title: Beyond the Ask and Advise: Implementation of a Computer Tablet Intervention to Enhance Provider Adherence to the 5As for Smoking Cessation.
abstract: BACKGROUND
  The 5As for smoking cessation is an evidence-based intervention to aid providers in counseling patients to quit smoking. While most providers "ask" patients about their tobacco use patterns and "advise" them to quit, fewer patients report being "assessed" for their interest in quitting, and even fewer report subsequent "assistance" in a quit attempt and having follow-up "arranged".
  
  
  OBJECTIVE
  This article describes the design of an implementation study testing a computer tablet intervention to improve provider adherence to the 5As for smoking cessation. Findings will contribute to the existing literature on technology acceptance for addressing addictive behaviors, and how digital tools may facilitate the broader implementation of evidence-based behavioral counseling practices without adversely affecting clinical flow or patient care.
  
  
  METHODS
  This project develops and tests a computer-facilitated 5As (CF-5As) model that administers the 5As intervention to patients with a computer tablet, then prompts providers to reinforce next steps. During the development phase, 5As' content will be programmed onto computer tablets, alpha and beta-testing of the service delivery model will be done, and pre-intervention interview and questionnaire data will be collected from patients, providers, and clinic staff about 5As fidelity and technology adoption. During the program evaluation phase, a randomized controlled trial comparing a group who receives the CF-5As intervention to one that does not will be conducted to assess 5As fidelity. Using the technology acceptance model, a mixed methods study of contextual and human factors influencing both 5As and technology adoption will also be conducted.
  
  
  CONCLUSIONS
  Technology is increasingly being used in clinical settings. A technological tool that connects patients, providers, and clinic staff to facilitate the promotion of behavioral interventions such as smoking cessation may provide an innovative platform through which to efficiently and effectively implement evidence-based practices.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Kalkhoran
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Appelle
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Napoles
authors.affiliation: Palo Alto University, Palo Alto, CA, USA; San Francisco General Hospital, Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Ricardo F
authors.initials: RF
authors.lastname: Munoz
authors.affiliation: Division of HIV/AIDS, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Lum
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Alvarado
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gregorich
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA. Electronic address: Jason.Satterfield@ucsf.edu.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Satterfield
mesh_terms: D000328:Adult; D034201:Computers, Handheld; D003695:Delivery of Health Care / Q000379:methods*; D055317:Evidence-Based Practice; D019983:Guideline Adherence; D006801:Humans; D008491:Medical Informatics Applications; D016540:Smoking Cessation / Q000379:methods*
keywords: Digital health; Implementation science; Smoking cessation