Training health care providers in the treatment of tobacco use and dependence: Pre- and post-training results

Department of Health Behavior and Health Education, College of Public Health, University of Arkansas University for Medical Sciences, Little Rock, AR 72205-7199, USA.
Journal of Evaluation in Clinical Practice (Impact Factor: 1.08). 09/2009; 15(4):607-13. DOI: 10.1111/j.1365-2753.2008.01058.x
Source: PubMed


Health care providers have an extended reach into the population of tobacco users. Increasing the number and variety of health care providers that deliver the evidence-based, brief interventions for tobacco use prescribed by the Public Health Service Clinical Practice Guideline is likely to result in more tobacco users exposed to evidence-based treatments and more successful quit attempts. Effective training is key to increasing provider performance and proficiency in this regard.
A 1-hour didactic training was delivered to 1286 health care providers (185 physicians, 359 nurses, 75 dental providers and 667 other health-related professions). Pre- and post-training tests assessed provider attitudes, knowledge and behaviours. Paired samples t-tests were used to compare pre- and post-test results. Analysis of variance was used to test for significant differences among professional groups.
Prior to training, physicians engaged in more interventions and reported more knowledge and more positive attitudes towards treating tobacco use than the other professions. Post-training, differences among physicians, nurses and dental providers were minimal. All professions reported significantly more knowledge and more positive attitudes on nearly all measures.
A large potential benefit can be garnered from a brief, targeted, 1-hour training in the brief, evidence-based interventions for treating tobacco use and dependence. Increases in perceived knowledge and positive attitudes towards treatment among the professional groups suggest that trainees will perform interventions at higher frequency post-training. Overall gains were highest for dental providers and nurses.

Download full-text


Available from: Christine Elizabeth Sheffer, Sep 23, 2015
12 Reads
  • Source
    • "Fostering self-efficacy to address lifestyle behaviors by way of practical application is essential in entry-level education if the outcomes of HP interventions are to be maximized (Makni et al. 2002; Sheffer et al. 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Health promotion (HP) warrants being a clinical competency for health professionals given the global burden of lifestyle-related conditions; these are largely preventable with lifestyle behavior change. Physical therapists have a practice pattern conducive to HP, including lifestyle behavior change. The extent to which HP content is included in entry-level physical therapy (PT) curricula, and how it is taught however, is unknown. The aim of this study was to benchmark lifestyle behavior HP content within entry-level curricula of international PT programs. The sampling frame included 258 accredited PT academic programs spanning six countries. An internet-based survey was used to assess HP curricular content. Descriptive questions for HP topics (smoking cessation, nutrition, weight control, alcohol consumption, exercise, and stress management) included hours allotted and instructional methods used. Chi square tests examined differences between the proportion of programs in the United States (US) and other countries (combined) for HP topics, and among HP topics regarding instructional methods. The response rate was 48 %. Most programs (>80 %) included all HP topics except alcohol consumption (65.5 % of programs). Instructional methods used were primarily theory-based; few programs (range 2.6-24.1 %) combined theory, practical and attainment of clinical competency for all HP topics (exercise prescription notwithstanding). Proportionally, more US programs included alcohol and nutrition than other countries combined. Overall, HP lifestyle behavior topics were included to varying extent; however, instructional methods used and hours allotted per topic varied across PT curricula. Universal standards of HP practice as a clinical competency are warranted within the profession.
    Advances in Health Sciences Education 09/2012; 18(4). DOI:10.1007/s10459-012-9404-x · 2.12 Impact Factor
  • Source
    • "Nevertheless, given that their curricula were the same, the greater improvement in the intervention group may be due to our intervention. This improvement agrees with data reported by other authors (Rapp et al., 2006; Sejr and Osler, 2002; Sheffer et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: To examine the effectiveness of a tobacco control course on the improvement of knowledge, attitudes and beliefs about smoking among health sciences' students. METHODS: This was a quasi-experimental study of community intervention carried out during the years 2005-2008, at 2 university health science centres in northwest Spain. A total of 290 students on the intervention and 256 on the control campus took part in the study. The intervention consisted of a course on the prevention and control of tobacco use offered only on the intervention campus. Data were collected before the intervention and 6months afterwards. RESULTS: After the course, significant differences between groups were observed in the improvement of knowledge, attitudes and perceived ability to act in tobacco control. CONCLUSIONS: The introduction of training concerning smoking through active methodologies had a positive impact on the knowledge, attitudes and beliefs about tobacco of students.
    Nurse education today 12/2011; 32(8). DOI:10.1016/j.nedt.2011.11.007 · 1.36 Impact Factor
  • Source
    • "Pre-training assessment instrument—The pre-training assessment instrument was a 23-item, 2-page questionnaire that has been described elsewhere (Sheffer et al. 2009). Similar to the work of Pbert (2003), Applegate et al. (2008) and Crews et al (2008), the questionnaire gathered information about provider gender; ethnicity/race; tobacco use history (8-items); frequency with which providers followed the PHS Guidelines; frequency of seeing the effects of tobacco use on the health of patients; level of pro-activity in addressing tobacco use; and perceived success in helping patients stop using tobacco. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper is a report of a study conducted to examine the effects of a brief training in the treatment of tobacco use and dependence on the tobacco use intervention-related knowledge and attitudes of nurses.   Nurses are the largest group of healthcare providers and they have an extended reach into the population of tobacco users. Thus, increasing the number of nurses who deliver brief evidence-based interventions for tobacco use and dependence, such as that prescribed by the Public Health Service Clinical Practice Guideline in the United States of America, is likely to expose more tobacco users to evidence-based treatments and lead to more successful quit attempts. Effective training is key to improving provider proficiency in delivering evidence-based interventions for tobacco use and dependence.   A 1-hour didactic training was delivered to 359 nurses from 2006 to 2007, including 54 Advanced Practice Nurses, 250 Registered Nurses and 55 Licensed Practical Nurses. Pre- and post-training tests assessed attitudes, knowledge and behaviours. Paired samples t-tests were used to compare pre- and post-test results.   Statistically significant increases on nearly all measures were achieved, with Registered Nurses and Licensed Practical Nurses realizing the largest gains.   Given the overwhelming impact of tobacco use on patients, all nurses should be provided with training in the delivery of brief, evidence-based interventions for tobacco use. As the most trusted healthcare provider group with an extended reach into the tobacco using population, nurses have a large potential impact on the prevalence of tobacco use.
    Journal of Advanced Nursing 10/2010; 67(1):176-83. DOI:10.1111/j.1365-2648.2010.05483.x · 1.74 Impact Factor
Show more