Internet Delivered Support for Tobacco Control in Dental Practice: Randomized Controlled Trial
Internet Delivered Support for Tobacco Control in Dental Practice: Randomized Controlled Trial
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DOI：
10.2196/jmir.1095
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发表时间：
2008-01-01
影响因子：
7.4
通讯作者：
Kiefe, Catarina I.
中科院分区：
文献类型：
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作者：
Houston, Thomas K.;Richman, Joshua S.;Kiefe, Catarina I.
背景：看牙医是控制烟草的一个独特机会。尽管有证据表明在牙科环境中有效，但提供者提供的简短戒烟建议并未得到充分利用。 目的：评估旨在加强提供者在牙科诊所中戒烟的简短建议的实施的互联网提供的干预措施。方法：牙科诊所 (N = 190) 被随机分配到干预网站或等待名单对照。干预前和 8 个月的随访后，每个诊所向 100 名患者分发退出卡（评估提供者表现的简短患者调查，在牙科就诊后立即完成）。根据这些退出卡，我们评估：是否向患者询问烟草使用情况（ASK），以及在烟草使用者中，是否建议他们戒烟（ADVISE）。所有带有后续提示退出卡数据的干预实践均进行随机分析，无论其是否参与互联网提供的干预。结果：在 190 个随机实践中，143 个 (75%) 牙科实践提供了后续数据。意向后干预实践的平均绩效在 ASK 上提高了 4%（29% 基线，调整后优势比 = 1.29 [95% CI 1.17-1.42]），在 ADVISE 上提高了 11%（44% 基线，OR = 1.55 [95% CI 1.28-1.87]）。 ASK 的控制措施提高了 3%（Adj. OR I. 18 [95% CI 1.07-1.29]），而 ADVISE 的控制措施没有显着改善。显着的按时间分组的交互效应表明，在研究期间，干预实践比 ADVISE 的对照实践改善更多（P = 0.042），但 ASK 则不然。结论：这种低强度、易于传播的干预措施成功地提高了提供者在戒烟建议方面的表现。
Background: The dental visit is a unique opportunity for tobacco control. Despite evidence of effectiveness in dental settings, brief provider-delivered cessation advice is underutilized.Objective: To evaluate an Internet-delivered intervention designed to increase implementation of brief provider advice for tobacco cessation in dental practice settings. Methods: Dental practices (N = 190) were randomized to the intervention website or wait-list control. Pre-intervention and after 8 months of follow-up, each practice distributed exit cards (brief patient surveys assessing provider performance, completed immediately after the dental visit) to 100 patients. Based on these exit cards, we assessed: whether patients were asked about tobacco use (ASK) and, among tobacco users, whether they were advised to quit tobacco (ADVISE). All intervention practices with follow-tip exit card data were analyzed as randomized regardless of whether they participated in the Internet-delivered intervention.Results: Of the 190 practices randomized, 143 (75%) dental practices provided follow-up data. Intervention practices' mean performance improved post-intenention by 4% on ASK (29% baseline, adjusted odds ratio = 1.29 [95% CI 1.17-1.42]), and by 11% on ADVISE (44% baseline, OR = 1.55 [95% CI 1.28-1.87]). Control practices improved by 3% on ASK (Adj. OR I. 18 [95% CI 1.07-1.29]) and did not significantly improve in ADVISE. A significant group-by-time interaction effect indicated that intervention practices improved more over the study period than control practices for ADVISE (P = 0.042) but not for ASK.Conclusion: This low-intensity, easily disseminated intervention was successful in improving provider performance on advice to quit.