Implementing a tobacco assisted referral program in dental practices. Little, S. J., Hollis, J. F., Fellows, J. L., Snyder, J. J., & Dickerson, J. F. Journal of Public Health Dentistry, 69(3):149–155, 2009.
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OBJECTIVES: The objectives of this study are to design and implement a system-level tobacco-control intervention in a large prepaid dental group practice and assess effects on staff performance measures and patient satisfaction. METHODS: We matched 14 dental facilities on size, socioeconomic status, smoking rate, and periodontal status, and then randomly assigned them to intervention or usual-care control. We trained intervention staff in an "Assisted Referral" team approach for assessing tobacco use, providing tailored advice and brief counseling, and encouraging smokers to talk by telephone with a specially trained tobacco counselor. Patients could call from the office or ask that the counselor call them later. Telephone counselors helped patients explore motivations and barriers for quitting; review available cessation-support strategies, programs, and medications; and identify next steps. RESULTS: During the 14-month study period, 66,516 members had annual- or new-patient examinations. Both intervention and control sites had high rates of tobacco assessment (97 percent) and advice (93 percent). Intervention patients were more likely than controls (69 percent versus 3 percent, P \textless 0.01) to receive additional chair-side tobacco counseling and assistance, and 11 percent agreed to receive additional telephone counseling. Intervention patients were more satisfied than controls with the dental team's tobacco-control efforts (P \textless 0.03). Referral rates varied substantially for different staff. CONCLUSIONS: The Assisted Referral approach was successfully integrated into routine dental care, was well received by patients, and resulted in increased patient satisfaction. Because free telephone-based tobacco counseling is now available nationwide, the approach may be a practical strategy for most dental-care settings.
@article{little_implementing_2009,
	title = {Implementing a tobacco assisted referral program in dental practices},
	volume = {69},
	issn = {0022-4006},
	doi = {10.1111/j.1752-7325.2008.00113.x},
	abstract = {OBJECTIVES: The objectives of this study are to design and implement a system-level tobacco-control intervention in a large prepaid dental group practice and assess effects on staff performance measures and patient satisfaction.
METHODS: We matched 14 dental facilities on size, socioeconomic status, smoking rate, and periodontal status, and then randomly assigned them to intervention or usual-care control. We trained intervention staff in an "Assisted Referral" team approach for assessing tobacco use, providing tailored advice and brief counseling, and encouraging smokers to talk by telephone with a specially trained tobacco counselor. Patients could call from the office or ask that the counselor call them later. Telephone counselors helped patients explore motivations and barriers for quitting; review available cessation-support strategies, programs, and medications; and identify next steps.
RESULTS: During the 14-month study period, 66,516 members had annual- or new-patient examinations. Both intervention and control sites had high rates of tobacco assessment (97 percent) and advice (93 percent). Intervention patients were more likely than controls (69 percent versus 3 percent, P {\textless} 0.01) to receive additional chair-side tobacco counseling and assistance, and 11 percent agreed to receive additional telephone counseling. Intervention patients were more satisfied than controls with the dental team's tobacco-control efforts (P {\textless} 0.03). Referral rates varied substantially for different staff.
CONCLUSIONS: The Assisted Referral approach was successfully integrated into routine dental care, was well received by patients, and resulted in increased patient satisfaction. Because free telephone-based tobacco counseling is now available nationwide, the approach may be a practical strategy for most dental-care settings.},
	language = {eng},
	number = {3},
	journal = {Journal of Public Health Dentistry},
	author = {Little, Sally J. and Hollis, Jack F. and Fellows, Jeffrey L. and Snyder, John J. and Dickerson, John F.},
	year = {2009},
	pmid = {19192102},
	keywords = {Behavior Therapy, Counseling, Dental Facilities, Female, Health Plan Implementation, Health Services Research, Humans, Male, Middle Aged, Patient Satisfaction, Program Evaluation, Referral and Consultation, Telephone, Tobacco Use Cessation, Translational Medical Research},
	pages = {149--155},
}

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