Effectiveness of performance coaching for enhancing rates of smoking cessation treatment delivery by primary care providers: Study protocol for a cluster randomized controlled trial.
Smoking cessation is one of the most powerful preventive interventions available to primary care providers. Rates of tobacco treatment delivery in primary care settings, however, remain sub-optimal. This paper reports on rationale, design, and protocol for a matched-paired, cluster-randomized controlled trial to compare the incremental effectiveness of performance coaching on physician delivery of smoking cessation assistance when delivered as part of a practice-level intervention for smoking cessation (the Ottawa Model for Smoking Cessation; OMSC). Outcome measures included frequency of provider smoking cessation treatment delivery, patient quit attempts, and 7-day point prevalence abstinence measured at 6 months, and changes in provider attitudes and beliefs related to smoking cessation treatment delivery. Primary care clinics were randomly assigned, using a matched paired design, to one of two treatment conditions: OMSC Group or OMSC+Performance Coaching Group. All practices were supported with implementing the OMSC. Half of the practices also received a 1.5 hour, skills-based, coaching session to address barriers encountered in the delivery of smoking cessation treatments and individualized performance feedback reports. All providers, and a cross sectional sample of patients from their practices, were surveyed before and after the implementation of the intervention. Multi-level modeling was used to compare intervention groups. If shown to be effective, the study will lead to an improved understanding of how to best assist clinicians to enhance the delivery of smoking cessation practice and will provide evidence to guide the design of smoking cessation interventions in primary care.


BACKGROUND
clinicaltrials.gov Identifier: NCT01603524.
Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Canada. Electronic address: SPapadakis@ottawaheart.ca.
Sophia
S
Papadakis
Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Andrew L
AL
Pipe
Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Robert D
RD
Reid
Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
Heather
H
Tulloch
Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
Kerri-Anne
KA
Mullen
Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
Roxane
R
Assi
School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.
Adam G
AG
Cole
Faculty of Medicine, University of Ottawa, Ottawa, Canada; Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
George
G
Wells
D003430:Cross-Sectional Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training; D010353:Patient Education as Topic / Q000379:methods*; D011320:Primary Health Care / Q000458:organization & administration*; D012107:Research Design; D020377:Self Efficacy; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D012959:Socioeconomic Factors; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data
Primary care; Randomized controlled trial; Smoking cessation; Study protocol; Training