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Implementation of the Tobacco Tactics intervention versus usual care in Trinity Health community hospitals.
- Source :
-
Implementation science : IS [Implement Sci] 2016 Nov 04; Vol. 11 (1), pp. 147. Date of Electronic Publication: 2016 Nov 04. - Publication Year :
- 2016
-
Abstract
- Background: Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) implementation framework, a National Institutes of Health-sponsored study compared the nurse-administered Tobacco Tactics intervention to usual care. A prior paper describes the effectiveness of the Tobacco Tactics intervention. This subsequent paper provides data describing the remaining constructs of the RE-AIM framework.<br />Methods: This pragmatic study used a mixed methods, quasi-experimental design in five Michigan community hospitals of which three received the nurse-administered Tobacco Tactics intervention and two received usual care. Nurses and patients were surveyed pre- and post-intervention. Measures included reach (patient participation rates, characteristics, and receipt of services), adoption (nurse participation rates and characteristics), implementation (pre-to post-training changes in nurses' attitudes, delivery of services, barriers to implementation, opinions about training, documentation of services, and numbers of volunteer follow-up phone calls), and maintenance (continuation of the intervention once the study ended).<br />Results: Reach: Patient participation rates were 71.5 %. Compared to no change in the control sites, there were significant pre- to post-intervention increases in self-reported receipt of print materials in the intervention hospitals (n = 1370, p < 0.001). Adoption: In the intervention hospitals, all targeted units and several non-targeted units participated; 76.0 % (n = 1028) of targeted nurses and 317 additional staff participated in the training, and 92.4 % were extremely or somewhat satisfied with the training.<br />Implementation: Nurses in the intervention hospitals reported increases in providing advice to quit, counseling, medications, handouts, and DVD (all p < 0.05) and reported decreased barriers to implementing smoking cessation services (p < 0.001). Qualitative comments were very positive ("user friendly," "streamlined," or "saves time"), although problems with showing patients the DVD and charting in the electronic medical record were noted. Maintenance: Nurses continued to provide the intervention after the study ended.<br />Conclusions: Given that nurses represent the largest group of front-line providers, this intervention, which meets Joint Commission guidelines for treating inpatient smokers, has the potential to have a wide reach and to decrease smoking, morbidity, and mortality among inpatient smokers. As we move toward more population-based interventions, the RE-AIM framework is a valuable guide for implementation.<br />Trial Registration: ClinicalTrials.gov, NCT01309217.
- Subjects :
- Attitude of Health Personnel
Counseling
Delivery of Health Care
Female
Health Promotion methods
Hospitals, Community
Humans
Male
Middle Aged
Patient Participation statistics & numerical data
Practice Patterns, Nurses'
Smoking Cessation methods
Telemedicine methods
Cigarette Smoking
Nursing Care methods
Smoking Prevention methods
Subjects
Details
- Language :
- English
- ISSN :
- 1748-5908
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Implementation science : IS
- Publication Type :
- Academic Journal
- Accession number :
- 27814722
- Full Text :
- https://doi.org/10.1186/s13012-016-0511-6