Laschober Tanja C, Muilenburg Jessica L, Eby Lillian T
University of Georgia, 325 Psychology Building, Athens, GA 30602, USA ; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA.
University of Georgia, 325 Psychology Building, Athens, GA 30602, USA ; Department of Health Promotion and Behavior, 325 Psychology Building, Athens, GA 30602, USA.
J Addict Behav Ther Rehabil. 2015;4(1). doi: 10.4172/2324-9005.1000134.
Despite efforts to promote the use of tobacco cessation services (TCS), implementation extensiveness remains limited. This study investigated three factors (cognitive, behavioral, environmental) identified by social cognitive theory as predictors of substance use disorder counselors' likelihood of use versus non-use of tobacco cessation (TC) 5 A's (ask patients about tobacco use, advise to quit, assess willingness to quit, assist in quitting, arrange for follow-up contact), counseling, and pharmacotherapy with their patients who smoke cigarettes.
Data were collected in 2010 from 942 counselors working in 257 treatment programs that offered TCS. Cognitive factors included perceived job competence and TC attitudes. Behavioral factors encompassed TC-related skills and general training. External factors consisted of TC financial resource availability and coworker TC attitudes. Data were analyzed using logistic regression models with nested data.
Approximately 86% of counselors used the 5 A's, 76% used counseling, and 53% used pharmacotherapy. When counselors had greater TC-related skills and greater general training they were more likely to implement the 5 A's. Implementation of counseling was more likely when counselors had more positive attitudes toward TC treatment, greater general training, greater financial resource availability, and when coworkers had more positive attitudes toward TC treatment. Implementation of pharmacotherapy was more likely when counselors had more positive attitudes toward TC treatment, greater general training, and greater financial resource availability.
Findings indicate that interventions to promote TCS implementation should consider all three factors simultaneously as suggested by social cognitive theory.
尽管人们努力推广戒烟服务（TCS），但其实施的广泛程度仍然有限。本研究调查了社会认知理论确定的三个因素（认知、行为、环境），这些因素可预测物质使用障碍咨询师对吸烟患者使用或不使用戒烟（TC）5A's（询问患者吸烟情况、建议戒烟、评估戒烟意愿、协助戒烟、安排后续随访）、咨询和药物治疗的可能性。
2010年从257个提供TCS的治疗项目中的942名咨询师处收集数据。认知因素包括感知到的工作能力和对戒烟的态度。行为因素包括与戒烟相关的技能和一般培训。外部因素包括戒烟的资金资源可用性和同事对戒烟的态度。使用嵌套数据的逻辑回归模型对数据进行分析。
约86%的咨询师使用了5A's，76%的咨询师使用了咨询，53%的咨询师使用了药物治疗。当咨询师具备更强的与戒烟相关的技能和更多的一般培训时，他们更有可能实施5A's。当咨询师对戒烟治疗态度更积极、接受更多一般培训、有更多资金资源可用，且同事对戒烟治疗态度更积极时，实施咨询的可能性更大。当咨询师对戒烟治疗态度更积极、接受更多一般培训且有更多资金资源可用时，实施药物治疗的可能性更大。
研究结果表明，促进戒烟服务实施的干预措施应如社会认知理论所建议的那样，同时考虑所有这三个因素。
