A Cluster-Randomized Clinical Trial Testing the Effectiveness of the Addressing Tobacco Through Orga
Thursday, November 15, 2018
Posted by: Natalia Gromov
Alex Flitter, Su Fen Lubitz, Douglas Ziedonis, Nathaniel Stevens, Frank Leone, David Mandell, John Kimberly, Oscar Lopez, Rinad S Beidas, Robert A Schnoll.
A Cluster-Randomized Clinical Trial Testing the Effectiveness of the Addressing Tobacco Through Organizational Change (ATTOC) Model for Improving the Treatment of Tobacco Use in Community Mental Healthcare: Preliminary Study Feasibility and Baseline Findings.
Nicotine & Tobacco Research, nty239, https://doi.org/10.1093/ntr/nty239
People with mental illness are more likely to smoke and less likely to receive tobacco treatment than the general population. The Addressing Tobacco Through Organizational Change (ATTOC) approach supports organizational change to increase tobacco treatment in this population. We describe preliminary study feasibility and baseline behaviors and attitudes among clients and staff regarding tobacco treatment, and assess correlates of treatment of smoking. Preliminary accrual, engagement, and baseline data are reported from a cluster-randomized trial comparing ATTOC to usual care. Feasibility, thus far, was the rate of site and participant accrual and engagement (e.g., participants remaining in the trial). Correlates of assessing smoking, advising cessation, and providing treatment were assessed. Site and participant accrual is 80% (8/10) and 86% (456/533), and engagement is 100% and 82%. Staff asking about smoking was reported by 63% of clients and 38% of staff; staff advising cessation was reported by 57% of clients and 46% of staff; staff report assisting clients with any medication ≤ 22% of the time, while < 18% of clients report receiving a cessation medication; 59% of clients want tobacco treatment, but 36% of staff think that it is part of their job. Staff assisting with medications is related to more training, believing treating smoking is part of their job, and believing patients are concerned about smoking (p’s<.05). This trial of training in tobacco treatment within mental healthcare is feasible thus far; self-reported rates of tobacco treatment are low and associated with clinician attitudes and barriers. Evaluation of ways to help address tobacco use treatment in community mental healthcare is feasible and needed, including the use of technical assistance and training guided by an organizational change approach.
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