Matthews Alicia K, Duangchan Cherdsak, Afuko Jennifer, Opuada Hope, Donenberg Geri
School of Nursing, Columbia University, New York, United States.
College of Nursing, University of Illinois Chicago, Chicago, United States.
Tob Prev Cessat. 2024 Oct 30;10. doi: 10.18332/tpc/191728. eCollection 2024.
Federally qualified healthcare centers (FQHC) treat a large population of low-income patients disproportionately burdened by tobacco use. This study investigated healthcare providers' knowledge, attitudes, and referral patterns of patients who smoke to a state tobacco quitline.
The study used a descriptive-qualitative design. In-depth interviews were conducted in 2021 with a sample of healthcare providers recruited from a federally qualified healthcare center (FQHC) in a large city in the Midwest. The interviews were guided by a standardized moderator's guide and lasted 30-45 minutes. Written informed consent was obtained before each interview, and participants completed a brief self-administered survey.
Among the 25 participants, 92% were female and 44% were Black. Participants included medical providers (52%), behavioral health providers (16%), and other types of providers (32%). Participants' age and work experience averaged 41.5 and 5.25 years, respectively. Only 32% of providers reported having specialty training in smoking cessation or addiction counseling. Over half (52%) of the participants never or rarely referred patients to the Illinois Tobacco Quitline (ITQL). Providers reported several barriers to referring patients to the ITQL, including limited knowledge about services offered, time constraints, difficulties with the referral process, and lack of feedback between providers and the ITQL. Further, providers described patient-related barriers, including low motivation to quit smoking, language barriers, and failure of patients to respond to calls from the quitline. Recommendations were described for improving patient and provider education, referral processes, and increasing bi-directional communication between providers and the quitline.
Providers identified numerous barriers to referring patients for smoking cessation treatment. Addressing the identified barriers requires a multi-faceted approach involving education, streamlined processes, supportive infrastructure, and patient-centered interventions to strengthen provider use and satisfaction with the available resources.
联邦合格医疗中心（FQHC）治疗的大量低收入患者受烟草使用的影响尤其严重。本研究调查了医疗服务提供者对吸烟患者的知识、态度以及将其转介至州戒烟热线的模式。
本研究采用描述性定性设计。2021年，对从中西部一个大城市的联邦合格医疗中心（FQHC）招募的医疗服务提供者样本进行了深入访谈。访谈由标准化的主持人指南指导，持续30 - 45分钟。每次访谈前均获得书面知情同意，参与者完成一份简短的自我管理调查问卷。
在25名参与者中，92%为女性，44%为黑人。参与者包括医疗服务提供者（52%）、行为健康服务提供者（16%）和其他类型的服务提供者（32%）。参与者的年龄和工作经验平均分别为41.5岁和5.25年。只有32%的服务提供者报告接受过戒烟或成瘾咨询方面的专业培训。超过一半（52%）的参与者从未或很少将患者转介至伊利诺伊州戒烟热线（ITQL）。服务提供者报告了将患者转介至ITQL的几个障碍，包括对所提供服务的了解有限、时间限制、转介过程困难以及服务提供者与ITQL之间缺乏反馈。此外，服务提供者描述了与患者相关的障碍，包括戒烟动力低、语言障碍以及患者未回应戒烟热线的电话。针对改善患者和服务提供者教育、转介流程以及增加服务提供者与戒烟热线之间的双向沟通提出了建议。
服务提供者确定了将患者转介接受戒烟治疗的众多障碍。解决这些已确定的障碍需要多方面的方法，包括教育、简化流程、支持性基础设施以及以患者为中心的干预措施，以加强服务提供者对可用资源的使用和满意度。
