Tobacco Use Disorder Clinical Trial
Official title:
Dental Tobacco Control.Net:Improving Practice
This is a randomized, controlled trial (RCT) to test the efficacy of an internet continuing dental education intervention designed to increase tobacco cessation counseling in dental practices. The intervention involves surveying practices regarding preventive care, surveying adult patients about their tobacco habits and preventive care provided by dental practice and training/educating the dentist and office staff on tobacco cessation. With patients who smoke and indicate that they have quit, we followed up with testing their saliva for the presence of cotinine. We have enrolled general dentists and periodontists who practice in the Southeastern United States.
Tobacco use has been described as the number one behavioral health problem of our time with
a projected 8.4 million total smoking related deaths worldwide by the year 2020. Current
clinical practice guidelines entitled "Treating Tobacco Use and Dependence" provide a
summary of evidence-based recommendations. Despite the evidence of tobacco risk and the
efficacy of tobacco control interventions, 30% of current smokers report that they have
never been advised to stop smoking by a healthcare provider. Nearly half (47.9%) of dentists
report they have never intervened to assist tobacco users in quitting. Our intervention is
designed to improve the rate of tobacco cessation advice delivered in dental practices.
This proposal is in response to the request for applications "Translational Research in
Dental Practice-based Tobacco Control Interventions" (RFA: DE-03-007). Our exploration of
barriers and facilitators will assist in clarifying processes that influence translation of
tobacco-related knowledge into clinical dental practice. Our trial will integrate
theoretically grounded methods of provider behavior change, medical informatics, and tobacco
control research to translate guidelines into dental clinical practice. We will avoid a
"one-size-fits-all" approach by tailoring strategies for tobacco cessation counseling to
individual practices. The intervention will be longitudinal, with updates and continuous
access for dentists and dental staff over 2 years. Our evaluation will extend from processes
of care to patient outcomes. Ancillary analyses will assess differences in tobacco
counseling rates associated with practice, provider, and patient-level variables including
disparities in counseling by race. To assess the relative impact of various components of
the multi-modal intervention, we will conduct secondary analyses of the association of
amount of use of each specific component with frequency of tobacco cessation counseling
within the intervention group.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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