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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Theresa Benincasa, PhD, Health Studies, Temple University, 4405 Mariner Lane, Fairfax, VA 22033, 703-815-1049, benincasa@compuserve.com
There is a performance gap between recommendations for smoking cessation services in primary care medical settings and actual practice. The Year 2000 Health Objectives for the Nation encourage physicians to advise their smoking patients to quit and to offer them support materials and assistance. Nonetheless, the opportunity to intervene with smokers in the primary care environment is routinely missed. This study assessed how the perceptions of physicians and office staff relate to implementation of a smoking cessation program. A multitheoretical approach studied the medical practice as organization and the smoking cessation program as an innovation. This study performed a primary analysis of process data previously collected from an NCI-funded randomized trial of a smoking cessation intervention in primary care medical practices. Cross-sectional survey data from physicians and office coordinators in the 23 medical practices were used to correlate the perceptions of the smoking cessation program with achievement of the implementation objectives. Triangulation of quantitative and qualitative data increased understanding of how the independent variables affected implementation outcomes. Patient enrollment rates in the program were higher in practices where staff members perceived fewer patient- and staff-related barriers. Rates were also higher where staff members perceived greater management support. Intervention delivery was more extensive in practices where physicians perceived the innovation more positively. National guidelines for practice-based smoking cessation programs do not adequately address the dynamic process of implementation. Improved implementation can result by embracing a more theoretically based model of the organization and the perceptions of its workers.
Learning Objectives: Participants will be able to
Keywords: Smoking Cessation, Primary Care
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.