Current trends in tobacco prevention and cessation in Nebraska physicians' offices

Helen E. McIlvain, Benjamin F. Crabtree, Carol Gilbert, Russell Havranek, Elisabeth L Backer

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

BACKGROUND. Despite years of intervention, few studies describe the extent to which recommended tobacco use prevention and cessation activities occur in community-based family practices. This study was designed to discover current practice patterns in these areas and to describe physician outcome and efficacy expectations. METHODS. An exploratory comparative case study of 11 family practices used direct observation of practices and clinical encounters, chart reviews, and in-depth interviews. Qualitative and quantitative information was gathered on (1) intensity of tobacco use prevention and cessation; (2) physicians' attitudes and beliefs regarding outcome expectations; and (3) physicians' perceptions of their ability to counsel. Qualitative content analysis and descriptive statistics were used to construct case studies for comparisons. RESULTS. Themes common to most practices included the 'provision of little prevention' and 'a lack of perceived need to address smokeless tobacco.' Responsibility for tobacco activities fell almost solely to physicians. Although physicians felt confident in their counseling skills, the skills they identified were fairly basic. Most physicians were pessimistic about the positive effects of these activities. None of the practices was using any specifically developed 'package,' and pharmaceutical companies provided almost all patient education material. There was considerable variation in intensity of activities because of differences in attitudes, expectation, and background. CONCLUSIONS. To increase tobacco control activities, practice systems need to be individually evaluated to identify what is needed, how it will fit within the practice culture, and how it can best be implemented in this specific practice. One- size-fits-all interventions probably will not be widely implemented.

Original languageEnglish (US)
Pages (from-to)193-202
Number of pages10
JournalJournal of Family Practice
Volume44
Issue number2
StatePublished - Feb 1 1997

Fingerprint

Tobacco Use Cessation
Physicians' Offices
Physicians
Family Practice
Tobacco
Smokeless Tobacco
Aptitude
Patient Education
Case-Control Studies
Counseling
Observation
Interviews
Pharmaceutical Preparations

Keywords

  • Preventive health services
  • health promotion
  • physician's practice patterns
  • smoking cessation
  • tobacco

ASJC Scopus subject areas

  • Family Practice

Cite this

McIlvain, H. E., Crabtree, B. F., Gilbert, C., Havranek, R., & Backer, E. L. (1997). Current trends in tobacco prevention and cessation in Nebraska physicians' offices. Journal of Family Practice, 44(2), 193-202.

Current trends in tobacco prevention and cessation in Nebraska physicians' offices. / McIlvain, Helen E.; Crabtree, Benjamin F.; Gilbert, Carol; Havranek, Russell; Backer, Elisabeth L.

In: Journal of Family Practice, Vol. 44, No. 2, 01.02.1997, p. 193-202.

Research output: Contribution to journalArticle

McIlvain, HE, Crabtree, BF, Gilbert, C, Havranek, R & Backer, EL 1997, 'Current trends in tobacco prevention and cessation in Nebraska physicians' offices', Journal of Family Practice, vol. 44, no. 2, pp. 193-202.
McIlvain, Helen E. ; Crabtree, Benjamin F. ; Gilbert, Carol ; Havranek, Russell ; Backer, Elisabeth L. / Current trends in tobacco prevention and cessation in Nebraska physicians' offices. In: Journal of Family Practice. 1997 ; Vol. 44, No. 2. pp. 193-202.
@article{30ce9449e36b4444a9b4916ee19d79b3,
title = "Current trends in tobacco prevention and cessation in Nebraska physicians' offices",
abstract = "BACKGROUND. Despite years of intervention, few studies describe the extent to which recommended tobacco use prevention and cessation activities occur in community-based family practices. This study was designed to discover current practice patterns in these areas and to describe physician outcome and efficacy expectations. METHODS. An exploratory comparative case study of 11 family practices used direct observation of practices and clinical encounters, chart reviews, and in-depth interviews. Qualitative and quantitative information was gathered on (1) intensity of tobacco use prevention and cessation; (2) physicians' attitudes and beliefs regarding outcome expectations; and (3) physicians' perceptions of their ability to counsel. Qualitative content analysis and descriptive statistics were used to construct case studies for comparisons. RESULTS. Themes common to most practices included the 'provision of little prevention' and 'a lack of perceived need to address smokeless tobacco.' Responsibility for tobacco activities fell almost solely to physicians. Although physicians felt confident in their counseling skills, the skills they identified were fairly basic. Most physicians were pessimistic about the positive effects of these activities. None of the practices was using any specifically developed 'package,' and pharmaceutical companies provided almost all patient education material. There was considerable variation in intensity of activities because of differences in attitudes, expectation, and background. CONCLUSIONS. To increase tobacco control activities, practice systems need to be individually evaluated to identify what is needed, how it will fit within the practice culture, and how it can best be implemented in this specific practice. One- size-fits-all interventions probably will not be widely implemented.",
keywords = "Preventive health services, health promotion, physician's practice patterns, smoking cessation, tobacco",
author = "McIlvain, {Helen E.} and Crabtree, {Benjamin F.} and Carol Gilbert and Russell Havranek and Backer, {Elisabeth L}",
year = "1997",
month = "2",
day = "1",
language = "English (US)",
volume = "44",
pages = "193--202",
journal = "Journal of Family Practice",
issn = "0094-3509",
publisher = "Appleton-Century-Crofts",
number = "2",

}

TY - JOUR

T1 - Current trends in tobacco prevention and cessation in Nebraska physicians' offices

AU - McIlvain, Helen E.

AU - Crabtree, Benjamin F.

AU - Gilbert, Carol

AU - Havranek, Russell

AU - Backer, Elisabeth L

PY - 1997/2/1

Y1 - 1997/2/1

N2 - BACKGROUND. Despite years of intervention, few studies describe the extent to which recommended tobacco use prevention and cessation activities occur in community-based family practices. This study was designed to discover current practice patterns in these areas and to describe physician outcome and efficacy expectations. METHODS. An exploratory comparative case study of 11 family practices used direct observation of practices and clinical encounters, chart reviews, and in-depth interviews. Qualitative and quantitative information was gathered on (1) intensity of tobacco use prevention and cessation; (2) physicians' attitudes and beliefs regarding outcome expectations; and (3) physicians' perceptions of their ability to counsel. Qualitative content analysis and descriptive statistics were used to construct case studies for comparisons. RESULTS. Themes common to most practices included the 'provision of little prevention' and 'a lack of perceived need to address smokeless tobacco.' Responsibility for tobacco activities fell almost solely to physicians. Although physicians felt confident in their counseling skills, the skills they identified were fairly basic. Most physicians were pessimistic about the positive effects of these activities. None of the practices was using any specifically developed 'package,' and pharmaceutical companies provided almost all patient education material. There was considerable variation in intensity of activities because of differences in attitudes, expectation, and background. CONCLUSIONS. To increase tobacco control activities, practice systems need to be individually evaluated to identify what is needed, how it will fit within the practice culture, and how it can best be implemented in this specific practice. One- size-fits-all interventions probably will not be widely implemented.

AB - BACKGROUND. Despite years of intervention, few studies describe the extent to which recommended tobacco use prevention and cessation activities occur in community-based family practices. This study was designed to discover current practice patterns in these areas and to describe physician outcome and efficacy expectations. METHODS. An exploratory comparative case study of 11 family practices used direct observation of practices and clinical encounters, chart reviews, and in-depth interviews. Qualitative and quantitative information was gathered on (1) intensity of tobacco use prevention and cessation; (2) physicians' attitudes and beliefs regarding outcome expectations; and (3) physicians' perceptions of their ability to counsel. Qualitative content analysis and descriptive statistics were used to construct case studies for comparisons. RESULTS. Themes common to most practices included the 'provision of little prevention' and 'a lack of perceived need to address smokeless tobacco.' Responsibility for tobacco activities fell almost solely to physicians. Although physicians felt confident in their counseling skills, the skills they identified were fairly basic. Most physicians were pessimistic about the positive effects of these activities. None of the practices was using any specifically developed 'package,' and pharmaceutical companies provided almost all patient education material. There was considerable variation in intensity of activities because of differences in attitudes, expectation, and background. CONCLUSIONS. To increase tobacco control activities, practice systems need to be individually evaluated to identify what is needed, how it will fit within the practice culture, and how it can best be implemented in this specific practice. One- size-fits-all interventions probably will not be widely implemented.

KW - Preventive health services

KW - health promotion

KW - physician's practice patterns

KW - smoking cessation

KW - tobacco

UR - http://www.scopus.com/inward/record.url?scp=0031020727&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031020727&partnerID=8YFLogxK

M3 - Article

VL - 44

SP - 193

EP - 202

JO - Journal of Family Practice

JF - Journal of Family Practice

SN - 0094-3509

IS - 2

ER -