Counseling Youth in Tobacco-Use Prevention: Determinants of Clinician Compliance

• Published in: Preventive medicine Vol. 29; no. 1; pp. 13 - 21
• Main Authors: Russos, Stergios, Keating, Kristen, Hovell, Melbourne F., Jones, Jennifer A., Slymen, Donald J., Hofstetter, C.Richard, Rubin, Budd, Morrison, Theodore
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.1999
• Subjects: Adolescent; Adult; Attitude of Health Personnel; California; Chi-Square Distribution; Child; clinician compliance; Counseling - education; Counseling - statistics & numerical data; Cross-Sectional Studies; determinants of clinician practices; Female; Health Care Surveys; Health Promotion - methods; Health Promotion - standards; Humans; Male; Middle Aged; Orthodontics - statistics & numerical data; Patient Education as Topic - statistics & numerical data; Professional Practice - statistics & numerical data; Program Evaluation; Regression Analysis; Smoking - therapy; Smoking Prevention; social learning; tobacco control; Tobacco Use Disorder - prevention & control; Tobacco Use Disorder - therapy; determinants of clinician practices; social learning; clinician compliance; tobacco control
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1006/pmed.1999.0495

Objective. The rate and determinants of tobacco prevention and cessation counseling to youth were examined for orthodontists participating in a controlled trial to decrease the incidence of tobacco use among adolescents. Methods. A cross-sectional interview design in private practice offices throughout Southern California was used. The survey was completed with 126 (82%) orthodontists. Clinicians randomly assigned to the experimental group (N = 77) received a 1.5 h workshop, anti-tobacco materials, reimbursement for provision of anti-tobacco prescriptions, and quarterly checkup visits. Control group clinicians (N = 77) did not receive training, materials, or visits. Results. Experimental group clinicians talked to more adolescent nonsmokers about never beginning tobacco use than did control group clinicians (P < 0.05). Experimental group clinicians talked to more adolescent tobacco users than did control group clinicians; however, the difference was not statistically significant. Content and determinants of counseling were af fected by participation in the intervention. Conclusions. Though training and support increased prevention and cessation counseling, absolute rates remained less than optimal. Social learning factors were associated with prevention and cessation coun seling.