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Parental tobacco screening and counseling in the pediatric emergency department: practitioners' attitudes, perceived barriers, and suggestions for implementation and maintenance.
J Emerg Nurs. 2014 Jul; 40(4):336-45.JE

Abstract

INTRODUCTION

The pediatric emergency department (PED) is a venue that underuses parental tobacco screening and brief cessation counseling. We sought to explore PED practitioners' attitudes and perceived barriers regarding the implementation and adoption of tobacco screening/cessation counseling of parental smokers in the PED setting, as well as to solicit suggestions for improving the sustainability and maintenance of such practices.

METHODS

We conducted an exploratory, qualitative study of a convenience sample of PED practitioners using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Individual, focused interviews were conducted to determine factors that would maximize the implementation and maintenance of parental tobacco screening and intervention counseling as standard PED practice.

RESULTS

Thirty interviews were conducted from which relevant data, patterns, and themes were identified. Reach factors included targeting parental smokers with children with respiratory diseases, having adequate training of practitioners, and providing "prearranged" counseling packages. Effectiveness factors included practitioner desire for outcome data about intervention effectiveness (eg, changes in children's secondhand smoke exposure and parental quit rates). Solutions to increase intervention adoption included quick electronic health record prompts and the provision of onsite tobacco cessation experts. Implementation suggestions emphasized the importance of financial support and the alignment of tobacco screening/counseling with strategic plans. Maintenance factors included institutional and technical support, as well as the importance of intervention "champions" in the PED.

DISCUSSION

By highlighting important viewpoints of practitioners regarding tobacco screening and counseling, the findings can help guide and direct the development and evaluation of sustainable interventions to facilitate tobacco use treatment in the PED.

Authors+Show Affiliations

Cincinnati, OH; Tucson, AZ. Electronic address: melinda.mahabee-gittens@cchmc.org.Cincinnati, OH; Tucson, AZ.Cincinnati, OH; Tucson, AZ.Cincinnati, OH; Tucson, AZ.Cincinnati, OH; Tucson, AZ.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24029045

Citation

Mahabee-Gittens, E Melinda, et al. "Parental Tobacco Screening and Counseling in the Pediatric Emergency Department: Practitioners' Attitudes, Perceived Barriers, and Suggestions for Implementation and Maintenance." Journal of Emergency Nursing, vol. 40, no. 4, 2014, pp. 336-45.
Mahabee-Gittens EM, Dixon CA, Vaughn LM, et al. Parental tobacco screening and counseling in the pediatric emergency department: practitioners' attitudes, perceived barriers, and suggestions for implementation and maintenance. J Emerg Nurs. 2014;40(4):336-45.
Mahabee-Gittens, E. M., Dixon, C. A., Vaughn, L. M., Duma, E. M., & Gordon, J. S. (2014). Parental tobacco screening and counseling in the pediatric emergency department: practitioners' attitudes, perceived barriers, and suggestions for implementation and maintenance. Journal of Emergency Nursing, 40(4), 336-45. https://doi.org/10.1016/j.jen.2013.06.001
Mahabee-Gittens EM, et al. Parental Tobacco Screening and Counseling in the Pediatric Emergency Department: Practitioners' Attitudes, Perceived Barriers, and Suggestions for Implementation and Maintenance. J Emerg Nurs. 2014;40(4):336-45. PubMed PMID: 24029045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parental tobacco screening and counseling in the pediatric emergency department: practitioners' attitudes, perceived barriers, and suggestions for implementation and maintenance. AU - Mahabee-Gittens,E Melinda, AU - Dixon,Cinnamon A, AU - Vaughn,Lisa M, AU - Duma,Elena M, AU - Gordon,Judith S, Y1 - 2013/09/09/ PY - 2013/03/21/received PY - 2013/05/02/revised PY - 2013/06/01/accepted PY - 2013/9/14/entrez PY - 2013/9/14/pubmed PY - 2015/9/22/medline KW - Emergency department KW - Parental smoking KW - Secondhand smoke exposure KW - Smoking cessation counseling KW - Tobacco screening SP - 336 EP - 45 JF - Journal of emergency nursing JO - J Emerg Nurs VL - 40 IS - 4 N2 - INTRODUCTION: The pediatric emergency department (PED) is a venue that underuses parental tobacco screening and brief cessation counseling. We sought to explore PED practitioners' attitudes and perceived barriers regarding the implementation and adoption of tobacco screening/cessation counseling of parental smokers in the PED setting, as well as to solicit suggestions for improving the sustainability and maintenance of such practices. METHODS: We conducted an exploratory, qualitative study of a convenience sample of PED practitioners using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Individual, focused interviews were conducted to determine factors that would maximize the implementation and maintenance of parental tobacco screening and intervention counseling as standard PED practice. RESULTS: Thirty interviews were conducted from which relevant data, patterns, and themes were identified. Reach factors included targeting parental smokers with children with respiratory diseases, having adequate training of practitioners, and providing "prearranged" counseling packages. Effectiveness factors included practitioner desire for outcome data about intervention effectiveness (eg, changes in children's secondhand smoke exposure and parental quit rates). Solutions to increase intervention adoption included quick electronic health record prompts and the provision of onsite tobacco cessation experts. Implementation suggestions emphasized the importance of financial support and the alignment of tobacco screening/counseling with strategic plans. Maintenance factors included institutional and technical support, as well as the importance of intervention "champions" in the PED. DISCUSSION: By highlighting important viewpoints of practitioners regarding tobacco screening and counseling, the findings can help guide and direct the development and evaluation of sustainable interventions to facilitate tobacco use treatment in the PED. SN - 1527-2966 UR - https://www.unboundmedicine.com/medline/citation/24029045/Parental_tobacco_screening_and_counseling_in_the_pediatric_emergency_department:_practitioners'_attitudes_perceived_barriers_and_suggestions_for_implementation_and_maintenance_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0099-1767(13)00217-1 DB - PRIME DP - Unbound Medicine ER -