for Tobacco Dependence through Unified Certification of Tobacco Treatment Specialists

et al. 2014

Self Cite

View full text Add to dashboard Cite

Each year, tobacco use causes over 6 million deaths and is responsible for hundreds of billions of dollars in health care and economic costs in the world (WHO, 2011). If current trends continue, tobacco is expected to kill over 1 billion people in the 21st century, making it one of the single greatest causes of preventable death and disease in history (WHO, 2011). Long-term abstinence from tobacco use dramatically improves individuals’ health, reduces the incidence of tobacco-related disease, and is clearly responsible for saving lives (Anthonisen et al., 2005). Most tobacco users express a desire to achieve long-term abstinence from tobacco use and make numerous unsuccessful quit attempts over the course of many years (Borland, Partos, Yong, Cummings, & Hyland, 2012; CDC, 2011). Evidence-based treatments for tobacco use and dependence greatly improve the chances that quit attempts result in long-term abstinence (Chambless & Hollon, 1998; Chambless et al., 1998; Compas, Haaga, Keefe, Leitenberg, & Williams, 1998; Fiore et al., 2008; Zwar et al., 2004). Increasing the availability of high-quality evidence-based treatment for tobacco use and dependence will make it more likely that tobacco users use evidence-based treatments and that quit attempts translate into long-term abstinence. The professionalisation of treatment for tobacco dependence by the development of a rigorous, unified Tobacco Treatment Specialist (TTS) certification process will increase the availability of high-quality evidence-based treatment for tobacco use and dependence for all tobacco users.

show abstract

A survey of tobacco‐related knowledge, attitudes and behaviours of primary care providers in Mississippi

Cited by 63 publications

References 29 publications

Physician smoking cessation counseling and adherence to the Clinical Practice Guideline

Physician smoking cessation counseling and adherence to the Clinical Practice Guideline

Tobacco Intervention Practices of Primary Care Physicians Treating Lower Socioeconomic Status Patients

Increasing the Quality and Availability of Evidence-based Treatment for Tobacco Dependence through Unified Certification of Tobacco Treatment Specialists

Contact Info

Product

Resources

About