title: Implementing tobacco use treatment guidelines in public health dental clinics in New York City.
abstract: In this study we evaluated the effect of a multicomponent intervention to implement the Public Health Service (PHS) guideline Treating Tobacco Use and Dependence in six randomly selected dental clinics in New York University's College of Dentistry. The main outcome measure-provider adherence to tobacco use treatment guidelines-was assessed by auditing a random selection of patient charts pre (698) and post (641) intervention. The intervention components included a chart reminder and referral system, free nicotine replacement therapy (NRT), and provider training and feedback. The results showed that rates of screening for tobacco use did not change between pre and post test chart audits. However, providers were significantly more likely to offer advice (28.4 percent pre, 49 percent post), assess readiness to quit (17.8 percent pre, 29.9 percent post), and offer assistance (6.5 percent pre and 15.6 percent post) in the post test period. Increases in NRT distribution were associated with booster training sessions but declined in the time periods between those trainings. Research is needed to further define sustainable strategies for implementing tobacco use treatment in dental clinics. The results of this study suggest the feasibility and effectiveness of using a tailored multicomponent approach to implement tobacco use treatment guidelines in dental clinics.
authors: New York University College of Dentistry, 380 Second Ave., New York, NY 10010, USA. ds186@nyu.edu
authors: Donna
authors: D
authors: Shelley
authors: Jaime
authors: J
authors: Anno
authors: Tuo-Yen
authors: TY
authors: Tseng
authors: Greg
authors: G
authors: Calip
authors: John
authors: J
authors: Wedeles
authors: Madeleine
authors: M
authors: Lloyd
authors: Mark S
authors: MS
authors: Wolff
mesh_terms: D016009:Chi-Square Distribution; D019230:Dental Audit; D003740:Dental Clinics; D003792:Dental Records; D004497:Education, Dental; D005240:Feasibility Studies; D005246:Feedback; D019983:Guideline Adherence; D006284:Health Plan Implementation; D006801:Humans; D009519:New York City; D009538:Nicotine / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011636:Public Health Dentistry; D000074606:Smoking Prevention; D020340:Tobacco Use Cessation / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine