title: Smoking prevention and cessation intervention delivery by pediatric providers, as assessed with patient exit interviews.
abstract: OBJECTIVE
  The goal was to evaluate the degree to which a smoking prevention and cessation intervention was delivered by providers to adolescents in the pediatric office setting.
  
  
  METHODS
  Eight pediatric clinics in central Massachusetts were assigned randomly to either a special intervention (brief pediatric provider-delivered intervention plus peer counseling) or the usual care condition. Subjects (n = 2710) were adolescents 13 to 17 years of age, both smokers (smoked in the past 30 days) and nonsmokers/former smokers. The degree to which smoking prevention and treatment interventions were delivered by providers was assessed through patient exit interviews with adolescents after their clinic visits; interviews assessed the occurrence of 10 possible intervention steps.
  
  
  RESULTS
  The percentage of providers engaging in the smoking interventions differed significantly between the special intervention and usual care conditions, according to adolescent reports in the patient exit interviews. For nonsmokers/former smokers, overall patient exit interview scores were 7.24 for the special intervention condition and 4.95 for the usual care condition. For current smokers, overall patient exit interview scores were 8.40 and 6.24 for the special intervention and usual care conditions, respectively. Intervention fidelity of special intervention providers was 72.2% and 84.0% for nonsmokers/former smokers and current smokers, respectively.
  
  
  CONCLUSIONS
  Pediatric providers who receive training and reminders to deliver a brief smoking prevention and cessation intervention to adolescents in the context of routine pediatric primary care practice can do so feasibly and with a high degree of fidelity to the intervention protocol.
authors.affiliation: Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA. lori.pbert@umassmed.edu
authors.forename: Lori
authors.initials: L
authors.lastname: Pbert
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Fletcher
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Flint
authors.forename: Martin H
authors.initials: MH
authors.lastname: Young
authors.forename: Susan
authors.initials: S
authors.lastname: Druker
authors.forename: Joseph
authors.initials: J
authors.lastname: DiFranza
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010372:Pediatrics; D010817:Physician-Patient Relations; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation; D000074606:Smoking Prevention; D016896:Treatment Outcome