Preventing Chronic Disease | Partnering with Health Care Systems to Assess Tobacco Treatment Practices and Beliefs Among Clinicians: Evaluating the Process - CDC

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Preventing Chronic Disease | Partnering with Health Care Systems to Assess Tobacco Treatment Practices and Beliefs Among Clinicians: Evaluating the Process - CDC

MEDSCAPE CME Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Preventing Chronic Disease. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at www.medscape.org/journal/pcd; (4) view/print certificate. Release date: May 29, 2014; Expiration date: May 29, 2015

Learning Objectives Upon completion of this activity, participants will be able to: Distinguish sociodemographic variables associated with higher rates of smoking Analyze physicians’ performance in the clinical management of smoking Evaluate a survey program of physicians and nurses regarding the clinical management of smoking   EDITOR Teresa L. Ramsey, Writer-Editor, Preventing Chronic Disease. Disclosure: Teresa L. Ramsey has disclosed no relevant financial relationships. CME AUTHOR Charles P. Vega, MD, Associate Professor and Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships. AUTHORS AND CREDENTIALS Disclosures: Michael D. Celestin, Jr., MA, CHES, CTTS, Alton Hart, Jr., MD, MPH, Sarah Moody-Thomas, PhD, have disclosed no relevant financial relationships. Affiliations: Michael D. Celestin, Jr., Sarah Moody-Thomas, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana; Alton Hart, Jr., Virginia Department of Health Crater Health District, Petersburg, Virginia.

Partnering with Health Care Systems to Assess Tobacco Treatment Practices and Beliefs Among Clinicians: Evaluating the Process

Michael D. Celestin Jr, MA; Alton Hart Jr, MD, MPH; Sarah Moody-Thomas, PhD

Suggested citation for this article: Celestin MD Jr, Hart A Jr, Moody-Thomas S. Partnering with Health Care Systems to Assess Tobacco Treatment Practices and Beliefs Among Clinicians: Evaluating the Process. Prev Chronic Dis 2014;11:130277. DOI: http://dx.doi.org/10.5888/pcd11.130277.

Abstract

Background
Tobacco is a major cause of preventable illness and death. However, clinician use of an evidence-based guideline for treatment of tobacco use is low. This case study describes the process for conducting a pre-intervention assessment of clinician practices and beliefs regarding treatment of tobacco use.

Community Context
Louisiana State University Health System, one of the largest safety-net public hospital systems in the United States, consists of 10 facilities in population centers across the state of Louisiana. The system serves a large proportion of the state’s underinsured and uninsured, low-income, and racial/ethnic minority populations, groups that have high rates of tobacco use.

Methods
Activities included 1) partnering with hospital administrators to generate support for conducting a clinician assessment, 2) identifying and adapting a survey tool to assess clinicians’ practices and beliefs regarding treatment of tobacco use, 3) developing a survey protocol and obtaining approval from the institutional review board, and 4) administering the survey electronically, using the hospital’s e-mail system.

Outcome
Existing partnerships and system resources aided survey administration. Use of the hospital’s internal e-mail system and distribution of an online survey were effective means to engage clinicians. Following notification, 43.6% of 4,508 clinicians opened their e-mail containing the invitation letter with a Web link to the survey; of these, 83.1% (1,634) completed the survey.

Interpretation
Partnering with stakeholders and using existing resources within the health care system are essential to successful implementation of a system-wide survey of clinician practices and beliefs regarding treatment of tobacco use.

Author Information

Corresponding Author: Michael D. Celestin Jr, MA, CHES, CTTS, 2020 Gravier St, 3rd Fl, New Orleans, LA 70112. Telephone: 504-568-5742. E-mail:mceles@lsuhsc.edu.

Author Affiliations: Alton Hart, Jr, Virginia Department of Health Crater Health District, Petersburg, Virginia; Sarah Moody-Thomas, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana.

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References

1. Centers for Disease Control and Prevention. Smoking-attributable mortality, years of potential life lost, and productivity losses — United States, 2000–2004. MMWR Morb Mortal Wkly Rep 2008;57(45):1226–8. PubMed
2. US Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease and Prevention and Health Promotion, Office on Smoking and Health; 2004. http://www.surgeongeneral.gov/library/reports/smokingconsequences/index.html. Accessed April 22, 2013.
3. King BA, Dube SR, Tynan MA. Current tobacco use among adults in the United States: findings from the national adult tobacco survey. Am J Public Health 2012;102(11):e93–100. CrossRef PubMed
4. The State of Louisiana Department of Health and Hospitals. 2010 Behavioral Risk Factor Surveillance System report. Baton Rouge (LA): Louisiana Department of Health and Hospitals; 2010. http://new.dhh.louisiana.gov/assets/oph/pcrh/2010_Rprt_BRFSS_FNL_.pdf. Accessed April 22, 2013.
5. Healthy People 2020 topics and objectives — tobacco use. Washington (DC): US Department of Health and Human Services; 2013. http://healthypeople.gov/2020/topicsobjectives2020/pdfs/tobaccouse.pdf. Accessed April 22, 2013.
6. Clinical Practice Guideline Treating Tobacco Use and Dependence 2008 Update Panel, Liaisons, and Staff. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A US Public Health Service report. Am J Prev Med 2008;35(2):158–76. CrossRef PubMed
7. McLeod CC, Klabunde CN, Willis GB, Stark D. Health care provider surveys in the United States, 2000–2010: a review. Eval Health Prof 2013;36(1):106–26. CrossRef PubMed
8. Jamal A, Dube SR, Malarcher AM, Shaw L, Engstrom MC; Centers for Disease Control and Prevention (CDC). Tobacco use screening and counseling during physician office visits among adults — National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005–2009. MMWR Morb Mortal Wkly Rep 2012;61(Suppl):38–45. PubMed
9. Sheffer CE, Anders M, Brackman SL, Steinberg MB, Barone C. Tobacco intervention practices of primary care physicians treating lower socioeconomic status patients. Am J Med Sci 2012;343(5):388–96. CrossRef PubMed
10. Sarna L, Bialous SA, Wells M, Kotlerman J, Wewers ME, Froelicher ES. Frequency of nurses’ smoking cessation interventions: report from a national survey. J Clin Nurs 2009;18(14):2066–77. CrossRef PubMed
11. Applegate BW, Sheffer CE, Crews KM, Payne TJ, Smith PO. A survey of tobacco-related knowledge, attitudes and behaviours of primary care providers in Mississippi. J Eval Clin Pract 2008;14(4):537–44. CrossRef PubMed
12. Tong EK, Strouse R, Hall J, Kovac M, Schroeder SA. National survey of US health professionals’ smoking prevalence, cessation practices, and beliefs. Nicotine Tob Res 2010;12(7):724–33. CrossRef PubMed
13. Centers for Disease Control and Prevention. Tobacco control state highlights 2012. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2013. http://www.cdc.gov/tobacco/data_statistics/state_data/state_highlights/2012/index.htm. Accessed October 11, 2013.
14. Highlights of the 2002 first extraordinary and regular sessions of the Louisiana Legislature. Baton Rouge (LA): Louisiana House of Representatives; 2002. http://www.house.louisiana.gov/H_Highlights/HighlightsOf2002Sessions.pdf. Accessed April 22, 2013.
15. Louisiana State University Health System. LSU health annual report. Baton Rouge (LA): LSU Health; 2011. http://www.lsuhospitals.org/AnnualReports/2011_LSU_Health_ANNUAL_REPORT_[7-25-12].pdf. Accessed April 22, 2013.
16. Moody-Thomas S, Celestin MD Jr, Horswell R. Use of systems change and health information technology to integrate comprehensive tobacco cessation services in a statewide system for delivery of healthcare. Open J Prev Med 2013;03(01):75–83. CrossRef
17. Moody-Thomas S, Celestin MD Jr, Tseng TS, Horswell R. Patient tobacco use, quit attempts, and perceptions of health care provider practices in a safety-net healthcare system. Ochsner J 2013;13(3):367–74. PubMed
18. Purcell EP, Mitchell C, Celestin MD, Evans KR, Haynes V, McFall A, et al. Research to reality (R2R) mentorship program: building partnership, capacity, and evidence. Health Promot Pract 2013;14(3):321–7. CrossRef PubMed
19. Partnership for Prevention. Healthcare provider reminder systems, provider education, and patient education: working with healthcare delivery systems to improve the delivery of tobacco-use treatment to patients — an action guide. The community health promotion handbook: action guides to improve community health. Washington (DC): Partnership for Prevention; 2008. http://www.prevent.org/data/files/initiatives/tobaccousetreatment.pdf. Accessed July 9, 2013.
20. Klabunde CN, Willis GB, McLeod CC, Dillman DA, Johnson TP, Greene SM, et al. Improving the quality of surveys of physicians and medical groups: a research agenda. Eval Health Prof 2012;35(4):477–506. CrossRef PubMed