Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers

Kathy Le, Tzuan A. Chen, Isabel Martinez Leal, Virmarie Correa-Fernández, Ezemenari M. Obasi, Bryce Kyburz, Teresa Williams, Kathleen Casey, Matthew Taing, Daniel P. O’Connor and Lorraine R. Reitzel
Additional contact information
Kathy Le: Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
Tzuan A. Chen: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
Isabel Martinez Leal: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
Virmarie Correa-Fernández: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
Ezemenari M. Obasi: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
Bryce Kyburz: Integral Care, 1430 Collier Street, Austin, TX 78704, USA
Teresa Williams: Integral Care, 1430 Collier Street, Austin, TX 78704, USA
Kathleen Casey: Integral Care, 1430 Collier Street, Austin, TX 78704, USA
Matthew Taing: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
Daniel P. O’Connor: Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA
Lorraine R. Reitzel: Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA

IJERPH, 2021, vol. 18, issue 19, 1-16

Abstract: Although tobacco use is the leading preventable cause of death and is elevated among patients with substance use disorders, many substance use treatment centers (SUTCs) do not offer tobacco use interventions (i.e., screening and treatment). This study examined a key outcome of the implementation of a tobacco-free workplace program that provided education and specialized training to employees; namely, changes in clinician provision of the five As (Asking about tobacco use; Advising to quit; Assessing willingness to quit; Assisting with quitting; Arranging follow-up) from before to after the larger program implementation. The five As are a brief tobacco screening and treatment protocol that was taught as part of the program and that formed the basis for further intervention (e.g., provision of nicotine replacement therapies, Motivational Interviewing to enhance desire and willingness to make a quit attempt). Moreover, we also examined organizational moderators that may have impacted changes in the delivery of the five As over time among clinicians from 15 participating SUTCs. The number of the centers’ total and unique annual patient visits; full-time employees; and organizational readiness for implementing change were assessed as potential moderators of change in clinicians’ behaviors over time. Clinicians completed pre- and post-program implementation surveys assessing their provision of the five As. Results demonstrated significant increases in Asking ( p = 0.0036), Advising ( p = 0.0176), Assisting ( p < 0.0001), and Arranging ( p < 0.0001). SUTCs with higher Change Efficacy ( p = 0.025) and lower Resource Availability ( p = 0.019) had greater increases in Asking. SUTCs with lower Resource Availability had greater increases in Assessing ( p = 0.010). These results help guide tobacco control program implementation to increase the provision of tobacco use interventions (i.e., the five As) to SUTC patients and elucidate Change Efficacy and Resource Availability as organizational factors promoting this clinician behavior change.

Keywords: smoking; implementation science; tobacco control; training; education; organizational moderators; readiness for change; tobacco use disorders; intervention; non-profit substance abuse treatment centers; substance use disorders (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (9)

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