title: Improving smoking cessation counseling using a point-of-care health intervention tool (IT): from the Virginia Practice Support and Research Network (VaPSRN).
abstract: OBJECTIVE
  Primary care practices are an ideal setting for reducing national smoking rates because >70% of smokers visit their physician annually, yet smoking cessation counseling is inconsistently delivered to patients. We designed and created a novel software program for handheld computers and hypothesized that it would improve clinicians' ability to provide patient-tailored smoking cessation counseling at the point of care.
  
  
  METHODS
  A handheld computer software program was created based on smoking cessation guidelines and an adaptation of widely accepted behavioral change theories. The tool was evaluated using a validated before/after survey to measure physician smoking cessation counseling behaviors, knowledge, and comfort/self-efficacy.
  
  
  RESULTS
  Participants included 17 physicians (mean age, 41 years; 71% male; 5 resident physicians) from a practice-based research network. After 4 months of use in direct patient care, physicians were more likely to advise patients to stop smoking (P = .049) and reported an increase in use of the "5 As" (P = .03). Improved self-efficacy in counseling patients regarding smoking cessation (P = .006) was seen, as was increased comfort in providing follow-up to patients (P = .04).
  
  
  CONCLUSIONS
  Use of a handheld computer software tool improved smoking cessation counseling among physicians and shows promise for translating evidence about smoking cessation counseling into practice and educational settings.
authors.affiliation: Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC 29203, USA. sstrayer@uscmed.sc.edu
authors.forename: Scott M
authors.initials: SM
authors.lastname: Strayer
authors.forename: Steven W
authors.initials: SW
authors.lastname: Heim
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Rollins
authors.forename: Marit L
authors.initials: ML
authors.lastname: Bovbjerg
authors.forename: Mohan
authors.initials: M
authors.lastname: Nadkarni
authors.forename: David B
authors.initials: DB
authors.lastname: Waters
authors.forename: Fern R
authors.initials: FR
authors.lastname: Hauck
authors.forename: John B
authors.initials: JB
authors.lastname: Schorling
mesh_terms: D000328:Adult; D034201:Computers, Handheld; D003299:Cooperative Behavior; D003376:Counseling / Q000379:methods*; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D058007:Physicians, Primary Care; D016540:Smoking Cessation; D012984:Software; D011795:Surveys and Questionnaires; D014768:Virginia