Longitudinal Analysis of Website Utilization for an Interprofessional Shared Tobacco Cessation Curriculum (Preprint)

BACKGROUND Because tobacco use is a major cause of morbidity and mortality worldwide, it is essential to prepare healthcare providers to assist patients with quitting smoking. The Rx for Change shared curriculum created in 1999 fills an educational gap in tobacco cessation training in health professional schools of all disciplines. In 2004, a website was launched to host teaching materials and tools for educators and clinicians. OBJECTIVE The objective of this study was to characterize users and utilization of a website hosting shared teaching materials over a period of 15 years. METHODS Data from the Rx for Change website have been collected prospectively since its launch. In this study, end-user data were analyzed to determine user characteristics, how they heard about the website, intended use of the materials, and number of file downloads and logins over time. RESULTS Total number of website registrants was 15,576, representing all 50 states and 94 countries. The most represented discipline was pharmacy (41.2%), and nearly half of users were students or residents. The most common source of referral to the website was a faculty member or colleague (33.4%), and the purpose of enhancing personal knowledge and skills was the most commonly cited intended use of the curricular materials. A total of 259,835 file downloads occurred during the 15-year period, and the most commonly downloaded file type was ancillary handouts. CONCLUSIONS The Rx for Change website demonstrated sustained use, providing immediate access to tobacco cessation teaching and practice tools for educators and clinicians over the first 15 years of its existence. The website had a broad interprofessional reach, which increases the likelihood of smokers receiving assistance from multiple types of health care providers. The consistent utilization over time and large number of downloads, provided evidence for the feasibility and impact of a public access website hosting a shared tobacco cessation curriculum for health professionals.

Realist evaluation for programs and services in the health area: an integrative review of the theoretical and methodological literature

Objective: to identify and analyze the concepts of the realist evaluation and the methodologies recommended for its development in the health area. Method: an integrative review, which included theoretical and methodological studies published in the following databases: COCHRANE Library, EVIPNet, Health Systems Evidence, LILACS, PDQ-Evidence, PubMed, Rx for Change, and SciELO, in addition to Teses-CAPES and Google Scholar, for the gray literature. The mediation category underlay the analysis. Results: 19 references were included, published between 1997 and 2018. It is an innovative proposal to direct the process of evaluating health programs, interventions, and/or policies, with the democratic participation of the parties involved, such as users, workers, managers and researchers; it proposes to elaborate theories about what works, for whom, in what context, and how. The mediation category indicated the need for these theories not to be restricted to the micro-context, but to incorporate the elements of the social macro-structure to which they are connected. Conclusion: It is indicated that the realist evaluation is to be conducted in 21 stages. It takes into account qualitative and procedural methods, which makes it powerful for understanding human and social relationships in the context analyzed. Theories that come from evaluating the functioning of the programs analyzed have greater explanatory chances if they are built by reference to the social totality.

Impact of a Shared Tobacco Cessation Curriculum in California Schools of Pharmacy

Purpose: To characterize the long-term impact of a shared, evidence-based tobacco cessation curriculum (Rx for Change) on tobacco-related education in California schools of pharmacy (n=8). Methods: Faculty members responsible for teaching tobacco-related content completed a survey assessing implementation of tobacco education, curricular time devoted to tobacco, and teaching and assessment methods utilized. Using historical data, the total number of students trained since 2000 was estimated. Results: All schools utilized the shared curriculum, and in 2012–2013, a median of 435 minutes (range: 240–600 minutes) was devoted to tobacco-related content within required curricula. Between 2000 and 2013, an estimated 10,616 pharmacy students in California received Rx for Change training. Conclusion: After more than a decade, a shared tobacco cessation curriculum continues to be widely utilized and provides a strong foundation for legislative efforts to enhance pharmacists' scope of practice related to prescriptive authority for tobacco cessation.

Evaluation of a Tobacco Cessation Curricular Intervention Among Acute Care Nurse Practitioner Faculty Members

Background In 2002, a report indicated that tobacco-related curricular content in educational programs for acute care nurse practitioners was insufficient. To provide healthcare professionals with the necessary knowledge and skills to intervene with patients who smoke tobacco, the Summer Institute for Tobacco Control Practices in Nursing Education was implemented at Georgetown University in Washington, DC. Objective To evaluate the impact of a train-the-trainer program in which the Rx for Change: Clinician-Assisted Tobacco Cessation curriculum was used among faculty members of acute care nurse practitioner programs. Methods Thirty faculty members participated in the 2-day train-the-trainer program. Surveys were administered at baseline and 12 months after training to examine perceived effectiveness for teaching tobacco content, the value of using an evidence-based national guideline, and the number of hours of tobacco content integrated in curricula. Results The percentage of faculty members who devoted at least 3 hours to tobacco education increased from 22.2% to 74.1% (P<.001). Perceived effectiveness in teaching tobacco cessation also increased (P < .001), as did mean scores for the perceived value of using an evidence-based national guideline (P<.001). Conclusions Use of the Rx for Change train-the-trainer program can enhance the level of tobacco education provided in acute care nurse practitioner programs. Widespread adoption of an evidence-based tobacco education in nursing curricula is recommended to help decrease tobacco-related morbidity and mortality.