title: Feasibility of a smoking cessation intervention for teens in the emergency department: reach, implementation fidelity, and acceptability.
abstract: BACKGROUND
  Traditional efficacy research alone is insufficient to move interventions from research to practice. Motivational interviewing has been adapted for brief encounters in a variety of health care settings for numerous problem behaviors among adolescents and adults. Some experts suggest that motivational interviewing can support a population health approach to reach large numbers of teen smokers without the resource demands of multi-session interventions.
  
  
  OBJECTIVE
  To determine the reach, implementation fidelity, and acceptability of a brief motivational tobacco intervention for teens who had treatment in a hospital emergency department.
  
  
  METHODS
  Among 74 teens 14 to 19 years old, 40 received a brief motivational tobacco intervention and 34 received brief advice/care as usual at baseline. Follow-up data were collected from the interventional group at 1, 3, and 6 months and from the control group at 6 months. For the interventional group, data also were collected from the teens' parents, the health care personnel who provided the intervention, and emergency department personnel.
  
  
  RESULTS
  Findings indicated low levels of reach, high levels of implementation fidelity, and high levels of acceptability for teen patients, their parents, and emergency department personnel. Data suggest that practitioners can operationalize motivational interventions as planned in a clinical setting and that patients and others with an interest in the outcomes may find the interventions acceptable. However, issues of reach may hinder use of the intervention among teens in clinical settings.
  
  
  CONCLUSIONS
  Further investigation is needed on mechanisms to reduce barriers to participation, especially barriers related to patient acuity.
authors.affiliation: Department of Community Medicine, West Virginia University, Morgantown, WV, USA. khorn@hsc.wvu.edu
authors.forename: Kimberly
authors.initials: K
authors.lastname: Horn
authors.forename: Geri
authors.initials: G
authors.lastname: Dino
authors.forename: Candice
authors.initials: C
authors.lastname: Hamilton
authors.forename: N
authors.initials: N
authors.lastname: Noerachmanto
authors.forename: Jianjun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010358:Patient Participation / Q000379:methods*; D018802:Patient-Centered Care / Q000379:methods; D016540:Smoking Cessation / Q000379:methods*