Intervention development for integration of conventional tobacco cessation interventions into routine CAM practice

Abstract

Background: Practitioners of complementary and alternative medicine (CAM) therapies are an important and growing presence in health care systems worldwide. A central question is whether evidence-based behavior change interventions routinely employed in conventional health care could also be integrated into CAM practice to address public health priorities. Essential for successful integration are intervention approaches deemed acceptable and consistent with practice patterns and treatment approaches of different types of CAM practitioners -that is, they have context validity. Intervention development to ensure context validity was integral to Project CAM Reach (CAMR), a project examining the public health potential of tobacco cessation training for chiropractors, acupuncturists and massage therapists (CAM practitioners). This paper describes formative research conducted to achieve this goal. Methods: Intervention development, undertaken in three CAM disciplines (chiropractic, acupuncture, massage therapy), consisted of six iterative steps: 1) exploratory key informant interviews; 2) local CAM practitioner community survey; 3) existing tobacco cessation curriculum demonstration with CAM practitioners; 4) adapting/tailoring of existing curriculum; 5) external review of adaptations; 6) delivery of tailored curriculum to CAM practitioners with follow-up curriculum evaluation.

Process for massage therapy practice and essential assessment

“…Furthermore, clients receive education to help them participate in the decision making process (Bergman and Connaughton, 2013;Constand et al, 2014;Fuertes et al, 2007;Maizes et al, 2009;Muramoto et al, 2015;Smith et al, 2013;Winn et al, 2015). As the experts stated, their description of client centered agrees with the literature and they believe clients should be included within the treatment decisions and goal setting.…”

Implementation of tobacco cessation brief intervention in complementary and alternative medicine practice: qualitative evaluation

“…Key informants in those interviews raised three primary concerns [26] that would be addressed in the CAMR study:First, that regularly raising the issue of tobacco cessation might compromise their relationship with patients, particularly those whose key complaints may not be seen by the patient as tobacco-related.Second, given that most patients pay for CAM services out-of-pocket, practitioners were concerned that promoting cessation might cause patients to leave their practice.Third, practitioners were concerned that introducing cessation materials, such as pamphlets or posters, to new patients might be perceived as a “sales pitch” aimed at promoting additional, fee-based products or services [26]. …”

Online Tobacco Cessation Training and Competency Assessment for Complementary and Alternative Medicine (CAM) Practitioners: Protocol for the CAM Reach Web Study

“…With a few exceptions [ 13 - 16 ], CAM practitioners have been largely overlooked in the nation’s tobacco control agenda. For more than two decades, public health efforts have targeted physicians for tobacco brief intervention (BI) training [ 17 ].…”