Knowing how to help tobacco users. Dentists' familiarity and compliance with the clinical practice guideline.
BACKGROUND
A U.S. Public Health Service-sponsored clinical practice guideline urges all health care providers to make tobacco-use cessation counseling a routine part of clinical practice. This study assessed practices of dentists in east Texas, their adherence to the guideline and barriers to adherence.


METHODS
A cross-sectional survey mailed September 2003 through January 2004 assessed demographic characteristics and knowledge, attitudes and activities of 783 dentists. The survey focused on familiarity with the guideline, adherence to the recommended steps (including the "5 A's" for tobacco users willing to quit and the "5 R's" for tobacco users unwilling to quit), perceived barriers and time spent counseling.


RESULTS
Most dentists were unfamiliar with the guideline and usually did not follow its recommended steps. Less than 20 percent of dentists spent three or more minutes per patient on counseling. Knowledge of and training in using the guideline were significantly associated with adherence and time spent counseling. Lack of training was cited as the greatest barrier.


CONCLUSIONS
Most dentists in east Texas are unaware of the clinical practice guideline. Lack of training is a major barrier to adherence. Practice Implications. Opportunities for improving patients' health through brief counseling interventions are missed. Measures are needed to increase dentists' familiarity with and adherence to the guideline.
Hu
Shaohua
S
Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center, Houston, Texas 77030, USA. Shaohua.hu@uth.tmc.edu
Pallonen
Unto
U
McAlister
Alfred L
AL
Howard
Brian
B
Kaminski
Robert
R
Stevenson
Gene
G
Servos
Thomas
T
D000328:Adult; D001291:Attitude of Health Personnel; D003376:Counseling; D003430:Cross-Sectional Studies; D003812:Dentist-Patient Relations; D003815:Dentists / Q000523:psychology; D004497:Education, Dental; D005260:Female; D019983:Guideline Adherence; D015438:Health Behavior; D006801:Humans; D008297:Male; D009042:Motivation; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D019239:Practice Patterns, Dentists'; D012309:Risk-Taking; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013781:Texas; D013997:Time Factors