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APHA Scientific Session and Event Listing

Dorothy Hung, PhD, MA, MPH and Donna Shelley, MD, MPH. Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 W. 168th Street, Suite 526, New York, NY 10032, 212.342.0154, dh2237@columbia.edu

This research describes correlates of provider compliance with the “5A” Public Health Service guidelines. Additionally, the study will be the first to compare the impact of paper versus electronic chart systems on tobacco practice patterns. Surveys were conducted among healthcare providers from community clinics serving low-income, minority populations in NYC. Data collection is currently underway, with an estimated final study sample of approximately 1000 respondents. Preliminary results are based on a 90% response rate. Of surveyed providers, routine use of clinical systems was positively associated with ascertaining tobacco status (p<0.01). Belief that tobacco cessation is part of a provider's role, and beliefs regarding one's effectiveness and confidence in helping smokers quit were positively associated with asking about tobacco, advising smokers to quit, assessing readiness to quit (p<0.10), and prescribing pharmacotherapy (p<0.05). Knowledge of PHS guidelines was associated with increased prescription of tobacco pharmacotherapy and arrangement of follow-up (p<0.05). Compared to physicians, registered nurses were less likely to ask (p<0.001), advise (p<0.05), and assess tobacco status (p<0.05). However, nurses can aid more with initial 5As which may prompt and allow physicians more time to assist quit efforts. Final results from the full sample and comparisons of paper versus electronic chart systems will be presented. This research has important implications for reducing health disparities in tobacco use. Continued efforts are needed to disseminate guidelines and implement systems to improve tobacco treatment among high-risk populations. Findings also suggest restructuring provider roles and implementing a team approach to more effectively address tobacco use.

Learning Objectives: Readers will be able to

• articulate Public Health Service (PHS) clinical guidelines for tobacco identification and treatment;
• identify correlates of healthcare provider compliance with tobacco guidelines;
• discuss effects of paper versus electronic chart systems on tobacco practice patterns; and
• discuss roles and responsibilities of different types of providers in addressing tobacco use.

Keywords: Tobacco, Practice Guidelines

Presenting author's disclosure statement:

Not Answered