Mahabee-Gittens E Melinda, Dixon Cinnamon A, Vaughn Lisa M, Duma Elena M, Gordon Judith S
Cincinnati, OH; Tucson, AZ.
Cincinnati, OH; Tucson, AZ.
J Emerg Nurs. 2014 Jul;40(4):336-45. doi: 10.1016/j.jen.2013.06.001. Epub 2013 Sep 9.
The pediatric emergency department (PED) is a venue that underuses parental tobacco screening and brief cessation counseling. We sought to explore PED practitioners' attitudes and perceived barriers regarding the implementation and adoption of tobacco screening/cessation counseling of parental smokers in the PED setting, as well as to solicit suggestions for improving the sustainability and maintenance of such practices.
We conducted an exploratory, qualitative study of a convenience sample of PED practitioners using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Individual, focused interviews were conducted to determine factors that would maximize the implementation and maintenance of parental tobacco screening and intervention counseling as standard PED practice.
Thirty interviews were conducted from which relevant data, patterns, and themes were identified. Reach factors included targeting parental smokers with children with respiratory diseases, having adequate training of practitioners, and providing "prearranged" counseling packages. Effectiveness factors included practitioner desire for outcome data about intervention effectiveness (eg, changes in children's secondhand smoke exposure and parental quit rates). Solutions to increase intervention adoption included quick electronic health record prompts and the provision of onsite tobacco cessation experts. Implementation suggestions emphasized the importance of financial support and the alignment of tobacco screening/counseling with strategic plans. Maintenance factors included institutional and technical support, as well as the importance of intervention "champions" in the PED.
By highlighting important viewpoints of practitioners regarding tobacco screening and counseling, the findings can help guide and direct the development and evaluation of sustainable interventions to facilitate tobacco use treatment in the PED.
儿科急诊科（PED）是一个对家长进行烟草筛查和简短戒烟咨询利用不足的场所。我们试图探讨儿科急诊科从业者对于在儿科急诊科环境中对家长吸烟者实施和采用烟草筛查/戒烟咨询的态度和感知障碍，并征求关于提高此类做法的可持续性和维持率的建议。
我们使用RE-AIM（覆盖、效果、采用、实施和维持）框架，对儿科急诊科从业者的便利样本进行了一项探索性定性研究。进行了个别重点访谈，以确定能最大限度地将家长烟草筛查和干预咨询作为儿科急诊科标准做法加以实施和维持的因素。
进行了30次访谈，从中确定了相关数据、模式和主题。覆盖因素包括针对患有呼吸道疾病儿童的家长吸烟者、对从业者进行充分培训以及提供“预先安排好的”咨询套餐。效果因素包括从业者希望获得有关干预效果的结果数据（例如儿童二手烟暴露的变化和家长戒烟率）。提高干预采用率的解决办法包括快速电子健康记录提示和提供现场戒烟专家。实施建议强调了财政支持的重要性以及烟草筛查/咨询与战略计划的一致性。维持因素包括机构和技术支持，以及儿科急诊科中干预“倡导者”的重要性。
通过突出从业者关于烟草筛查和咨询的重要观点，研究结果有助于指导和推动可持续干预措施的制定和评估，以促进儿科急诊科的烟草使用治疗。
