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A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance.

Authors :
Jenssen BP
Kelleher S
Karavite DJ
Nekrasova E
Thayer JG
Ratwani R
Shea JA
Nabi-Burza E
Drehmer JE
Winickoff JP
Grundmeier RW
Schnoll RA
Fiks AG
Source :
Applied clinical informatics [Appl Clin Inform] 2023 May; Vol. 14 (3), pp. 439-447. Date of Electronic Publication: 2023 Mar 27.
Publication Year :
2023

Abstract

Background: Research is needed to identify how clinical decision support (CDS) systems can support communication about and engagement with tobacco use treatment in pediatric settings for parents who smoke. We developed a CDS system that identifies parents who smoke, delivers motivational messages to start treatment, connects parents to treatment, and supports pediatrician-parent discussion.<br />Objective: The objective of this study is to assess the performance of this system in clinical practice, including receipt of motivational messages and tobacco use treatment acceptance rates.<br />Methods: The system was evaluated at one large pediatric practice through a single-arm pilot study from June to November 2021. We collected data on the performance of the CDS system for all parents. Additionally, we surveyed a sample of parents immediately after the clinical encounter who used the system and reported smoking. Measures were: (1) the parent remembered the motivational message, (2) the pediatrician reinforced the message, and (3) treatment acceptance rates. Treatments included nicotine replacement therapy, quitline referral (phone counseling), and/or SmokefreeTXT referral (text message counseling). We described survey response rates overall and with 95% confidence intervals (CIs).<br />Results: During the entire study period, 8,488 parents completed use of the CDS: 9.3% ( n  = 786) reported smoking and 48.2% ( n  = 379) accepted at least one treatment. A total of 102 parents who smoke who used the system were approached to survey 100 parents (98% response rate). Most parents self-identified as female (84%), aged 25 to 34 years (56%), and Black/African American (94%), and had children with Medicaid insurance (95%). Of parents surveyed, 54% accepted at least one treatment option. Most parents recalled the motivational message (79%; 95% CI: 71-87%), and 31% (95% CI: 19-44%) reported that the pediatrician reinforced the motivational message.<br />Conclusion: A CDS system to support parental tobacco use treatment in pediatric primary care enhanced motivational messaging about smoking cessation and evidence-based treatment initiation.<br />Competing Interests: None declared.<br /> (Thieme. All rights reserved.)

Details

Language :
English
ISSN :
1869-0327
Volume :
14
Issue :
3
Database :
MEDLINE
Journal :
Applied clinical informatics
Publication Type :
Academic Journal
Accession number :
36972687
Full Text :
https://doi.org/10.1055/a-2062-9627