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Taghrid Asfar, David J. Lee, Cynthia Owsley, Gerald McGwin, Emily W Gower, David S Friedman, Ann P Murchison, Eileen L Mayro, Jinan Saaddine; Training Eye-care Providers to Deliver Smoking Cessation Counseling to Their Patients . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):125.
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Mounting scientific evidence indicates that smoking can lead to visual impairment and blindness. Eye care providers are uniquely positioned to help their patients quit smoking. The current study developed, implemented, and evaluated a smoking cessation internet-based training program targeting eye care providers. The training program was based on the 3A1R: “Ask about tobacco use, Advise to quit, Assess willingness to quit, and Refer to a telephone tobacco quit line (QL)”.
The training program was developed and pre-tested among 10 eye-care providers. Feedback from these providers was used to improve the training materials. Eye care providers (n=654) at four academic centers were invited to participate in the study. The program included a 30-minute video integrated into the Wills Eye Hospital Knowledge Portal (http://www.willseyeonline.org/). Providers were asked to complete pre- and post-training survey to test their current smoking cessation practices, knowledge with the QL, and changes in their attitudes and knowledge with respect to the 3A1R.
A total of 116 eye care providers participated in the study. Eighty (69.0%) participants were White, 20 (17.2%) Asian, 4 (3.4%) Black, and 5 (4.3%) Hispanic. Half of the participants were male 62 (53.4%), 49 (42.2%) ophthalmologists, 10 (8.6%) optometrists, 42 (36.2%) ophthalmology residents and 14 (12.1%) fellows. Only half of the participating providers reported routinely asking patients about their smoking status, 47.4% advised their patients to quit, 23.3% assessed patients’ motivation to quit, 2.6% assisted patients in quitting, and 0.9% arranged a follow-up to address smoking. Surprisingly, 69% of providers were not familiar with tobacco QLs, and only 7.8% referred their smoking patients to tobacco QLs. At the post-training survey, providers’ confidence improved with respect to the 3A1R guidelines by 9% for Ask (95% Confidence Interval CI; 0.05-0.16;p<.001); 23.0% for Advise (0.15-0.32;p<.001); 12.8% for Assess (0.07-0.21;p<.001); and 46.8% for Refer (0.37-0.56;p=.25).
Eye-care providers’ perceived efficacy in helping their smoking patients improved significantly and immediately after receiving the training. On-line training targeting eye health care professionals has the potential to reduce the burden of tobacco-associated eye disease.
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