Training Pediatric Residents to Provide Smoking Cessation Counseling to Parents

Abstract

The objective was to assess the effectiveness of a smoking cessation educational program on pediatric residents' counseling. Residents were randomly selected to receive the intervention. Residents who were trained were compared to untrained residents. Self-reported surveys and patient chart reviews were used. Measures included changes in self-reported knowledge, attitudes and behaviors of residents, and differences in chart documentation and caretaker-reported physician counseling behaviors. The intervention was multidimensional including a didactic presentation, a problem-solving session, clinic reminders, and provision of patient education materials. Results showed that residents who were trained were more likely to ask about tobacco use in their patients' households. They were also more likely to advise caretakers to cut down on or to quit smoking, to help set a quit date, and to follow up on the advice given at a subsequent visit. Trained residents were more likely to record a history of passive tobacco exposure in the medical record. These residents also reported improved confidence in their counseling skills and documented that they had done such counseling more often than did untrained residents. Caretakers of pediatric patients who smoke seen by intervention residents were more likely to report that they had received tobacco counseling. Following this intervention, pediatric residents significantly improved their behaviors, attitudes, and confidence in providing smoking cessation counseling to parents of their pediatric patients.

Consumo de tabaco en médicos residentes de pediatría en la Argentina. Prevalencia actual y tendencia en los últimos diez años

“…Existe evidencia de que el entrenamiento específico en la materia incrementa la conducta activa de los profesionales frente al tabaquismo de los pacientes. [28][29][30] Debe tenerse en cuenta que, por tratarse de una encuesta realizada a los médicos, podría estar sobreestimada la frecuencia 28,31 se informa que solo un 10% y un 21% de los fumadores respectivamente referían que su médico les ofreció ayuda para dejar de fumar. El incremento observado en las conductas analizadas (preguntar, advertir y aconsejar) podría estar relacionado con una mayor proporción de profesionales que habían recibido información sobre el cese del tabaquismo.…”

Smoking cessation promotion in the pediatric clinic: Increasing pediatricians’ rate of screening for second hand smoke exposure, counseling caregivers to stop smoking and referring caregivers to smoking cessation programs

“…Caregiver exit interviewers were used in five (Hipple et al, 2013;Hymowitz et al, 2008) (Hymowitz et al, 2001; J. D. Klein et al, 1995) while physician self-report surveys were used in four studies (Hymowitz et al, 2001; J. D. Klein et al, 1995) (Scal et al, 2004) (Collins et al, 2005) (Table 1). …”

“…Electronic (Beaty et al, 2013) (Sharifi et al, 2014) and manual (Collins et al, 2005;Houston et al, 2006) chart review was used in four studies to measure outcome (Table 1).…”

“…Pediatric residents were the only subjects in 6 studies (Collins, D'Angelo, Stearns, & Campbell, 2005;Houston et al, 2006) (Hymowitz, Pyle, Haddock, & Schwab, 2008;Hymowitz, Schwab, & Eckholdt, 2001; J. D. Klein, Portilla, Goldstein, & Leininger, 1995;Lee et al, 2004;Scal, Hennrikus, Ehrlich, Ireland, & Borowsky, 2004), while pediatricians were the sole subjects in 2 studies (Beaty et al, 2013;Hipple, Nabi-Burza, Hall, Regan, & Winickoff, 2013) (Table 1). The effects of the intervention were investigated in both pediatricians and pediatric residents in 1 study (Sharifi et al, 2014) (Table 1).…”

“…Klein et al, 2010;Scal et al, 2004;Sharifi et al, 2014). Eight studies also assessed pediatricians' interventions on screening caregivers for smoking behaviors (Collins et al, 2005;Hipple et al, 2013;Houston et al, 2006;Hymowitz et al, 2008;Hymowitz et al, 2001;J. Klein et al, 2010;Sharifi et al, 2014)( (Beaty et al, 2013) while five studies examined the effect of an intervention on pediatricians' providing referrals to caregivers (Beaty et al, 2013;Hymowitz et al, 2008;Hymowitz et al, 2001; J.…”