title: Assessing the congruence between physician behavior and expert opinion in smoking cessation counseling.
abstract: This study examines the degree of transfer of smoking cessation innovation from research to health care settings by comparing frequency-of-practice ratings by a national sample of family practice physicians (n = 903, response rate = 70%) and importance ratings by smoking cessation and prevention experts (n = 58, response rate = 84%) for 14 counseling techniques. The physician survey elicited a profile that combines traditional and behavioral techniques--discussing smoking with patients, encouraging goal setting, suggesting specific steps for quitting, and presenting pamphlets. They refer to others infrequently and rarely report planning for follow-up about smoking. The experts rated these selected techniques as moderately to highly important. They favored a behavioral approach coupled with active follow-up. The major differences between physician and expert rankings were that the experts placed higher priority on planned follow-up and a lower priority on pamphlets. The uneven quality of counseling reported by physicians suggests that weighting their responses according to expert opinion would provide a more sensitive profile. Scaled weighting produced scores that may help researchers define a composite quality-quantity measure of activity.
authors.affiliation: Center for Health Promotion, Research and Development, School of Public Health, University of Texas Health Science Center, Houston 77225.
authors.forename: P D
authors.initials: PD
authors.lastname: Mullen
authors.forename: J R
authors.initials: JR
authors.lastname: Ito
authors.forename: J P
authors.initials: JP
authors.lastname: Carbonari
authors.forename: C C
authors.initials: CC
authors.lastname: DiClemente
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D004059:Diffusion of Innovation; D006801:Humans; D007318:Inservice Training; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D010819:Physician's Role; D010817:Physician-Patient Relations; D012106:Research; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*