Increasing Rates of Tobacco Treatment Delivery in Primary Care Practice: Evaluation of the Ottawa Model for Smoking Cessation

被引:41
|
作者
Papadakis, Sophia [1 ,2 ]
Cole, Adam G. [3 ]
Reid, Robert D. [1 ,2 ]
Coja, Mustafa [1 ]
Aitken, Debbie [1 ]
Mullen, Kerri-Anne [1 ]
Gharib, Marie [1 ]
Pipe, Andrew L. [1 ,2 ]
机构
[1] Univ Ottawa, Inst Heart, Div Prevent & Rehabil, Ottawa, ON, Canada
[2] Univ Ottawa, Fac Med, Ottawa, ON, Canada
[3] Univ Waterloo, Sch Publ Hlth & Hlth Syst, Waterloo, ON N2L 3G1, Canada
关键词
smoking cessation; primary care; evidence-based practice; knowledge translation; health services research; PRIMARY-HEALTH-CARE; INTERVENTION; DEPENDENCE; TRIAL;
D O I
10.1370/afm.1909
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
PURPOSE We report on the effectiveness of the Ottawa Model for SmokingCessation (OMSC), a multicomponent knowledge translation intervention, in increasing the rate at which primary care providers delivered smoking cessation interventions using the 3 A's model-Ask, Advise, and Act, and examine clinic-, provider-and patient-level determinants of 3 A's delivery. METHODS We examined the effect of the knowledge translation intervention in 32 primary care practices in Ontario, Canada, by assessing a cross-sectional sample of patients before the implementation of the OMSC and a second cross-sectional sample following implementation. We used 3-level modeling (clinic, clinician, patient) to examine the main effects and predictors of 3 A's delivery. RESULTS Four hundred eighty-one primary care clinicians and more than 3,500 tobacco users contributed data to the evaluation. Rates of delivery of the 3 A's increased significantly following program implementation (Ask: 55.3% vs 71.3%, P < .001; Advise: 45.5% vs 63.6%, P < .001; Act: 35.4% vs 54.4%, P < .001). The adjusted odds ratios (AOR) for the delivery of 3 A's between the pre- and post-assessments were AOR = 1.94; (95% CI, 1.61-2.34) for Ask, AOR = 1.92; (95% CI, 1.60-2.29) for Advise, and AOR = 2.03; (95% CI, 1.71-2.42) for Act. The quality of program implementation and the reason for clinic visit were associated with increased rates of 3 A's delivery. CONCLUSIONS Implementation of the OMSC was associated with increased rates of smoking cessation treatment delivery. High quality implementation of the OMSC program was associated with increased rates of 3 A's delivery.
引用
收藏
页码:235 / 243
页数:9
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