Impact of an Online Training Program in Smoking Cessation Interventions in Hospitals

Abstract

Purpose To assess changes in the self‐reported performance of smoking cessation interventions according to the 5A's model (Ask; Advise; Assess; Assist; and Arrange follow‐up) among clinicians; and to identify the main barriers and facilitators in smoking cessation implementation before and after an online smoking cessation training program. Design Pre‐post evaluation. Methods We assessed self‐reported smoking cessation interventions in the implementation of the 5A's model among clinicians working in Catalan hospitals (Spain). In addition, we assessed individual‐, behavioral‐, and organizational‐level factors that act as barriers and facilitators in the implementation of the 5A's model. We used a questionnaire of 63 items reflecting each of the 5A's performance (scored from 0 = none to 10 = most possible). The questionnaire was completed both immediately before and 6 months after the training. We analyzed the data of those participants who had a clinical role and answered pre‐ and post‐questionnaires. We used the nonparametric test for paired data (Wilcoxon) to examine changes in scores. Findings A total of 127 clinicians completed the pre‐post questionnaire; 63.0% were registered nurses, 17.3% were nursing assistants, 7.9% were physicians, and 11.8% were other professionals (p < .001). Overall, there were significant increases in the implementation of the assist component (from a score of 4.5 to 5.2; p < .003) and arrange a follow‐up component (from 3.6 to 4.5; p < .001) of the intervention. Scores in the perception of the level of overall preparation, preparedness in using smoking cessation drugs, level of competence, and organizational recognition improved (p < .001) at the follow‐up; however, the score in the perception that implementing smoking cessation is part of their job decreased (from 6.3 to 4.4; p < .001). Conclusions The online training had a positive impact on the implementation of assist and arrange follow‐up components. Although self‐preparedness in the management of smokers increased, the motivation and involvement of key professionals decreased. Organizational factors related to the incorporation of resources (such as protocols, records, etc.) should be improved for the correct progression of smoking cessation interventions within the institutions. Clinical Relevance Smoking cessation training programs should incorporate some motivational content to increase the engagement of health professionals in smoking cessation interventions in their clinical practice.

Impact of a nurse‐led brief tobacco cessation training program for healthcare professionals

“…Tobacco cessation training initiatives can help address these challenges and improve the practices of healthcare professionals. Brief tobacco cessation training programs for health professionals have been associated with an increase in the delivery of the 5As for tobacco cessation (Martínez et al., 2018, 2019; Payne et al., 2014) increasing participants' perceived self‐efficacy (Payne et al., 2014) and their positive opinions and attitudes towards such a role (Martínez et al., 2018; Payne et al., 2014). The structure of such tobacco cessation training programs varies, however, the content is generally based on three topics: the basic science (the principles on tobacco use and associated diseases); the clinical science (the behavioral strategies, such as the use of the 5As, and pharmacological agents); and the socio‐political topics of tobacco control (to encourage greater advocacy and lobbying), which tends to be inadequately covered (Ye et al., 2018).…”

Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries

“…We found that a high proportion of healthcare professionals completed the four modules of the e-learning program. However, the completion of all the modules and the exam was lower than expected in comparison to health professionals who did the same e-learning smoking cessation program in Catalonia (Spain) (Martínez et al, 2019). Doctors and participants from Bolivia had higher rates of completion, including the modules and taking the test, compared to the other two countries.…”

Factors associated with receipt of the 5As model of brief intervention for smoking cessation among hospitalized patients

“…Our study explored several of these factors, but did not study training. However, a previous study conducted in Catalonia showed that training health professionals increases the level of performance of the 5As [19]. In this sense, future research should continue exploring these factors at multiple levels, including the ones we have explored in this study that characterize patients (such as age, gender and comorbidities) and hospitals (such as unit of admission and provision of smoking cessation services).…”

“…In order to monitor adherence to tobacco cessation guidelines, several studies have relied upon provider self‐reports [16,17]. Studies conducted among health‐care providers show a good implementation of the first two components of the 5As model, ask and advise, ranging from 60 to 75%, but lower implementation for the remaining following components [18–21]. Further, studies comparing the performance of providers with patients’ perception show that providers tend to overestimate their performance [22,23].…”