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Grant Details

Grant Number: 5R01CA107442-04 Interpret this number
Primary Investigator: Gordon, Judith
Organization: Oregon Research Institute
Project Title: Tobacco Cessation Via Public Health Dental Clinics
Fiscal Year: 2008
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Abstract

DESCRIPTION (provided by applicant): The prevalence of tobacco use is especially high in lower socioeconomic status (SES) populations in the U.S. Community Health Centers provide comprehensive primary care services, and usually/ dental services, to large numbers o flow-income smokers and smokeless tobacco users. The typical patient has multiple dental visits, which can be used for tobacco cessation advice and counseling by the dental office team. The proposed study builds on a successful pilot study conducted in two public health dental clinics. The pilot yielded positive results and provided valuable experience to inform the proposed study. This study will examine the effectiveness of public health dental practitioners of providing a brief office-based intervention designed to help patients quit smoking or smokeless tobacco use, as compared to usual care. We propose to conduct a randomized clinical trial in which 14 public health dental clinics in Oregon, Mississippi, and New York City will be stratified by state, matched within state by racial/ethnic composition, and then randomly assigned to either the Intervention or Usual Care Control condition. In both conditions, tobacco-using patients (>=18) will be asked by the front office staff to complete a Tobacco Use Survey. In the Intervention Condition, the dental team will provide a brief intervention that is modeled on the "5 A's" advocated by the Clinical Practice Guideline. All consenting patients will be assessed at baseline, 6 weeks and 7.5 months following enrollment by mailed surveys and follow-up phone calls to non-responders. We anticipate enrolling 3,240 tobacco-using patients over a six-month period and that 2,221 patients will complete all follow-up assessments. The primary outcome will be prolonged abstinence reported at 6 months. Dental practitioners will be assessed at baseline, and at 6 weeks and 12 months post-training to assess protocol implementation, protocol maintenance, and changes in attitudes toward providing tobacco intervention to patients. Organizational measures will be conducted at baseline and 12 months to assess clinic and system-wide [actors related to the adoption, implementation and maintenance of the intervention in this setting. The proposed project is innovative in several ways. 1) It targets a high-risk, under-served population who visit public health centers for dental care. 2) It will be conducted in three HRSA regions with diverse racial and ethnic populations, allowing us to assess the effect of the intervention on three different racial/ethnic groups (Hispanic/Latino; African American and Write). 3) Diffusion strategies will guide recruitment and retention of clinics and patients. 4) The RE-AIM framework will be used to translate and evaluate the intervention in a "real world'' setting. 5) It is a disseminable model that, if effective, can used by public dental clinics throughout the US.

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Publications

Tobacco cessation via public dental clinics: results of a randomized trial.
Authors: Gordon JS, Andrews JA, Albert DA, Crews KM, Payne TJ, Severson HH
Source: Am J Public Health, 2010 Jul;100(7), p. 1307-12.
EPub date: 2010 May 13.
PMID: 20466951
Related Citations

Grant Numbers:
NCI NIH HHS - R01-CA107442

MeSH Terms:
Humans Nicotinic Agonists Mississippi
Dental Clinics Oregon New York
Patient Education as Topic Nicotine Smoking Cessation
Adult Middle Aged Female
Male Community Dentistry

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Smoking cessation quitlines: an underrecognized intervention success story.
Authors: Lichtenstein E, Zhu SH, Tedeschi GJ
Source: Am Psychol, 2010 May-Jun;65(4), p. 252-61.
PMID: 20455619
Related Citations

Grant Numbers:
NCI NIH HHS - R01-CA104573 NCI NIH HHS - CA107442-04 NCI NIH HHS - R01 CA104573-05
NCI NIH HHS - CA098685-05 NCI NIH HHS - R01 CA104573

MeSH Terms:
United States Allied Health Personnel Randomized Controlled Trials as Topic
Motivation Humans Psychological Theory
Hotlines Counseling Health Services Accessibility
Mentors Inservice Training Ethnic Groups
Cost-Benefit Analysis Smoking Cessation Treatment Outcome
Language Research

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A survey of oral and maxillofacial surgeons' tobacco-use-related knowledge, attitudes and intervention behaviors.
Authors: Crews KM, Sheffer CE, Payne TJ, Applegate BW, Martin A, Sutton T
Source: J Am Dent Assoc, 2008 Dec;139(12), p. 1643-51.
PMID: 19047670
Related Citations

Grant Numbers:
NIDA NIH HHS - DA-12844 NCI NIH HHS - CA107442-01A2

MeSH Terms:
United States Attitude of Health Personnel Humans
Surgery, Oral Specialties, Surgical Smoking
Patient Education as Topic Adult Smoking Cessation
Health Knowledge, Attitudes, Practice Middle Aged Female
Male

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