scholarly journals An economic evaluation of a computer-tailored e-learning program to promote smoking cessation counseling guideline adherence among practice nurses

2019 ◽  
Vol 102 (10) ◽  
pp. 1802-1811 ◽  
Author(s):  
Dennis de Ruijter ◽  
Ciska Hoving ◽  
Silvia Evers ◽  
Raesita Hudales ◽  
Hein de Vries ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Economic Evaluation ◽  
Guideline Adherence ◽  
Learning Program ◽  
Smoking Cessation Counseling ◽  
Practice Nurses ◽  
Promote Smoking Cessation ◽  
E Learning

An economic evaluation of a computer-tailored e-learning program to promote smoking cessation counseling guideline adherence among practice nurses (Preprint)

2018 ◽  
Author(s):  
Dennis de Ruijter ◽  
Ciska Hoving ◽  
Silvia Evers ◽  
Raesita Hudales ◽  
Hein de Vries ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Guideline Adherence ◽  
Cost Utility ◽  
Learning Program ◽  
Smoking Cessation Counseling ◽  
Practice Nurses ◽  
Patient Level ◽  
E Learning

BACKGROUND To date, no evidence is available about the cost-effectiveness of digital support programs to improve smoking cessation care by healthcare professionals in primary care. OBJECTIVE To conduct an economic evaluation of a tailored e-learning program, which successfully improved practice nurses’ smoking cessation guideline adherence, from a societal perspective. METHODS The economic evaluation was embedded in a randomized controlled trial, in which 269 practice nurses recruited 388 smoking patients. Cost-effectiveness was assessed using guideline adherence as effect measure on practice nurse level, and continued smoking abstinence on patient level. Cost-utility was assessed on patient level, using patients’ Quality Adjusted Life Years (QALYs) as effect measure. RESULTS The e-learning program was likely to be cost-effective on practice nurse level, as adherence to an additional guideline step cost €1,586. On patient level, cost-effectiveness was slightly likely after six months (cost per additional quitter: €7,126), but not after twelve months. The cost-utility analysis revealed slight cost-effectiveness (cost per QALY gained: €18,431) on patient level. CONCLUSIONS Providing practice nurses with a tailored e-learning program is cost-effective to improve their smoking cessation counseling. Cost-effectiveness on patient level was not found, which may result from smoking relapse. Widespread implementation of the e-learning program can improve the quality of smoking cessation care in general practice. Strategies to prevent patients’ smoking relapse should be further explored to improve patients’ long-term abstinence. CLINICALTRIAL Dutch Trial Register NTR4436; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4436. (Archived by WebCite at http://www.webcitation.org/6zJQuSRq0)

scholarly journals Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries

2020 ◽  
Author(s):  
Ana Vides-Porras ◽  
Paula Cáceres ◽  
Assumpta Company ◽  
Olga Guillen ◽  
Martha Alicia Arrien ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Latin American ◽  
Tobacco Consumption ◽  
Evaluation Study ◽  
Continuous Medical Education ◽  
Learning Program ◽  
Middle Income ◽  
Technical Problems ◽  
Promote Smoking Cessation ◽  
E Learning

Abstract Continuous medical education focused on health problems emerging in low- and middle-income countries (LMICs) is scarce. Although tobacco consumption is increasing in LMICs, there is a lack of tobacco cessation training programs in these countries. To promote smoking cessation interventions in Bolivia, Guatemala and Paraguay, we adapted an e-learning program developed in Catalonia (Spain). This process evaluation study reports on reach, dose and satisfaction of participants with the course, as well as the contextual factors of its application. We conducted a multiple method evaluation, which included a survey and several focus groups, each one specific to the same type of healthcare professional (nurses, doctors, other professionals). Two hundred and ninety-two participants registered into the online course. The motivation for undertaking the course was different between doctors and nurses. The main sources of difficulty in enrolling and finishing the course were the technical problems experienced when accessing the platform, and lack of acquaintance with computers and the Internet in general. Our results show that implementing e-learning education in hospitals from LMICs is feasible, especially when there are similarities between participating countries and the country in which the original program was developed. However, several elements such as strong organizational commitment, technical support and resources and adequate communication channels should be provided to facilitate enrollment and training completion. Efforts to improve Internet access should be made to avoid jeopardizing students’ motivation to enroll and complete online training.

scholarly journals The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Dennis de Ruijter ◽  
Math Candel ◽  
Eline Suzanne Smit ◽  
Hein de Vries ◽  
Ciska Hoving
Keyword(s):  
Smoking Cessation ◽  
Guideline Adherence ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Learning Program ◽  
Related Factors ◽  
Counseling Experience ◽  
Behavioral Predictors ◽  
E Learning

BACKGROUND Improving practice nurses’ (PN) adherence to smoking cessation counseling guidelines will benefit the quality of smoking cessation care and will potentially lead to higher smoking abstinence rates. However, support programs to aid PNs in improving their guideline uptake and adherence do not exist yet. OBJECTIVE The aim of this study was to assess the effects of a novel computer-tailored electronic learning (e-learning) program on PNs’ smoking cessation guideline adherence. METHODS A Web-based randomized controlled trial (RCT) was conducted in which an intervention group (N=147) with full access to the e-learning program for 6 months was compared with a control group (N=122) without access. Data collection was fully automated at baseline and 6-month follow-up via online questionnaires, assessing PNs’ demographics, work-related factors, potential behavioral predictors based on the I-Change model, and guideline adherence. PNs also completed counseling checklists to retrieve self-reported counseling activities for each consultation with a smoker (N=1175). To assess the program’s effectiveness in improving PNs’ guideline adherence (ie, overall adherence and adherence to individual counseling guideline steps), mixed linear and logistic regression analyses were conducted, thus accommodating for the smokers being nested within PNs. Potential effect moderation by work-related factors and behavioral predictors was also examined. RESULTS After 6 months, 121 PNs in the intervention group (82.3%, 121/147) and 103 in the control group (84.4%, 103/122) completed the follow-up questionnaire. Mixed linear regression analysis revealed that counseling experience moderated the program’s effect on PNs’ overall guideline adherence (beta=.589; 95% CI 0.111-1.068; PHolm-Bonferroni =.048), indicating a positive program effect on adherence for PNs with a more than average level of counseling experience. Mixed logistic regression analyses regarding adherence to individual guideline steps revealed a trend toward moderating effects of baseline levels of behavioral predictors and counseling experience. More specifically, for PNs with less favorable scores on behavioral predictors (eg, low baseline self-efficacy) and high levels of counseling experience, the program significantly increased adherence. CONCLUSIONS Results from our RCT showed that among PNs with more than average counseling experience, the e-learning program resulted in significantly better smoking cessation guideline adherence. Experienced PNs might have been better able to translate the content of our e-learning program into practically applicable counseling strategies compared with less experienced colleagues. Less favorable baseline levels of behavioral predictors among PNs possibly contributed to this effect, as there was more room for improvement by consulting the tailored content of the e-learning program. To further substantiate the effectiveness of e-learning programs on guideline adherence by health care professionals (HCPs), it is important to assess how to support a wider range of HCPs. CLINICALTRIAL Netherlands Trial Register NTR4436; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4436 (Archived by WebCite at http://www.webcitation.org/6zJQuSRq0)

Evaluation of a Web-Based Training in Smoking Cessation Counseling Targeting U.S. Eye-Care Professionals

2017 ◽  
Vol 45 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Taghrid Asfar ◽  
David J. Lee ◽  
Byron L. Lam ◽  
Ann P. Murchison ◽  
Eileen L. Mayro ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Participation Rate ◽  
Care Providers ◽  
Eye Care ◽  
Smoking Cessation Counseling ◽  
Web Based ◽  
Quit Smoking ◽  
Promote Smoking Cessation ◽  
Counseling Practices

Background. Smoking causes blindness-related diseases. Eye-care providers are uniquely positioned to help their patients quit smoking. Aims. Using a pre-/postevaluation design, this study evaluated a web-based training in smoking cessation counseling targeting eye-care providers. Method. The training was developed based on the 3A1R protocol: “Ask about smoking, Advise to quit, Assess willingness to quit, and Refer to tobacco quitlines,” and made available in the form of a web-based video presentation. Providers ( n = 654) at four academic centers were invited to participate. Participants completed pretraining, posttraining, and 3-month follow-up surveys. Main outcomes were self-reported improvement in their motivation, confidence, and counseling practices at 3-month follow-up. Generalized linear mixed models for two time-points (pretraining and 3-month) were conducted for these outcomes. Results. A total of 113 providers (54.0% males) participated in the study (17.7% response rate). At the 3-month evaluation, 9.8% of participants reported improvement in their motivation. With respect to the 3A1R, 8% reported improvement in their confidence for Ask, 15.5% for Advise, 28.6% for Assess, and 37.8% for Refer. Similarly, 25.5% reported improvement in their practices for Ask, 25.5% for Advise, 37.2% for Assess, and 39.4% for Refer to tobacco quitlines ( p < .001 for all except for Refer confidence p = .05). Discussion. Although participation rate was low, the program effectively improved providers’ smoking cessation counseling practices. Conclusions. Including training in smoking cessation counseling in ophthalmology curriculums, and integrating the 3A1R protocol into the electronic medical records systems in eye-care settings, might promote smoking cessation practices in these settings.

scholarly journals Patient–Physician Discussions on Lung Cancer Screening: A Missed Teachable Moment to Promote Smoking Cessation

2018 ◽  
Vol 22 (3) ◽  
pp. 431-439 ◽  
Author(s):  
Hasmeena Kathuria ◽  
Elisa Koppelman ◽  
Belinda Borrelli ◽  
Christopher G Slatore ◽  
Jack A Clark ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Treatment Programs ◽  
Teachable Moment ◽  
Smoking Cessation Counseling ◽  
Tobacco Treatment ◽  
Physician Perspectives ◽  
Promote Smoking Cessation

Abstract Introduction Little is known about whether patients and physicians perceive lung cancer screening (LCS) as a teachable moment to promote smoking cessation or the degree to which physicians in “real world” settings link LCS discussions with smoking cessation counseling. We sought to characterize patient and physician perspectives of discussions about smoking cessation during LCS. Methods We conducted a qualitative study (interviews and focus groups) with 21 physicians and 28 smokers screened in four diverse hospitals. Transcripts were analyzed for characteristics of communication about smoking cessation and LCS, the perceived effect on motivation to quit smoking, the degree to which physicians leverage LCS as a teachable moment to promote smoking cessation, and suggestions to improve patient–physician communication about smoking cessation in the context of LCS. Results Patients reported that LCS made them more cognizant of the health consequences of smoking, priming them for a teachable moment. While physicians and patients both acknowledged that smoking cessation counseling was frequent, they described little connection between their discussions regarding LCS and smoking cessation counseling. Physicians identified several barriers to integrating discussions on smoking cessation and LCS. They volunteered communication strategies by which LCS could be leveraged to promote smoking cessation. Conclusions LCS highlights the harms of smoking to patients who are chronic, heavy smokers and thus may serve as a teachable moment for promoting smoking cessation. However, this opportunity is typically missed in clinical practice. Implications LCS highlights the harms of smoking to heavily addicted smokers. Yet both physicians and patients reported little connection between LCS and tobacco treatment discussions due to multiple barriers. On-site tobacco treatment programs and post-screening messaging tailored to the LCS results are needed to maximize the health outcomes of LCS, including smoking quit rates and longer-term smoking-related morbidity and mortality.

scholarly journals Maintenance of Smoking Cessation in Korean Single Mothers

2020 ◽  
Author(s):  
Mi-Ji Lee ◽  
Kang-Sook Lee
Keyword(s):  
Smoking Cessation ◽  
South Korea ◽  
Single Mothers ◽  
Smoking Cessation Counseling ◽  
Quit Smoking ◽  
Smoking Cessation Services ◽  
Promote Smoking Cessation ◽  
Pregnancy Status ◽  
Exhaled Carbon Monoxide ◽  
Sources Of Support

Abstract Background: Single mothers in South Korea are vulnerable to developing smoking habits, due to many difficulties and limitations; however, they have often been overlooked by smoking cessation support services. Therefore, this study aimed to investigate the demographic and smoking-related characteristics of single mothers registered with the Seeking Smoking Cessation Services Program in Seoul, South Korea, to identify factors associated with smoking cessation maintenance at 4, 6, 12, and 24 weeks after the they initially quit smoking.Methods: The participants were 77 single mothers registered at the Seeking Smoking Cessation Services Program. Data were included from a three-year span (January 2017 to December 2019). Smoking cessation counseling, motivational enhancement, and self-exploration counseling were provided for six months. The participants were evaluated on their smoking cessation status at 4, 6, 12, and 24 weeks.Results: Most participants were aged 22 years or younger. The rates of smoking cessation maintenance were 58.4%, 39%, 28%, and 18% at 4, 6, 12, and 24 weeks, respectively. The rate of smoking cessation maintenance increased as the number of counseling sessions attended increased. Smoking cessation maintenance was also significantly associated with pregnancy status, exhaled carbon monoxide level, and drinking. Conclusion: A counseling program to effectively promote smoking cessation and enhance motivation to maintain smoking cessation should be developed and provided to single mothers. Smoking cessation counselors have an important role as sources of support for those who want to quit smoking, and should aim to reduce the rate of smoking among single mothers by providing them with consistent counseling.

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