The pediatric resident training on tobacco project: interim findings.
OBJECTIVE
The Pediatric Residency Training on Tobacco Project is a four-year randomized prospective study of the efficacy of training pediatric residents to intervene on tobacco. At the start of the study (baseline), the pediatric residents uniformly agreed that environmental tobacco smoke (ETS) and tobacco use pose serious threats to the health of young people, and pediatricians should play a leadership role in the antismoking arena. However, very few went beyond advising patients and parents to modify their behavior by providing actual assistance, and many of them lacked necessary tobacco intervention skills and knowledge. We hypothesized that both standard training and special training programs would yield positive changes in intervention skills and activities, although the changes would be greater in residents exposed to the special training condition. In the present report, we present two-year outcome data from the resident tobacco surveys and objective structured clinical examinations (OSCEs) administered to independent waves of third-year residents in each experimental condition at baseline and year 2.


METHODS
Fifteen pediatric residency training programs in the New York/New Jersey metropolitan area were assigned randomly to special and standard training conditions (eight to special and seven to standard training). Resident tobacco surveys and OSCEs were administered to third-year residents at the start of the training programs (baseline) and at years 1 and 2 of the study. Comparisons between sequential waves of third-year residents with no (baseline) or two-year exposure to the training programs permitted assessment of changes in resident beliefs, intervention activities and intervention skills within each experimental condition.


RESULTS
By year 2, the residents associated with each training condition benefited from the training program, but the annual surveys and OSCEs revealed more significant positive changes for waves of residents in the special training condition. Most important, third-year residents exposed to the special training condition for two years were more likely than comparable residents in the standard training condition to reveal significant increases in the degree to which they provided active assistance for modifying smoking and ETS.


CONCLUSIONS
The two-year findings from the pediatric tobacco project are encouraging and suggest that the special training program is efficacious, although aspects of the program in need of improvement were identified.
Hymowitz
Norman
N
Department of Psychiatry, UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA. hymowitz@umdnj.edu
Schwab
Joseph
J
Haddock
Christopher Keith
CK
Pyle
Sara
S
Meshberg
Sarah
S
D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D009515:New Jersey; D009518:New York; D010372:Pediatrics / Q000193:education*; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000517:prevention & control*