Complementary and Alternative Medicine (CAM) practitioners’ readiness for tobacco intervention training: Development and psychometric properties of a new measure

Objective Complementary and Alternative Medicine (CAM) practitioners are an important potential resource for expanding the use of tobacco cessation brief interventions. Training these practitioners to conduct such interventions has been hampered, however, by a lack of tools for assessing the practitioners’ tobacco intervention behaviors and interest, and openness to non-CAM tobacco cessation aids (e.g., medications, quitlines). Recognizing this, we developed a new measure: the CAM Readiness for Training in Tobacco Intervention (CAM RTTI) questionnaire. Methods Together with a key informant group of CAM experts, we constructed 18 questionnaire items. For structured review and face validity assessment, the items were submitted to a national panel of CAM practitioners and tobacco cessation experts, and revised according to their comments. The items were then administered to a sample of 97 CAM practitioners (30 chiropractors, 26 licensed acupuncturists, 41 licensed massage therapists). Exploratory factor analysis and internal reliability tests were used to examine the items’ psychometric properties. Results Three underlying factors were indicated: current tobacco cessation activity, motivation/confidence regarding the conduct of tobacco cessation activity, and comfort providing patients/clients with information about non-CAM tobacco interventions. Acceptable internal validity was indicated for the factor-based subscales (Cronbach's alphas ranged .71–.81). Responses differed substantially across the factors/subscales. The practitioners indicated little current engagement in tobacco-cessation activities (factor 1), but were well-motivated to begin doing so (factor 2). Level of comfort with non-CAM tobacco interventions (factor 3) had pronounced dispersion from negative to positive. Conclusions CAM RTTI assessed three factors that can be critical to implementing effective tobacco intervention trainings for a CAM practitioner: (1) current tobacco intervention activity, (2) motivation/confidence and (3) comfort with non-CAM interventions. Moreover, it assessed these factors using language appropriate to CAM practitioners, providing the first measure, to our knowledge, specific to the development of tobacco intervention training for this group.