Background
Southern European countries still have a high number of smokers with the highest prevalence (males and females) recorded in Spain (29%) and Portugal (25%). Smokers are frequent users of health care services, and their contact with the health system might be an adequate teachable moment for quitting In fact, between 60% and 70% of patients make a quit attempt while they are hospitalized. Thus, hospitalization provides a unique opportunity to identify and engage smokers, initiate cessation treatments, and facilitate appropriate follow-up and support. However, in spite of these favorable conditions, evidence-based cessation programs are hardly available in hospitals from Southern European countries.
Overall Objective
The main objective of the proposed project is to evaluate the organizational adoption, the implementation, and the effectiveness of an evidence-based and system-level tobacco cessation program after training clinicians on the delivery of a smoking cessation intervention and promoting the use of implementation tools among two hospitals in each participant country (Portugal and Spain). Furthermore, we will assess whether patients progress in their intention to quit, increase the number of quit attempts, and achieve abstinence after hospitalization.
Methodology
This implementation research project will design a comprehensive tobacco cessation program that combines two evidence-based tested products: (1) an online tobacco cessation course, and (2) tobacco cessation materials addressed to clinicians and smokers based on the Ottawa model. The translation and the adaptation of the materials will be done by local partners. The adoption and implementation of the tobacco cessation program will follow the AHRQ model for transferring evidence into practice.
Evaluation
Several pre-post evaluations are planned: (1) Process: to assess coverage, fidelity and satisfaction with the program (we will consider a positive coverage when smokers’ inclusion will be ≥50% of smokers admitted); (2) Outcome: to measure changes on health professionals’ knowledge, attitudes and behaviors after the training (we will consider a positive change with an increase of ≥20% of these indicators); (3) Impact: to assess whether the intervention increases the number of smokers assisted and whether smoking cessation rates increase compared to baseline (good level consider with rates over ≥10% after 6 months of discharge).
Duration
February 2017- February 2019
Financial Support
Grant Reference: 25678023. Budget: 199,000.00 $. The study is financed by Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, hosted at Mayo Clinic, and Pfizer Independent Grants for Learning and Change (IGLC).
Research Team
- Cristina Martínez (ICO-IDIBELL)
- Esteve Fernández (ICO-IDIBELL)
- Assumpta Company
- Olga Guillen
- Laura Antón (ICO-IDIBELL)
- Ariadna Feliu (ICO-IDIBELL)
- Marta Enriquez (ICO-IDIBELL)
- Sofia Ravara
- Lídia Videira
- Hilson Cunha Filho
- Jose Precioso
- Manuel Macedo Gonçalves
- Constantine Vardavas
- Sophia Papadakis
Articles
Feliu A, Ravara S, Papadakis S, Enríquez M, Antón L, Saura J, Company A, Romero O, Ripoll R, Ruz A, Precioso J, Pascoal I, Videira L, Correia C, Ferreira S, Fernández E, Martínez C. Factores asociados a los cambios en el patrón de tabaquismo de los pacientes ingresados durante la hospitalización y un mes después del alta: Un estudio de cohortes. J Nurs Scholarsh. 2021 Nov 9. doi: 10.1111/jnu.12735. Epub ahead of print. PMID: 34755457. Enlace: https://pubmed.ncbi.nlm.nih.gov/34755457/