Dissemination of the AHCPR clinical practice guideline in community health centres

J. D. DePue, M. G. Goldstein, A. Schilling, P. Reiss, G. Papandonatos, C. Sciamanna, A. Kazura

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: To evaluate dissemination of the Agency for Health Care Policy and Research (AHCPR) Smoking cessation clinical practice guideline in community health centres. Design: Pre- and post-trial. Setting: Fourteen community health centres in Rhode Island. Subjects: Provider performance was assessed with 1798 and 1591 patient contacts, in pre-post cross sectional consecutive samples, respectively, and 891 contacts at one year follow up. Interventions: Three, one hour on-site provider training sessions, on review of effective tobacco interventions, use of office systems, and tobacco counselling skill building. Outcome measures: Chart documentation of four A's (Ask, Advise, Assist, and Arrange follow up) at most recent primary care visit. Results: While average performance rates increased for Ask and Advise (from 30% to 44%, and 19% to 26%, pre-post, respectively), significant increases were found only for some visit types, with further differences by patient sex. There were significant increases for Ask for all except obstetric/ gynaecological (ob/gyn) visit types. Patients at yearly physicals and first visits were more likely to be asked at all time points, while males were more likely to be asked at acute visits than were females. There were no significant increases for Advise, Assist, and Arrange across time, although female patients showed a differential increase in Advise post-training. Advise was significantly more likely in yearly physicals and first visits, and less likely in ob/gyn visits, at all time points. Conclusions: This guideline dissemination effort resulted in quite different provider counselling rates across patient sexes, and visit types. Guideline implementation may require more sustained efforts, with multiple strategies, which are reinforced at higher policy levels, to more fully integrate tobacco interventions into routine primary care practice with all patients who smoke.

Original languageEnglish (US)
Pages (from-to)329-335
Number of pages7
JournalTobacco Control
Volume11
Issue number4
DOIs
StatePublished - Jan 1 2002

Fingerprint

United States Agency for Healthcare Research and Quality
Community Health Centers
Practice Guidelines
nicotine
obstetrics
health care
counseling
health
contact
community
Obstetrics
Tobacco
performance
documentation
Counseling
smoking
Primary Health Care
Guidelines
Tobacco Use
Smoking Cessation

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Public Health, Environmental and Occupational Health

Cite this

DePue, J. D., Goldstein, M. G., Schilling, A., Reiss, P., Papandonatos, G., Sciamanna, C., & Kazura, A. (2002). Dissemination of the AHCPR clinical practice guideline in community health centres. Tobacco Control, 11(4), 329-335. https://doi.org/10.1136/tc.11.4.329
DePue, J. D. ; Goldstein, M. G. ; Schilling, A. ; Reiss, P. ; Papandonatos, G. ; Sciamanna, C. ; Kazura, A. / Dissemination of the AHCPR clinical practice guideline in community health centres. In: Tobacco Control. 2002 ; Vol. 11, No. 4. pp. 329-335.
@article{6c647018fecd4a95bf86efb0e1d895a5,
title = "Dissemination of the AHCPR clinical practice guideline in community health centres",
abstract = "Objective: To evaluate dissemination of the Agency for Health Care Policy and Research (AHCPR) Smoking cessation clinical practice guideline in community health centres. Design: Pre- and post-trial. Setting: Fourteen community health centres in Rhode Island. Subjects: Provider performance was assessed with 1798 and 1591 patient contacts, in pre-post cross sectional consecutive samples, respectively, and 891 contacts at one year follow up. Interventions: Three, one hour on-site provider training sessions, on review of effective tobacco interventions, use of office systems, and tobacco counselling skill building. Outcome measures: Chart documentation of four A's (Ask, Advise, Assist, and Arrange follow up) at most recent primary care visit. Results: While average performance rates increased for Ask and Advise (from 30{\%} to 44{\%}, and 19{\%} to 26{\%}, pre-post, respectively), significant increases were found only for some visit types, with further differences by patient sex. There were significant increases for Ask for all except obstetric/ gynaecological (ob/gyn) visit types. Patients at yearly physicals and first visits were more likely to be asked at all time points, while males were more likely to be asked at acute visits than were females. There were no significant increases for Advise, Assist, and Arrange across time, although female patients showed a differential increase in Advise post-training. Advise was significantly more likely in yearly physicals and first visits, and less likely in ob/gyn visits, at all time points. Conclusions: This guideline dissemination effort resulted in quite different provider counselling rates across patient sexes, and visit types. Guideline implementation may require more sustained efforts, with multiple strategies, which are reinforced at higher policy levels, to more fully integrate tobacco interventions into routine primary care practice with all patients who smoke.",
author = "DePue, {J. D.} and Goldstein, {M. G.} and A. Schilling and P. Reiss and G. Papandonatos and C. Sciamanna and A. Kazura",
year = "2002",
month = "1",
day = "1",
doi = "10.1136/tc.11.4.329",
language = "English (US)",
volume = "11",
pages = "329--335",
journal = "Tobacco Control",
issn = "0964-4563",
publisher = "BMJ Publishing Group",
number = "4",

}

DePue, JD, Goldstein, MG, Schilling, A, Reiss, P, Papandonatos, G, Sciamanna, C & Kazura, A 2002, 'Dissemination of the AHCPR clinical practice guideline in community health centres', Tobacco Control, vol. 11, no. 4, pp. 329-335. https://doi.org/10.1136/tc.11.4.329

Dissemination of the AHCPR clinical practice guideline in community health centres. / DePue, J. D.; Goldstein, M. G.; Schilling, A.; Reiss, P.; Papandonatos, G.; Sciamanna, C.; Kazura, A.

In: Tobacco Control, Vol. 11, No. 4, 01.01.2002, p. 329-335.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dissemination of the AHCPR clinical practice guideline in community health centres

AU - DePue, J. D.

AU - Goldstein, M. G.

AU - Schilling, A.

AU - Reiss, P.

AU - Papandonatos, G.

AU - Sciamanna, C.

AU - Kazura, A.

PY - 2002/1/1

Y1 - 2002/1/1

N2 - Objective: To evaluate dissemination of the Agency for Health Care Policy and Research (AHCPR) Smoking cessation clinical practice guideline in community health centres. Design: Pre- and post-trial. Setting: Fourteen community health centres in Rhode Island. Subjects: Provider performance was assessed with 1798 and 1591 patient contacts, in pre-post cross sectional consecutive samples, respectively, and 891 contacts at one year follow up. Interventions: Three, one hour on-site provider training sessions, on review of effective tobacco interventions, use of office systems, and tobacco counselling skill building. Outcome measures: Chart documentation of four A's (Ask, Advise, Assist, and Arrange follow up) at most recent primary care visit. Results: While average performance rates increased for Ask and Advise (from 30% to 44%, and 19% to 26%, pre-post, respectively), significant increases were found only for some visit types, with further differences by patient sex. There were significant increases for Ask for all except obstetric/ gynaecological (ob/gyn) visit types. Patients at yearly physicals and first visits were more likely to be asked at all time points, while males were more likely to be asked at acute visits than were females. There were no significant increases for Advise, Assist, and Arrange across time, although female patients showed a differential increase in Advise post-training. Advise was significantly more likely in yearly physicals and first visits, and less likely in ob/gyn visits, at all time points. Conclusions: This guideline dissemination effort resulted in quite different provider counselling rates across patient sexes, and visit types. Guideline implementation may require more sustained efforts, with multiple strategies, which are reinforced at higher policy levels, to more fully integrate tobacco interventions into routine primary care practice with all patients who smoke.

AB - Objective: To evaluate dissemination of the Agency for Health Care Policy and Research (AHCPR) Smoking cessation clinical practice guideline in community health centres. Design: Pre- and post-trial. Setting: Fourteen community health centres in Rhode Island. Subjects: Provider performance was assessed with 1798 and 1591 patient contacts, in pre-post cross sectional consecutive samples, respectively, and 891 contacts at one year follow up. Interventions: Three, one hour on-site provider training sessions, on review of effective tobacco interventions, use of office systems, and tobacco counselling skill building. Outcome measures: Chart documentation of four A's (Ask, Advise, Assist, and Arrange follow up) at most recent primary care visit. Results: While average performance rates increased for Ask and Advise (from 30% to 44%, and 19% to 26%, pre-post, respectively), significant increases were found only for some visit types, with further differences by patient sex. There were significant increases for Ask for all except obstetric/ gynaecological (ob/gyn) visit types. Patients at yearly physicals and first visits were more likely to be asked at all time points, while males were more likely to be asked at acute visits than were females. There were no significant increases for Advise, Assist, and Arrange across time, although female patients showed a differential increase in Advise post-training. Advise was significantly more likely in yearly physicals and first visits, and less likely in ob/gyn visits, at all time points. Conclusions: This guideline dissemination effort resulted in quite different provider counselling rates across patient sexes, and visit types. Guideline implementation may require more sustained efforts, with multiple strategies, which are reinforced at higher policy levels, to more fully integrate tobacco interventions into routine primary care practice with all patients who smoke.

UR - http://www.scopus.com/inward/record.url?scp=0036887011&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036887011&partnerID=8YFLogxK

U2 - 10.1136/tc.11.4.329

DO - 10.1136/tc.11.4.329

M3 - Article

C2 - 12432158

AN - SCOPUS:0036887011

VL - 11

SP - 329

EP - 335

JO - Tobacco Control

JF - Tobacco Control

SN - 0964-4563

IS - 4

ER -

DePue JD, Goldstein MG, Schilling A, Reiss P, Papandonatos G, Sciamanna C et al. Dissemination of the AHCPR clinical practice guideline in community health centres. Tobacco Control. 2002 Jan 1;11(4):329-335. https://doi.org/10.1136/tc.11.4.329