Richmond R, Mendelsohn C, Kehoe L
School of Community Medicine, University of New South Wales, Sydney, Australia.
Prev Med. 1998 Jan-Feb;27(1):77-83. doi: 10.1006/pmed.1997.0240.
Previous studies have examined methods of delivery of brief interventions and reinforcement contact and their effects on physicians' utilization of smoking cessation interventions. In this study the objectives were: (1) to determine the ongoing utilization by family physicians of a brief smoking cessation intervention 6 months after a training workshop and (2) to examine the effect of reinforcement contact on physician utilization. A supplementary aim was to assess point prevalence abstinence among patients identified as ready to quit smoking.
This was a randomized controlled trial of family physicians (98 in the Contact and 100 in the Noncontact group). Training was conducted in a 2-hr workshop. Doctors in the Contact group received three brief telephone calls at 2 weeks, 2 months, and 4 months after training. Main outcome measures were: (1) utilization, determined by responses to a mailed questionnaire about use of the program, and (2) the number of booklets distributed by full-time doctors, collected by practice secretaries or research assistant.
At 6 months 88% of physicians (93% of the Contact group and 84% of the Noncontact group, P = 0.06) were current users of the smoking cessation intervention. Full-time physicians in the Contact group distributed significantly more booklets (40.1) over 6 months than those in the Noncontact group (32.8) (P < 0.05). Twenty-one percent of patients reported not smoking at follow-up at an average of 9.9 months after intervention.
Most doctors continued to use the program 6 months after training and reinforcement contact encouraged greater recruitment of patients.
以往研究探讨了简短干预措施和强化联系的实施方法及其对医生戒烟干预措施使用情况的影响。本研究的目的是:(1)确定家庭医生在参加培训工作坊6个月后对简短戒烟干预措施的持续使用情况;(2)研究强化联系对医生使用情况的影响。一个补充目的是评估被确定准备戒烟的患者中的点患病率戒烟情况。
这是一项针对家庭医生的随机对照试验(接触组98名,非接触组100名)。培训在一个2小时的工作坊中进行。接触组的医生在培训后2周、2个月和4个月接到了三个简短的电话。主要结局指标为:(1)使用情况,通过对一份关于该项目使用情况的邮寄问卷的回复来确定;(2)由全职医生分发、由诊所秘书或研究助理收集的手册数量。
6个月时,88%的医生(接触组为93%,非接触组为84%,P = 0.06)是戒烟干预措施的当前使用者。接触组的全职医生在6个月内分发的手册显著多于非接触组(分别为40.1本和32.8本)(P < 0.05)。21%的患者在干预后平均9.9个月的随访中报告已戒烟。
大多数医生在培训6个月后仍继续使用该项目,强化联系鼓励了更多患者参与。