Beyond the Ask and Advise: Implementation of a Computer Tablet Intervention to Enhance Provider Adherence to the 5As for Smoking Cessation
Beyond the Ask and Advise: Implementation of a Computer Tablet Intervention to Enhance Provider Adherence to the 5As for Smoking Cessation
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DOI：
10.1016/j.jsat.2015.05.009
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发表时间：
2016-01-01
影响因子：
3.9
通讯作者：
Satterfield, Jason M.
中科院分区：
文献类型：
--
作者：
Kalkhoran, Sara;Appellle, Nicole A.;Satterfield, Jason M.
背景：戒烟5A是一项循证干预，旨在帮助提供者咨询患者戒烟。虽然大多数供应商“询问”患者的烟草使用模式，并“建议”他们戒烟，但很少有患者报告他们戒烟的兴趣得到“评估”，更少的患者报告在戒烟尝试中随后的“帮助”和后续的“安排”。目的：本文描述了一项实施研究的设计，测试电脑平板电脑干预，以提高供应商对戒烟5A的遵守。这些发现将有助于现有文献中关于解决成瘾行为的技术接受度，以及数字工具如何在不影响临床流程或患者护理的情况下促进基于证据的行为咨询实践的更广泛实施。方法：本项目开发和测试计算机辅助5A(CF-5AS)模型，该模型管理对使用电脑平板电脑的患者的5A干预，然后提示提供者加强下一步。在开发阶段，5A的内容将被编程到电脑平板电脑上，将对服务交付模式进行阿尔法和贝塔测试，并将从患者、提供者和诊所工作人员收集关于5A保真度和技术采用的干预前访谈和问卷数据。在计划评估阶段，将进行一项随机对照试验，比较接受CF-5AS干预和没有接受CF-5AS干预的一组，以评估5AS的保真度。使用技术接受模型，还将对影响5A和技术采用的背景因素和人为因素进行混合方法研究。结论：技术正越来越多地在临床环境中使用。连接患者、提供者和诊所工作人员以促进行为干预(如戒烟)的技术工具可能提供一个创新平台，通过该平台高效和有效地实施循证实践。(C)2015 Elsevier Inc.保留所有权利。
Background: The 5As for smoking cessation is an evidence-based intervention to aid providers in counseling patients to quit smoking. While most providers "ask" patients about their tobacco use patterns and "advise" them to quit, fewer patients report being "assessed" for their interest in quitting, and even fewer report subsequent "assistance" in a quit attempt and having follow-up "arranged".Purpose: This article describes the design of an implementation study testing a computer tablet intervention to improve provider adherence to the 5As for smoking cessation. Findings will contribute to the existing literature on technology acceptance for addressing addictive behaviors, and how digital tools may facilitate the broader implementation of evidence-based behavioral counseling practices without adversely affecting clinical flow or patient care.Methods: This project develops and tests a computer-facilitated 5As (CF-5As) model that administers the 5As intervention to patients with a computer tablet, then prompts providers to reinforce next steps. During the development phase, 5As' content will be programmed onto computer tablets, alpha and beta-testing of the service delivery model will be done, and pre-intervention interview and questionnaire data will be collected from patients, providers, and clinic staff about 5As fidelity and technology adoption. During the program evaluation phase, a randomized controlled trial comparing a group who receives the CF-5As intervention to one that does not will be conducted to assess 5As fidelity. Using the technology acceptance model, a mixed methods study of contextual and human factors influencing both 5As and technology adoption will also be conducted.Conclusions: Technology is increasingly being used in clinical settings. A technological tool that connects patients, providers, and clinic staff to facilitate the promotion of behavioral interventions such as smoking cessation may provide an innovative platform through which to efficiently and effectively implement evidence-based practices. (C) 2015 Elsevier Inc. All rights reserved.