Project Title: Clinically-Efficient Strategies to Address Tobacco Smoke Exposure in Pediatric Practice
Research Project Description:
The scientific premise for clinical strategies to reduce tobacco smoke exposure in children is well-established, yet compliance in pediatric practice remains low. Consequently, it remains unclear how to best support the uptake and sustainability of delivering evidence-based tobacco control interventions to parents in pediatric practice. Training for providers and clinic staff promotes best practices for tobacco control in clinical care, but implementation remains insufficient due to barriers to clinical efficiency, including competing time constraints during an office visit. However, the diffusion of electronic health records (EHRs) into clinical practice increases opportunities to engage clinics in intervention approaches that are potentially more sustainable by capitalizing on existing clinical processes. We propose a two-pronged approach to enhance implementation: 1) training providers and office staff on current best practices; and 2) deploying a brief EHR-based intervention in conjunction with provider-engaged adaptations to fit the intervention into practice workflow. We developed and piloted an innovative EHR-based process that confidentially screens parents pre- or in-visit for the use of tobacco and nicotine products. The provider receives the screening results in the EHR to enable counseling in addition to EHR-based referral to cessation services.
Medical students will work on all aspects of the study by assisting in facilitating implementation in clinical settings, assisting with focus groups and training activities, contributing to qualitative and quantitative analysis of study results, and dissemination of study findings at scientific meetings and in peer-reviewed publications.
Salloum RG, Theis RP, Pbert L, Gurka MJ, Porter M, Lee D, Shenkman EA, Thompson LA. Stakeholder Engagement in Developing an Electronic Clinical Support Tool for Tobacco Prevention in Adolescent Primary Care. Children (Basel). 2018 Dec 17;5(12). pii: E170. doi: 10.3390/children5120170. PubMed PMID: 30563001; PubMed Central PMCID: PMC6306818.
Theis RP, Malik AM, Thompson LA, Shenkman EA, Pbert L, Salloum RG.Considerations of Privacy and Confidentiality in Developing a Clinical Support Tool for Adolescent Tobacco Prevention: Qualitative Study. JMIR Form Res. 2019 Apr 28;3(2):e12406. doi: 10.2196/12406. PubMed PMID: 31066687; PubMed Central PMCID: PMC6528437.
LeLaurin JH, Theis RP, Thompson LA, Tan ASL, Young-Wolff KC, Carter-Harris L, Shenkman EA, Salloum RG. Tobacco-related counseling and documentation in adolescent primary care practice: Challenges and opportunities. Nicotine Tob Res. 2019 May 10. pii: ntz076. doi: 10.1093/ntr/ntz076. [Epub ahead of print] PubMed PMID: 31074792.
Entry Date: September 26, 2019