Improving Tobacco Cessation Rates Using Inline Clinical Decision Support

Drake, Lauren Alick; Suresh, Krithika; Chrastil, Hillary; Lewis, Carmen L.; Altman, Richard

doi:10.1055/a-1961-9800

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…16 Additionally, CDS systems can improve the delivery of clinical interventions for tobacco use in adult settings. [17][18][19][20][21] Further, other communication modalities geared toward adults, including internet-based or app-based services, may promote smoking cessation. [22][23][24][25] In pediatric settings, CDS systems have shown potential to support screening for SHS exposure and facilitate the connection to and delivery of evidence-based tobacco treatments.…”

Section: Background and Significancementioning

confidence: 99%

A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance

et al. 2023

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Background: Research is needed to identify how clinical decision support (CDS) systems can support communication about and engagement with tobacco use treatment in pediatric settings for parents who smoke. We developed a CDS system that identifies parents who smoke, delivers motivational messages to start treatment, connects parents to treatment, and supports pediatrician-parent discussion. Objective: To assess the performance of this system in clinical practice, including receipt of motivational messages and tobacco use treatment acceptance rates. Methods: The system was evaluated at one large pediatric practice through a single-arm pilot study from June-November 2021. We collected data on the performance of the CDS system for all parents. Additionally, we surveyed a sample of parents immediately after the clinical encounter who used the system and reported smoking. Measures were: 1) the parent remembered the motivational message, 2) the pediatrician reinforced the message, and 3) treatment acceptance rates. Treatments included nicotine replacement therapy, quitline referral (phone counseling), and/or SmokefreeTXT referral (text-message counseling). We described survey response rates overall and with 95% confidence intervals (CI). Results: During the entire study period, 8488 parents completed use of the CDS: 9.3% (n=786) reported smoking, and 48.2% (n=379) accepted at least one treatment. One hundred and two parents who smoke who used the system were approached to survey 100 parents (98% response rate). Most parents self-identified as female (84%), aged 25-34 years (56%), and Black/African American (94%), and had children with Medicaid insurance (95%). Of parents surveyed, 54% accepted at least one treatment option. Most parents recalled the motivational message (79%; 95% CI: 71-87%), and 31% (95% CI: 19-44%) reported the pediatrician reinforced the motivational message. Conclusion: A CDS system to support parental tobacco use treatment in pediatric primary care enhanced motivational messaging about smoking cessation and evidence-based treatment initiation.

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Section: Background and Significancementioning

confidence: 99%

A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance

et al. 2023

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Nudging oral habits; application of behavioral economics in oral health promotion: a critical review

Kazemian,

Hoseinzadeh,

Banihashem Rad

et al. 2023

Front. Public Health

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BackgroundOral health disorders significantly contribute to the global incidence of chronic diseases. Nudge interventions have demonstrated effectiveness in enhancing people’s decision-making and self-management capacities in a cost-efficient manner. As a result, these interventions could be valuable tools for fostering improved oral care habits. This critical review explores potential behavioral nudges applicable to promoting oral health.MethodsA thorough electronic literature search was conducted on Scopus, Embase, and PubMed databases for papers published post-2008. The search focused on empirical evidence concerning the direct and indirect application of Nudge theory in oral health enhancement. In addition, the investigation included the nudge intervention’s role in managing common non-communicable disease risk factors (tobacco, alcohol, and sugar) and their use in other health sectors.Results and conclusionThere is a dearth of studies on behavioral economics, particularly those involving reward and reminder techniques. However, various successful nudge interventions have been identified in other sectors that aim to improve health decisions. These include strategies encouraging healthier nutritional choices, tobacco and alcohol cessation, medication compliance, routine physical activity, and regular health check-ups. Such interventions can also have direct or indirect positive impacts on oral health. Implementing these interventions within an oral care framework could promote oral health due to similar underlying cognitive mechanisms. However, different types of nudge interventions have varying degrees of effectiveness. Furthermore, factors such as the method of delivery and the characteristics of the targeted population significantly influence the outcome of the intervention. Hence, it is imperative to conduct extensive studies in diverse socioeconomic settings to fully understand the potentials, limitations, and impacts of nudge interventions in promoting oral health.

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Improving Tobacco Cessation Rates Using Inline Clinical Decision Support

Cited by 2 publications

References 18 publications

A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance

A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance

Nudging oral habits; application of behavioral economics in oral health promotion: a critical review

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