Developing assessment and promotion of tobacco counselling : a cluster-randomised community trial among oral health professionals
Year: 2012
Type: dissertation
Study design: Clinical Trial
Abstract: Tobacco use adversely affects oral health. Tobacco use cessation (TUC) counselling guidelines recommend that brief TUC counselling should be provided to all tobacco users. In addition to TUC counselling, providing positive support to remain tobacco abstinent is particularly important among adolescents who are about to experiment with tobacco use. Despite excellent opportunities, implementation of tobacco use prevention and cessation (TUPAC) counselling among oral health professionals has proved challenging. Thus, the present study aimed to develop the assessment and promotion of TUPAC counselling among oral health professionals. A sample of Finnish dentists (n = 73) and dental hygienists (n = 22) employed by community dental clinics of the municipal health care regions of Tampere (28 clinics) and Vaasa (9 clinics) were invited to participate. Of those invited, 73 (76.8%) oral health professionals from 34 (91.9%) dental clinics participated. Applying a Theoretical Domains Framework (TDF), a 35-item Theoretical Domains Questionnaire (TDQ) was developed to assess factors influencing TUPAC counselling. The provision of TUC counselling at baseline was measured using a questionnaire and an electronic dental record audit to measure the effects of (1) educational and (2) educational + fee-for-service interventions. The estimates of internal consistency and factor analysis supported the reliability and validity of the TDQ developed. The present study showed that the provision of TUC counselling among a sample of oral health professionals was low. Identified implementation barriers suggest that the low adherence to TUPAC counselling could be due to reported environmental constraints (e.g. lack of support and resources), lack of skills, and low self-efficacy. Professional role and identity as well as memory, attention and decision processes were identified as potential determinants for TUPAC counselling. In assessing the effects of educational and education + fee-for-service interventions on preventive counselling, no statistically significant intervention effects were found. Regarding the provision of TUC counselling, signficiant group-by-time interaction showed that education alone and education with fee increased the implementation. . However, there was no statistically significant additional effect was received by adding fee-for-service to the education. In all groups, dental hygienists improved their preventive and cessation counselling more than dentists did. In conclusion, the data indicated a lack of competencies, environmental support and resources regarding TUPAC counselling. Educational intervention showed a favourable impact on the implementation of TUC counselling. In addition to education, interventions that promote professional role and identity in TUPAC counselling as well as interventions offering tools to support decision making (e.g. reminders, feedback) could prove effective.
Source: Työväentutkimus Vuosikirja
Author: Masamitsu Amemori
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1565688421