Screening and Counseling for Tobacco Use in Student Health Clinics: Reports of Health Care Providers.
Screening and Counseling for Tobacco Use in Student Health Clinics: Reports of Health Care Providers.
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DOI：
10.4278/ajhp.130820-quan-436
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Wolfson M
中科院分区：
文献类型：
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作者：
Sutfin EL;Swords DC;Song EY;Reboussin BA;Helme D;Klein E;Wolfson M
评估学生健康诊所的烟草筛查和咨询，包括促进者，障碍，以及与校园和州一级变量的关联。混合方法研究，包括在线调查和定性访谈。大学校园里的学生健康诊所。来自东南部10个州的71名诊所主任或指定人员（定量调查）和来自东南部4个州的8名主任或指定人员（定性访谈）。定量指标包括人口统计学、筛查和咨询实践、对此类实践的诊所级支持、对校园烟草的看法、机构规模、公共/私人地位、州烟草种植收入和州烟草控制资金。定性措施包括烟草筛查和咨询实践的障碍和促进因素。Logistic和线性回归模型评估筛查和咨询的相关性。定性资料采用多阶段解释性主题分析法进行分析。55%的在线调查受访者报告说，他们的诊所在每次访问时都会进行烟草筛查，而80%的受访者报告说，他们的诊所提供咨询和药物治疗。障碍包括缺乏：与患者接触的时间、与主诉的相关性、学生自我认同为烟草使用者、获得药物治疗的机会以及吸烟者戒烟的兴趣。在多变量模型中，更多的努力，以减少烟草使用，学生入学率，和国家一级的现金收入的烟草正相关的临床水平的支持。这项研究强调了错过的筛查机会。虽然咨询报告较高，但提供者发现了许多障碍。
Assess tobacco screening and counseling in student health clinics, including facilitators, barriers, and associations with campus and state-level variables. Mixed-methods study with an online survey and qualitative interviews. Student health clinics on college campuses. 71 clinic directors or designees from 10 southeastern states (quantitative survey) and 8 directors or designees from 4 southeastern states (qualitative interviews). Quantitative measures included demographics, screening and counseling practices, clinic-level supports for such practices, perceptions of tobacco on campus, institution size, public/private status, state tobacco farming revenue and state tobacco control funding. Qualitative measures included barriers and facilitators of tobacco screening and counseling practices. Logistic and linear regression models assessed correlates of screening and counseling. Qualitative data were analyzed using multi-stage interpretive thematic analysis. 55% of online survey respondents reported their clinics screen for tobacco at every visit, while 80% reported their clinics offer counseling and pharmacotherapy. Barriers included lack of: time with patients, relevance to chief complaint, student self-identification as a tobacco user, access to pharmacotherapy, and interest in quitting among smokers. In multivariable models, more efforts to reduce tobacco use, student enrollment, and state-level cash receipts for tobacco were positively associated with clinic-level supports. This study highlights missed opportunities for screening. While reports of counseling were higher, providers identified many barriers.