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Implementing Tobacco Use Treatment Guidelines in Public Health Dental Clinics in New York City
Author(s) -
Shelley Donna,
Anno Jaime,
Tseng TuoYen,
Calip Greg,
Wedeles John,
Lloyd Madeleine,
Wolff Mark S.
Publication year - 2011
Publication title -
journal of dental education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.53
H-Index - 68
eISSN - 1930-7837
pISSN - 0022-0337
DOI - 10.1002/j.0022-0337.2011.75.4.tb05076.x
Subject(s) - medicine , nicotine replacement therapy , audit , referral , family medicine , intervention (counseling) , public health , guideline , test (biology) , smoking cessation , nursing , paleontology , management , pathology , economics , biology
In this study we evaluated the effect of a multicomponent intervention to implement the Public Health Service (PHS) guideline Treating Tobacco Use and Dependence in six randomly selected dental clinics in New York University's College of Dentistry. The main outcome measure—provider adherence to tobacco use treatment guidelines—was assessed by auditing a random selection of patient charts pre (698) and post (641) intervention. The intervention components included a chart reminder and referral system, free nicotine replacement therapy (NRT), and provider training and feedback. The results showed that rates of screening for tobacco use did not change between pre and post test chart audits. However, providers were significantly more likely to offer advice (28.4 percent pre, 49 percent post), assess readiness to quit (17.8 percent pre, 29.9 percent post), and offer assistance (6.5 percent pre and 15.6 percent post) in the post test period. Increases in NRT distribution were associated with booster training sessions but declined in the time periods between those trainings. Research is needed to further define sustainable strategies for implementing tobacco use treatment in dental clinics. The results of this study suggest the feasibility and effectiveness of using a tailored multicomponent approach to implement tobacco use treatment guidelines in dental clinics.