TY - JOUR
T1 - Tobacco Cessation Training for Complementary and Alternative Medicine Practitioners
T2 - Results of a Practice-Based Trial
AU - Muramoto, Myra L.
AU - Gordon, Judith S.
AU - Bell, Melanie L.
AU - Nichter, Mark
AU - Floden, Lysbeth
AU - Howerter, Amy
AU - Ritenbaugh, Cheryl K.
N1 - Funding Information:
This work was supported by NIH National Cancer Institute grant 1RO1 CA137375-01A1. The National Cancer Institute had no role in study protocol design. The University of Arizona’s IRB approved the study (Number 0900000349R002). Authors contributed in the following ways to conducting the study and producing this manuscript: MM, JG, MN, and CR contributed to study conception and design, data analysis and interpretation; LF and AH contributed to data acquisition, analysis, and interpretation; MB contributed to data analysis and interpretation. All authors contributed to the writing and significant editing of the manuscript for important intellectual content. All authors read and approved the final version of the submitted manuscript. No financial disclosures were reported by the authors of this paper.
Publisher Copyright:
© 2016
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Introduction Brief behavioral intervention (BI) is a tobacco-cessation best practice well established among conventional healthcare practitioners. Complementary and alternative medicine (CAM) practitioners treat significant numbers of tobacco users, but do not systematically receive BI training. The CAM Reach study developed and evaluated a tobacco cessation BI training program/practice system intervention adapted specifically for CAM practitioners, and evaluated in real-world CAM practices. Study design Single-arm intervention. Data were collected in 2010–2014 and analyzed in 2015. Setting/participants Private practices of 30 chiropractors, 27 acupuncturists, 42 massage therapists (N=99), in metropolitan Tucson, Arizona. Intervention Eight-hour tobacco cessation BI continuing education workshop, in-office BI skills practice/assessment, and system intervention. Training tailored to the CAM practice setting addressed tobacco cessation best practices from the U.S. Public Health Service Guidelines. Main outcome measures Seventeen items (assessing practitioner behavior, motivation, and self-efficacy with tobacco cessation) comprising three factors, Tobacco Cessation Activity, Tobacco Cessation Motivation, and Non-CAM Tobacco Cessation Comfort, were assessed at baseline and 3, 6, 9, and 12 months post-training by practitioner self-report. Research staff visited practices at approximately the same intervals to directly observe changes in clinical practice systems. Results At 3 months, there were significant increases in practitioners’ tobacco cessation activities, motivation and confidence in helping patients quit tobacco, and comfort with providing information and referrals for guideline-based tobacco cessation aids (p<0.0001). Practitioners significantly increased rates of discussing cessation medications with patients (AOR=3.76, 95% CI=1.84, 7.68), and routinely asking about tobacco use in clinical practice (AOR=2.62, 95% CI=1.11, 6.20). Increases occurred across all three practitioner types and were sustained at 12 months—despite heterogeneity in professional training, practice patterns/organization, and practice business models. Conclusions Results suggest CAM practitioners are willing and able to offer BIs, and are an important, yet overlooked channel for promoting tobacco cessation and use of evidence-based cessation aids.
AB - Introduction Brief behavioral intervention (BI) is a tobacco-cessation best practice well established among conventional healthcare practitioners. Complementary and alternative medicine (CAM) practitioners treat significant numbers of tobacco users, but do not systematically receive BI training. The CAM Reach study developed and evaluated a tobacco cessation BI training program/practice system intervention adapted specifically for CAM practitioners, and evaluated in real-world CAM practices. Study design Single-arm intervention. Data were collected in 2010–2014 and analyzed in 2015. Setting/participants Private practices of 30 chiropractors, 27 acupuncturists, 42 massage therapists (N=99), in metropolitan Tucson, Arizona. Intervention Eight-hour tobacco cessation BI continuing education workshop, in-office BI skills practice/assessment, and system intervention. Training tailored to the CAM practice setting addressed tobacco cessation best practices from the U.S. Public Health Service Guidelines. Main outcome measures Seventeen items (assessing practitioner behavior, motivation, and self-efficacy with tobacco cessation) comprising three factors, Tobacco Cessation Activity, Tobacco Cessation Motivation, and Non-CAM Tobacco Cessation Comfort, were assessed at baseline and 3, 6, 9, and 12 months post-training by practitioner self-report. Research staff visited practices at approximately the same intervals to directly observe changes in clinical practice systems. Results At 3 months, there were significant increases in practitioners’ tobacco cessation activities, motivation and confidence in helping patients quit tobacco, and comfort with providing information and referrals for guideline-based tobacco cessation aids (p<0.0001). Practitioners significantly increased rates of discussing cessation medications with patients (AOR=3.76, 95% CI=1.84, 7.68), and routinely asking about tobacco use in clinical practice (AOR=2.62, 95% CI=1.11, 6.20). Increases occurred across all three practitioner types and were sustained at 12 months—despite heterogeneity in professional training, practice patterns/organization, and practice business models. Conclusions Results suggest CAM practitioners are willing and able to offer BIs, and are an important, yet overlooked channel for promoting tobacco cessation and use of evidence-based cessation aids.
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U2 - 10.1016/j.amepre.2016.02.017
DO - 10.1016/j.amepre.2016.02.017
M3 - Article
C2 - 27061892
AN - SCOPUS:84962385638
SN - 0749-3797
VL - 51
SP - e35-e44
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 2
ER -