Document Detail


Cardiology Rx for Change: Improving Clinical Attention to Tobacco Use and Secondhand Smoke Exposure in Cardiology.
MedLine Citation:
PMID:  21987417     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Heart disease is the leading cause of tobacco-related death in smokers and of deaths due to secondhand smoke (SHS) exposure in nonsmokers. This study centers on the development and evaluation of an evidence-based model curriculum for improving clinical attention to tobacco use and SHS exposure in cardiology. HYPOTHESIS: We hypothesized that the curriculum would be associated with improvements in clinician tobacco-related knowledge, attitudes, confidence, and counseling behaviors from pre-to post-training and at the 3-month follow-up. METHODS: The 1-hour Cardiology Rx for Change curriculum was evaluated with 22 cardiology fellows and 77 medical residents with consistent training effects observed between the 2 groups. RESULTS: Trainees' tobacco treatment knowledge increased significantly from pre- to post-training (t[81] = 6.51, P<0.001), and perceived barriers to providing cessation treatment decreased significantly (t[81] = -3.97, P<0.001). The changes, however, were not sustained at the 3-month follow-up, suggesting the need for booster training efforts. From pretraining to 3-month follow-up, the training was associated with significant sustained gains in clinician confidence for treating tobacco dependence (t[61] = 3.69, P = 0.001) and with improvements in clinicians assessing patients' readiness to quit smoking (from 61% to 79%, t[59] = 3.69,P<0.001) and providing assistance with quitting (from 47% to 59%, t[59] = 2.12, P = 0.038). Asking patients about tobacco use, advising cessation, and arranging follow-up also increased over time, but not significantly. All participants (100%) recommended the curriculum for dissemination to other training programs. CONCLUSIONS: Available online via http://rxforchange.ucsf.edu, Cardiology Rx for Change offers a packaged training tool for improving treatment of tobacco use and SHS exposure in cardiology care. © 2011 Wiley Periodicals, Inc. This work was supported by the Flight Attendant Medical Research Institute (FAMRI) William Cahan Distinguished Professor Award (PI: W. Grossman), and the State of California Tobacco-Related Disease Research Program (# 17RT-0077, PI: J.J. Prochaska). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Authors:
Judith J Prochaska; Neal L Benowitz; Stanton A Glantz; Karen Suchanek Hudmon; William Grossman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-10
Journal Detail:
Title:  Clinical cardiology     Volume:  -     ISSN:  1932-8737     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Center for Tobacco Control, Research, and Education; Department of Psychiatry. jprochaska@ucsf.edu.
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