VA HSR&D Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis VA Health Care System, Minneapolis, MN, USA.
Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
J Behav Health Serv Res. 2021 Jan;48(1):63-76. doi: 10.1007/s11414-020-09707-3.
Healthcare provider barriers to cessation resources may be undercutting quit rates for smokers with serious mental illness (SMI). The study aim was to examine how providers influence cessation treatment utilization among smokers with SMI. Data were taken from a trial conducted among smokers in Minnesota Health Care Programs. The sample was split into groups of participants with SMI (n = 939) and without SMI (n = 1382). Analyses assessed whether the association between SMI and treatment utilization was mediated by healthcare provider-delivered treatment advice and healthcare provider bias. Results revealed higher rates of treatment utilization among smokers with SMI than those without SMI (45.9% vs 31.7%, p < 0.001); treatment advice and provider bias did not mediate this association. Subsequent individual regression analyses revealed positive associations between treatment advice and treatment utilization (β 0.21-0.25, p < 0.05), independent of SMI status. Strategies to increase low-income smokers' contacts with providers may reduce treatment utilization barriers among these smokers.
医疗服务提供者在戒烟资源方面的障碍可能会降低患有严重精神疾病 (SMI) 的吸烟者的戒烟率。本研究旨在探讨提供者如何影响患有 SMI 的吸烟者接受戒烟治疗的情况。数据取自明尼苏达州医疗保健计划中对吸烟者进行的一项试验。将样本分为患有 SMI 的参与者组（n=939）和没有 SMI 的参与者组（n=1382）。分析评估了 SMI 与治疗利用之间的关联是否被医疗保健提供者提供的治疗建议和医疗保健提供者偏见所中介。结果显示，患有 SMI 的吸烟者的治疗利用率高于没有 SMI 的吸烟者（45.9% vs 31.7%，p<0.001）；治疗建议和提供者偏见并不能解释这种关联。随后的个体回归分析显示，治疗建议与治疗利用之间存在正相关（β0.21-0.25，p<0.05），与 SMI 状况无关。增加低收入吸烟者与提供者接触的策略可能会减少这些吸烟者的治疗利用障碍。
