Building capacity in tobacco control by establishing the Eastern Europe Nurses’ Center of Excellence for Tobacco Control

Abstract

INTRODUCTION Properly educated nurses delivering evidence-based tobacco dependence treatment could contribute to improving health and reducing regional disparities in tobacco-related disease and death in Central and Eastern Europe. The aims of this study are to describe development of the Eastern European Nurses’ Centre of Excellence for Tobacco Control (COE) and evaluate its online educational program on tobacco dependence treatment using the 5As framework. METHODS The online education evaluation followed a prospective, single group, pre- and post-assessment of changes in nurses’ self-reported tobacco cessation interventions. Leaders from five Eastern European countries (Hungary, Czech Republic, Romania, Slovakia, Slovenia) developed protocols for in-country tobacco control education. Nurses responded to a baseline survey, accessed an online nursing educational program, and completed a follow-up survey at 3 months, in the period December 2015 to June 2016. A total of 695 nurses from five countries answered questions on cessation interventions at baseline and of these 507 (73%) completed a follow-up survey at 3 months. RESULTS At the follow-up at 3 months, the 507 nurses self-reported a significant increase in providing all 5A components, i.e. nurses were significantly (p<0.0001) more likely to always /usually advise a patient to quit, assess interest in quitting (p=0.002), assist with a quit plan, review barriers to quitting and recommend a smoke-free home post-discharge (all p<0.0001). They were also significantly more likely (p=0.01) to agree or strongly agree that nurses have an obligation to advise patients on the risks of smoking. There was a significant increase (p<0.0001) in nurses’ estimate of the number of patients they provided a cessation intervention the previous week. Nurses who smoked were 60% more likely to assist and arrange compared to nurses who never smoked. CONCLUSIONS Coordinating multi-country activities through a COE was successful in engaging a network of nurses to use an online educational program and participate in other tobacco control activities.

Effectiveness of a smoking cessation educational program for Japanese nurses on subsequent changes of behavior in delivering smoking cessation counseling

“…Regarding the implementation rate of the 5As by nurses, in a study of 152 Czechoslovak nurses, Sarna et al11 reported that the prevalence of using 5As in real-world practice was 63.0% for ‘Ask’, 45.8% ‘Advise’, 38.9% ‘Assess’, 26.0% ‘Assist’ and only 11.8% for ‘Arrange’. Another study on 507 Eastern European nurses found that the prevalence of practicing the 5As was ‘Ask’ 70.4%, ‘Advise’ 65.7%, ‘Assess’ 58.6%, ‘Assist’ 36.3%, and ‘Arrange’ 20.4% 23 . In contrast, in Japan, a survey of 554 public health nurses by Li et al 24 indicated that the frequency of ‘Ask’ was as high as 83.9%, ‘Advice’ 58.0%, ‘Assess’ 24.3%, ‘Assist’ 32.5%, and ‘Arrange’ very high at 43.9%.…”

Conceptualising centres of excellence: a scoping review of global evidence

“…CoE is a team of specialised expertise2 7 17 24–47 or organisational environment2 5 24 30 35 36 48–56 that is established to provide outstanding healthcare,2 7 12 17 24–39 41 48 50 51 57–74 research,12 17 24 26–28 31 36 40 41 50 52 58 68 72 74–85 education and training,12 17 24 25 31 36 38 42 43 68 73 74 76 81–83 85–88 regulatory,57 83 89 policy,46 49 54 55 82 90 information technology45 53 91 or industrial44 92 93 services and support in high levels of efficient and effective performance. CoEs are geographically concentrated and focused on high potential in science and industry,46 as a world leader or a catalyst between neighbouring countries,60 72 82 anywhere from the local research and development (R&D) group up to a network of cooperative partners.…”

“…CoE could be established to provide specific regulatory decision making, including to advance the development and regulation of products25 83 and to fill in knowledge gaps 97. For instance, the World Bank has an Eastern and Southern Africa Higher Education Centers of Excellence project that strengthen selected Eastern and Southern African higher education institutions to deliver quality postgraduate education and build collaborative research capacity in the regional priority areas 82…”

How Self-Efficacy toward, Perceived Importance of, and Beliefs about Smoking Cessation Support Impact-Related Behaviors in Japanese Nursing Professionals

“…Except for Ask, engagers were implemented more than non-engagers. Past studies on implementation rates for the 5 As among nurses include a survey of 98 home care nurses (before SCS training) that found rates of 34.0% for Ask, 46.2% for Advise, 13.7% for Assess, 34.0% for Assist, and 0% for Arrange [ 21 ]; a study of 152 nurses in the Czech Republic that found rates of 63.0%, 45.8%, 38.9%, 26.0%, and 11.8%, respectively [ 14 ]; and a study of 507 nurses in Eastern Europe (before SCS training) reported rates of 70.4%, 65.7%, 58.6%, 36.3%, and 20.4%, respectively [ 25 ]. Li et al’s study of 554 Japanese public health nurses using a 36-item survey on the 5 As found rates of 83.9%, 58.0%, 24.3%, 32.5%, and 43.9%, respectively [ 19 ].…”