Implementing a Tobacco Assisted Referral Program in Dental Practices

• Published in: Journal of public health dentistry 2009-06, Vol.69 (3), p.149-155
• Main Authors: Little, Sally J., Hollis, Jack F., Fellows, Jeffrey L., Snyder, John J., Dickerson, John F.
• Format: Article
• Language: English
• Subjects: behavior intervention; Behavior Therapy - methods; Counseling; Dental Facilities; dental hygienists; Dentistry; dentists; Female; Health Plan Implementation; Health Services Research - methods; Humans; Male; Middle Aged; Patient Satisfaction; prevention; Program Evaluation; quality improvement; Referral and Consultation; Telephone; tobacco cessation; Tobacco Use Cessation - methods; translation research; Translational Medical Research - methods
• ISSN: 0022-4006; 1752-7325
• DOI: 10.1111/j.1752-7325.2008.00113.x

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