title: Health care workers' knowledge, attitudes and practices on tobacco use in economically disadvantaged dominican republic communities.
abstract: Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR.
authors: Department of Public Health Sciences, University of Rochester, Medical Center, Rochester, NY 14642, USA. mgprucha@gmail.com.
authors: Michael G
authors: MG
authors: Prucha
authors: Department of Clinical Sciences, School of Medicine, Temple University, Philadelphia, PA 19140, USA. susan.fisher@tuhs.temple.edu.
authors: Susan G
authors: SG
authors: Fisher
authors: Department of Public Health Sciences, University of Rochester, Medical Center, Rochester, NY 14642, USA. scott_mcintosh@urmc.rochester.edu.
authors: Scott
authors: S
authors: McIntosh
authors: Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. john_grable@urmc.rochester.edu.
authors: John C
authors: JC
authors: Grable
authors: Department of Public Health Sciences, University of Rochester, Medical Center, Rochester, NY 14642, USA. heather_holderness@urmc.rochester.edu.
authors: Heather
authors: H
authors: Holderness
authors: Department of Public Health Sciences, University of Rochester, Medical Center, Rochester, NY 14642, USA.
authors: Kelly
authors: K
authors: Thevenet-Morrison
authors: Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic. zquinones@pucmmsti.edu.do.
authors: Zahíra Quiñones
authors: ZQ
authors: de Monegro
authors: Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic. j-javier-s@hotmail.com.
authors: José Javier
authors: JJ
authors: Sánchez
authors: Centro de Atención Primaria Juan XXIII, Santiago, Dominican Republic. arisleydabautista@yahoo.com.
authors: Arisleyda
authors: A
authors: Bautista
authors: Hospital Regional Universitario José María Cabral y Báez, Santiago, Dominican Republic. s_diazpdt@yahoo.com.
authors: Sergio
authors: S
authors: Díaz
authors: Department of Public Health Sciences, University of Rochester, Medical Center, Rochester, NY 14642, USA. deborah_ossip@urmc.rochester.edu.
authors: Deborah J
authors: DJ
authors: Ossip
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003906:Developing Countries; D004293:Dominican Republic; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011204:Poverty Areas; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D014029:Tobacco Use Disorder / Q000150:complications / Q000175:diagnosis* / Q000628:therapy