Internet delivered support for tobacco control in dental practice: randomized controlled trial
Authors
Houston, Thomas K.Richman, Joshua S.
Ray, Midge N.
Allison, Jeroan J.
Gilbert, Gregg H.
Shewchuk, Richard M.
Kohler, Connie L.
Kiefe, Catarina I.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2008-11-06Keywords
Advertising as Topic*Dentistry
Health Services Accessibility
Health Surveys
Humans
*Internet
Mouth Neoplasms
Patient Selection
Questionnaires
Smoking
Smoking Cessation
*Social Support
Therapy, Computer-Assisted
Treatment Outcome
User-Computer Interface
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: The dental visit is a unique opportunity for tobacco control. Despite evidence of effectiveness in dental settings, brief provider-delivered cessation advice is underutilized. OBJECTIVE: To evaluate an Internet-delivered intervention designed to increase implementation of brief provider advice for tobacco cessation in dental practice settings. METHODS: Dental practices (N = 190) were randomized to the intervention website or wait-list control. Pre-intervention and after 8 months of follow-up, each practice distributed exit cards (brief patient surveys assessing provider performance, completed immediately after the dental visit) to 100 patients. Based on these exit cards, we assessed: whether patients were asked about tobacco use (ASK) and, among tobacco users, whether they were advised to quit tobacco (ADVISE). All intervention practices with follow-up exit card data were analyzed as randomized regardless of whether they participated in the Internet-delivered intervention. RESULTS: Of the 190 practices randomized, 143 (75%) dental practices provided follow-up data. Intervention practices' mean performance improved post-intervention by 4% on ASK (29% baseline, adjusted odds ratio = 1.29 [95% CI 1.17-1.42]), and by 11% on ADVISE (44% baseline, OR = 1.55 [95% CI 1.28-1.87]). Control practices improved by 3% on ASK (Adj. OR 1.18 [95% CI 1.07-1.29]) and did not significantly improve in ADVISE. A significant group-by-time interaction effect indicated that intervention practices improved more over the study period than control practices for ADVISE (P = 0.042) but not for ASK. CONCLUSION: This low-intensity, easily disseminated intervention was successful in improving provider performance on advice to quit. TRIAL REGISTRATION: clinicaltrials.gov NCT00627185, http://www.webcitation.org/5c5Kugvzj.Source
J Med Internet Res. 2008 Nov 4;10(5):e38. Link to article on publisher's siteDOI
10.2196/jmir.1095Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47116PubMed ID
18984559Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.2196/jmir.1095