The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72708

Mary Frazier, MD, MPH and Daniel Blumenthal, MD, MPH. Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, 404 752-1626, fraziem@msm.edu

OBJECTIVE: To increase the frequency and quality of tobacco control services delivered by primary care providers who serve low-income communities and African Americans. PROBLEM: Only 20 percent of the 70 percent of smokers who visit their physician receive advice to quit smoking. Ethnic and racial minorities are less likely to receive advice to quit smoking. METHODS: Through a series of five focus groups among African American physicians and Community Health Center providers, barriers experienced by providers when attempting to conduct tobacco cessation counseling were identified. Primary care providers and support staff identified barriers encountered by their patients when utilizing tobacco cessation resources or recommendations. Clinicians and support staff discussed preferences for recruiting practices to participate in a tobacco control program. RESULTS: Time constraints, language barriers, noncompliance with follow-up appointments, and lack of culturally appropriate patient-educational resources limited the provider’s ability to conduct tobacco cessation counseling. Patient-centered barriers to tobacco cessation included the lack of readiness to change, a lack of awareness of health risks, cost of pharmacotherapy, a low literacy rate, and competing social and medical demands. Monetary incentives, continuing medical education credits, and access to patient-educational resources were desirable recruitment strategies. CONCLUSION: Data from these focus groups can be used to tailor a tobacco cessation protocol for implementation among African American private practice physicians and Community Health Center providers. The curriculum would be designed to increase the adoption of the Agency for Healthcare and Quality Smoking Cessation Practice Guideline among providers that serve medically underserved communities.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to:
• 1. List four barriers that reduce the delivery of tobacco cessation counseling by providers of medically underserved communities.
• 2. Identify five barriers that providers report are obstacles for their low income patients and minority patients to accessing tobacco cessation resources
• 3. Discuss provider-generated recommendations for recruiting primary care practices to enroll a tobacco control study.

Keywords: Smoking Cessation, Minority Health

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.