title: A qualitative study of tobacco dependence treatment in 19 US dental hygiene programs.
abstract: BACKGROUND
  The US Public Health Service calls for health professionals to provide tobacco dependence counseling for patients. The purpose of this study was to understand how dental hygiene programs make decisions about and provide training for tobacco dependence counseling to help them graduate more fully competent hygienists.
  
  
  METHODS
  We conducted interviews (N = 32) with mainly program and clinic directors from 19 US dental hygiene education programs for this qualitative case study. We explored fluoride therapy training and tooth whitening training for comparison. Two analysts summarized the transcripts into a case study for each program.
  
  
  RESULTS
  All programs reported a similar process of learning about and choosing a method for teaching the topics explored. The programs used a common process, ADPIE (assess, diagnose, plan, implement, evaluate), to structure students'clinical encounters. Almost all programs train students to ask about tobacco use and to advise quitting, but few programs train students to effectively help patients to quit and only 2 programs evaluated the competence of all students to provide such training. ADPIE shows promise for integrating  tobacco dependence treatment more fully into the clinical training of dental hygiene students. Comparison to tooth whitening and fluoride therapy training indicated that complexity of the treatment and alignment with dental hygiene's mission were themes related to training decisions.
  
  
  CONCLUSIONS
  Full implementation of tobacco dependence counseling into dental hygiene education requires a commitment by dental hygiene educators to train students and faculty in counseling techniques and their evaluation. We identified an existing clinical structure as showing promise for facilitating improvement.
authors.affiliation: Department of Pediatric Dentistry, MC 850, College of Dentistry, University of Illinois at Chicago, 801 S Paulina St, Chicago, IL 60611, USA. akoerber@uic.edu
authors.forename: Anne
authors.initials: A
authors.lastname: Koerber
authors.forename: Joan M
authors.initials: JM
authors.lastname: Davis
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Newton
mesh_terms: D000288:Administrative Personnel / Q000523:psychology; D002983:Clinical Competence / Q000592:standards; D003376:Counseling / Q000193:education* / Q000379:methods; D003479:Curriculum / Q000592:standards; D003657:Decision Making; D003756:Dental Hygienists / Q000193:education* / Q000592:standards; D003812:Dentist-Patient Relations; D004497:Education, Dental / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D004521:Educational Measurement; D006284:Health Plan Implementation; D006801:Humans; D019982:Organizational Case Studies; D009936:Organizational Innovation; D011369:Professional-Patient Relations; D016730:Program Development; D036301:Qualitative Research; D012969:Sodium Fluoride / Q000627:therapeutic use*; D013335:Students, Dental / Q000523:psychology / Q000706:statistics & numerical data; D020340:Tobacco Use Cessation / Q000379:methods; D014029:Tobacco Use Disorder / Q000517:prevention & control* / Q000628:therapy; D058205:Tooth Bleaching Agents / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
chemical_list: D058205:Tooth Bleaching Agents; D012969:Sodium Fluoride