title: Increasing Rates of Tobacco Treatment Delivery in Primary Care Practice: Evaluation of the Ottawa Model for Smoking Cessation.
abstract: We report on the effectiveness of the Ottawa Model for Smoking Cessation (OMSC), a multicomponent knowledge translation intervention, in increasing the rate at which primary care providers delivered smoking cessation interventions using the 3 A's model-Ask, Advise, and Act, and examine clinic-, provider-and patient-level determinants of 3 A's delivery.
  
  
  
  We examined the effect of the knowledge translation intervention in 32 primary care practices in Ontario, Canada, by assessing a cross-sectional sample of patients before the implementation of the OMSC and a second cross-sectional sample following implementation. We used 3-level modeling (clinic, clinician, patient) to examine the main effects and predictors of 3 A's delivery.
  
  
  
  Four hundred eighty-one primary care clinicians and more than 3,500 tobacco users contributed data to the evaluation. Rates of delivery of the 3 A's increased significantly following program implementation (Ask: 55.3% vs 71.3%, P <.001; Advise: 45.5% vs 63.6%, P <.001; Act: 35.4% vs 54.4%, P <.001). The adjusted odds ratios (AOR) for the delivery of 3 A's between the pre- and post-assessments were AOR = 1.94; (95% CI, 1.61-2.34) for Ask, AOR = 1.92; (95% CI, 1.60-2.29) for Advise, and AOR = 2.03; (95% CI, 1.71-2.42) for Act. The quality of program implementation and the reason for clinic visit were associated with increased rates of 3 A's delivery.
  
  
  
  Implementation of the OMSC was associated with increased rates of smoking cessation treatment delivery. High quality implementation of the OMSC program was associated with increased rates of 3 A's delivery.
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada SPapadakis@ottawaheart.ca.
authors.forename: Sophia
authors.initials: S
authors.lastname: Papadakis
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: Adam G
authors.initials: AG
authors.lastname: Cole
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Reid
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Coja
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Debbie
authors.initials: D
authors.lastname: Aitken
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Kerri-Anne
authors.initials: KA
authors.lastname: Mullen
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Gharib
authors.affiliation: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Pipe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011320:Primary Health Care; D015397:Program Evaluation; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D057170:Translational Research, Biomedical; D055815:Young Adult; D014026:Nicotiana
keywords: evidence-based practice; health services research; knowledge translation; primary care; smoking cessation