The implementation of ask-advise-connect in a federally qualified health center: a mixed methods evaluation using the re-aim framework.

Autor:	Shorey Fennell B; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA., Cottrell-Daniels C; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA., Hoover DS; Hoover Editing, Asheville, NC, USA., Spears CA; Division of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA., Nguyen N; Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Piñeiro B; Centre d'Estudis Demogràfics, Universitat Autònoma de Barcelona, 08193 Bellaterra, Catalonia, Spain., McNeill LH; Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Wetter DW; Department of Population Health Sciences, Center for Health Outcomes and Population Equity, Huntsman Cancer Institute and the University of Utah, Salt Lake City, UT, USA., Vidrine DJ; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA., Vidrine JI; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
Jazyk:	angličtina
Zdroj:	Translational behavioral medicine [Transl Behav Med] 2023 Aug 11; Vol. 13 (8), pp. 551-560.
DOI:	10.1093/tbm/ibad007
Abstrakt:	Ask-Advise-Connect (AAC) efficiently links smokers in healthcare settings with evidence-based Quitline-delivered tobacco treatment through training clinic staff to systematically ask patients about smoking status, advise smokers to quit, and connect patients with state Quitlines using the electronic health record. This study utilized a mixed-methods approach, guided by the RE-AIM framework, to evaluate the implementation of AAC in a Federally Qualified Health Center (FQHC). AAC was implemented for 18 months at a FQHC serving primarily low-socioeconomic status (SES) Latinos and Latinas. Results are presented within the RE-AIM conceptual framework which includes dimensions of reach, effectiveness, adoption, implementation, and maintenance. Quantitative patient-level outcomes of reach, effectiveness, and Impact were calculated. Post-implementation, in-depth interviews were conducted with clinic leadership and staff (N = 9) to gather perceptions and inform future implementation efforts. During the implementation period, 12.0% of GNHC patients who reported current smoking both agreed to have their information sent to the Quitline and were successfully contacted by the Quitline (Reach), 94.8% of patients who spoke with the Quitline enrolled in treatment (Effectiveness), and 11.4% of all identified smokers enrolled in Quitline treatment (Impact). In post-implementation interviews assessing RE-AIM dimensions, clinic staff and leadership identified facilitators and advantages of AAC and reported that AAC was easy to learn and implement, streamlined existing procedures, and had a positive impact on patients. Staff and leadership reported enthusiasm about AAC implementation and believed AAC fit well in the clinic. Staff were interested in AAC becoming the standard of care and made suggestions for future implementation. Clinic staff at a FQHC serving primarily low-SES Latinos and Latinas viewed the ACC implementation process positively. Findings have implications for streamlining clinical smoking cessation procedures and the potential to reduce tobacco-related disparities. (© Society of Behavioral Medicine 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu