Article Figures & Data
Figures
- Figure 1.
Consolidated Standards of Reporting Trials diagram
FHT—family health team.
- Figure 2.
Rates of provider delivery of EBSCTs for the previous 12 months and index appointments: Ask was not included as an item in the survey regarding the previous 12 months.
EBSCT—evidence-based smoking cessation treatment.
- Figure 3.
Rates of provider delivery of EBSCTs at index appointments for all participants and for participants who reported they were ready to quit smoking within the next 30 days
EBSCT—evidence-based smoking cessation treatment.
- Figure 4.
Rates of provider delivery of ask, advise, assist, and arrange by each FHT at index appointments
FHT—family health team.
Tables
- Table 1.
Characteristics of health care providers sampled: Survey data were received from 288 of 438 (65.8%) clinicians who saw patients during one of the assessment periods. Data were missing for those intake clinicians who were employed as “floating” staff (or locums) and those clinicians who did not return surveys after 3 reminders.
CHARACTERISTIC VALUE Type of provider, % • Practising physician 80.7 • Medical resident 5.0 • Nurse practitioner 12.7 Mean (SD) age, y 39.5 (17.3) Participated in smoking cessation training in the past, % 33.0 Importance placed on smoking cessation within FHT, % • Extremely important 56.0 • Very important 26.3 • Important 15.1 • Somewhat important 2.3 • Not important 0.4 Self-reported importance placed on helping patients quit smoking, % • Extremely important 51.3 • Very important 37.2 • Important 8.5 • Somewhat important 12.1 • Not important 0.0 Mean (SD) self-efficacy* • Advising patients to quit 8.8 (1.4) • Providing brief counseling 8.3 (1.6) • Prescribing medications 8.3 (1.6) • Setting quit dates 7.6 (1.9) • Providing extended counseling to quit 7.5 (1.8) • Arranging follow-up support 6.9 (2.2) FHT—family health team.
↵* On a scale of 1 to 10, how would you describe your confidence in the following areas, 1 being not very confident and 10 being extremely confident?
- Table 2.
Demographic characteristics, health status, and tobacco use history of participants: N = 2501.
PARAMETER VALUE Mean (SD) age, y 47.7 (14.7) Male sex, % 38.1 Mean (SD) formal education, y 13.2 (2.8) Smoking-related illness, % • Heart disease, heart failure, or stroke 11.2 • Diabetes 13.0 • Cancer 3.5 • Chronic obstructive pulmonary disease 9.1 Mental health history, % • Anxiety or depression 45.7 • Other diagnosed mental illness 13.0 Mean (SD) cigarettes per d 16.7 (10.4) Mean (SD) length of time smoking, y 27.9 (15.1) Time to first cigarette in the morning, % • > 60 min 19.6 • 31 to 60 min 17.8 • 5 to 30 min 34.8 • < 5 min 27.7 Readiness to quit,* % • Ready in next 30 d 30.6 • Ready in next 6 mo 41.2 • Not ready 28.2 Mean (SD) self-efficacy† 5.1 (3.0) Purpose of visit, % • Annual examination or index appointment 20.5 • Follow-up appointment 79.5 VARIABLE INTRA-FHT* INTRAPROVIDER† σ2μ0‡ ICC P VALUE σ2μ0‡ ICC P VALUE Index visit • Ask 0.23 (0.07) 0.1 < .01 0.23 (0.06) 0.12 < .001 • Advise 0.40 (0.11) 0.1 < .01 0.14 (0.06) 0.14 < .05 • Assist 0.21 (0.07) 0.1 < .01 0.23 (0.07) 0.12 < .01 • Set quit dates 0.01 (0.05) 0.1 0.33 (0.13) 0.10 < .01 • Discuss medications 0.19 (0.07) 0.1 < .01 0.25 (0.08) 0.12 < .01 • Prescribe medications 0.12 (0.07) 0.0 NS 0.21 (0.13) 0.09 NS • Provide self-help 0.46 (0.14) 0.1 < .01 0.25 (0.11) 0.18 < .05 • Arrange follow-up 0.00 (0.00) 0.0 NS 0.12 (0.01) 0.04 < .001 Previous 12 mo • Advise 0.11 (0.05) 0.0 < .05 0.21 (0.08) 0.09 < .01 • Assist 0.11 (0.05) 0.0 < .05 0.18 (0.07) 0.08 < .01 • Set quit date 0.20 (0.24) 0.1 NS 0.70 (0.32) 0.22 < .05 • Discuss medications 0.06 (0.04) 0.0 NS 0.16 (0.06) 0.06 < .01 • Prescribe medications 0.04 (0.03) 0.0 NS 0.07 (0.07) 0.03 NS • Provide self-help 0.05 (0.04) 0.0 NS 0.32 (0.08) 0.10 < .001 - Table 4.
Odds ratio for FHT, provider, and patient variables associated with receiving advice to quit smoking at the index visit:Advise model: 1 = advice given (n = 1168), 0 = no advice given (n = 1301). Models adjusted for FHT-level and provider-level clustering effects. P values calculated based on Wald tests.
VARIABLES ADJUSTED OR (95% CI) P VALUE Patient Smoking-related illness < .01 • No 1.0 (Reference) • Yes 1.6 (1.2 to 2.1) Readiness to quit* < .001 • Not ready to quit 1.0 (Reference) • Ready in next 30 d 1.6 (1.3 to 1.9) Provider Importance of cessation† < .01 • Important, somewhat important, or not important 1.0 (Reference) • Extremely or very important 1.7 (1.1 to 2.7) Appointment Purpose of visit < .001 • Follow-up appointment 1.0 (Reference) • Annual examination 2.0 (1.6 to 2.5) FHT Physician champion < .01 • No 1.0 (Reference) • Yes 2.0 (1.1 to 3.6) FHT—family health team, OR—odds ratio.
↵* Which of the following best describes your feelings about smoking right now? (1 = ready to quit in next 30 d, 0 = ready to quit in next 6 mo, or not ready to quit.)
↵† As a practitioner, how would you describe the importance you place personally on helping your patients quit smoking? (Extremely important, very important, important, somewhat important, and not important.)
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