The effect of training on the use of tobacco-use cessation guidelines in dental settings.
BACKGROUND
An increase in the number of dentists conducting tobacco-use cessation treatment is needed. The authors assessed the effects of high-intensity training (HIT) or low-intensity training (LIT) and reimbursement on general dentists' tobacco-use-related attitudes and treatment behaviors.


METHODS
The authors randomly selected 265 dentists in three states and assigned them to one of five groups: HIT workshop groups with and without tobacco-use cessation counseling reimbursement, LIT mailed self-study groups with and without reimbursement or a control group. Outcomes at follow-up were dentists' self-reported tobacco-use-related attitudes and behaviors and patients' reports of dentists' behaviors.


RESULTS
Significantly more dentists in the intervention groups reported having positive attitudes and behaviors at follow-up than did dentists in the control group. Dentists in the HIT groups, however, reported assessing patients' willingness to quit and assisting them with the quitting process significantly more often than did dentists in the LIT groups. Significantly more patients of dentists in the intervention groups who used tobacco reported receiving advice and assistance from their dentists than did patients of dentists in the control group. Adding reimbursement to HIT or LIT conditions did not provide additional intervention effect.


CONCLUSIONS
Dentists trained by means of a workshop or self-study program used components of a recommended guideline more frequently and felt more positive toward tobacco-use cessation counseling than did dentists in the control group.


CONCLUSIONS
Although the workshop training was more successful than the self-study training, the latter's reach among dentists could have a more significant public health impact. The effect of reimbursement needs further study.
Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA. 94143-1361, USA. margaret.walsh@ucsf.edu
Margaret M
MM
Walsh
Marilyn
M
Belek
Preeti
P
Prakash
Barbara
B
Grimes
Barbara
B
Heckman
Nathan
N
Kaufman
Richard
R
Meckstroth
Catherine
C
Kavanagh
Jana
J
Murray
Jane A
JA
Weintraub
Steven
S
Silverstein
Stuart A
SA
Gansky
D001291:Attitude of Health Personnel; D002140:California; D016009:Chi-Square Distribution; D003815:Dentists / Q000523:psychology; D004498:Education, Dental, Continuing / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010414:Pennsylvania; D017410:Practice Guidelines as Topic; D060926:Remuneration; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation / Q000379:methods / Q000523:psychology; D014903:West Virginia