The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

HOSPITAL-INITIATED IMPLEMENTATION OF THE 5 A'S FOR SMOKING CESSATION BY RESPIRATORY THERAPISTS.

Michael E. Anders1, Christine E. Sheffer3, Shane Groves1, Matthew E. O'Neal2, Andrea L. Hoycus4, Tammy Poole5; 1Respiratory and Surgical Technologies, University of Arkansas for Medical Sciences, Little Rock, AR; 2Respiratory Care, Indiana University - Purdue University Indianapolis, Indianapolis, IN; 3Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR; 4Respiratory Care, Indiana University Health North Hospital, Indianapolis, IN; 5Respiratory Care, Indiana University Health Methodist Hospital, Indianapolis, IN

Background: Smoking is the leading preventable cause of death and diseases. Related health care costs are unsustainable. The Clinical Practice Guideline for the Treatment of Tobacco Use and Dependence (CPG) recommendations (5 A's: Ask about smoking status; Advise to quit; Assess willingness to quit; Assist quit attempt; Arrange follow-up) increase quit rates and are cost-effective. When linked to cessation programs, hospital-initiated implementation of the 5 A's is effective. However, the extent to which hospital-based respiratory therapists (RTs) implement the 5 A's and make referrals to cessation programs is unknown. The study purpose was to examine smoking cessation practices of hospital-based RTs. Method: RTs in five hospitals were invited to complete a questionnaire. The questionnaire elicited smoking cessation training, familiarity with the CPG, perceived importance, motivation and self-efficacy to help smokers quit, outcome expectancies, and frequency of implementation of the 5 A's. Responses were reported on a scale of 0-10 (0 = "Not at All;" 10 = "Most Possible"). Descriptive and regression analyses (alpha < .05) were performed. Results: Of 286 RTs eligible for the study, 202 (71%) participated. A large majority (81%) lacked smoking cessation training. On a 0-10 scale, the mean perceived importance of smoking cessation (7.8) and motivation to help smokers quit (7.3) were relatively high, but familiarity with the CPG was low (2.1). The RTs'frequency of implementation of the 5 A's progressively decreased: Ask = 7.2; Advise = 6.5; Assess = 5.5; Assist = 4.5; Arrange = 1.8. In regression analyses, increased familiarity with the CPG predicted increased implementation of the 5 A's (p < .01). Smoking cessation training (p = .02) and increased familiarity with the CPG (p < .01) predicted increased referrals to a cessation program. Conclusions: The American Association for Respiratory Care task force, 2015 and Beyond, projected that hospital-based respiratory therapists will provide more preventive care; our study results suggest that an opportunity exists to improve smoking cessation practices. Academic and continuing education programs need to include training that focuses on the CPG, and respiratory care departments should consider developing systematic plans to implement the 5 A's and refer smokers to cessation programs.
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