Implementing a Staff-Led Smoking Cessation Intervention in a Diverse Safety-Net Rheumatology Clinic: A Pre-Post Scalability Study in a Low-Resource Setting.

Autor: Brandt J; Emory University School of Medicine and Grady Health System, Atlanta, Georgia., Ramly E; University of Wisconsin School of Medicine and Public Health and University of Wisconsin College of Engineering, Madison.; Indiana University School of Public Health, Bloomington, Indiana., Lim SS; Emory University School of Medicine and Grady Health System, Atlanta, Georgia., Bao G; Emory University School of Medicine, Atlanta, Georgia., Messina ML; University of Wisconsin College of Engineering, Madison., Piper ME; UW Center for Tobacco Research and Intervention, Madison, Wisconsin., Bartels CM; University of Wisconsin College of Engineering, Madison.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2024 Sep; Vol. 76 (9), pp. 1342-1350. Date of Electronic Publication: 2024 Jun 03.
DOI: 10.1002/acr.25349
Abstrakt: Objective: Quit Connect (QC), our specialty clinic smoking cessation intervention, supports clinic staff to check, advise, and connect willing patients to a state quit line or class. QC improved tobacco screening and quit line referrals 26-fold in a predominantly White academic health care system population. Implementing QC includes education, electronic health record (EHR) reminders, and periodic audit feedback. This study tested QC's feasibility and impact in a safety-net rheumatology clinic with a predominantly Black population.
Methods: In this pre-post study, adult rheumatology visits were analyzed 12 months before through 18 months after QC intervention (November 2019 through November 2021, omitting COVID-19 peak April through November 2020). EHR data compared process and clinical outcomes, including offers, referrals to resources, completed referrals, and documented cessation. Clinic staff engaged in pre-post focus groups and questionnaires regarding intervention feasibility and acceptability. Cost-effectiveness was also assessed.
Results: Visit-level patients who smoked were 89.8% Black and 69.5% women (n = 550). Before intervention, clinic staff rarely asked patients about readiness to cut back smoking (<10% assessment). After QC intervention, staff assessed quit readiness in 31.8% of visits with patients who smoked (vs 8.1% before); 58.9% of these patients endorsed readiness to cut back or quit. Of 102 accepting cessation services, 37% (n = 17) of those reached set a quit date. Staff found the intervention feasible and acceptable. Each quit attempt cost approximately $4 to $10.
Conclusion: In a safety-net rheumatology clinic with a predominantly Black population, QC improved tobacco screening, readiness-to-quit assessment, and referrals and was also feasible and cost-effective.
(© 2024 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE
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