All ETDs from UAB

School

School of Public Health

Document Type

Dissertation

Department (new version)

Public Health

Date of Award

2003

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

For individuals with cystic fibrosis (CF), annual exams are part of the typical management regimen. These exams afford clinicians a regular opportunity to address potential sources of environmental tobacco smoke—a major cause of illness for children—by counseling CF patients' parents and significant others. Directors and coordinators were targeted in this study because of their system-level potential to impact center practices. The purpose of this study was to determine factors that influence CF care center adoption of the Agency for Health Care Research and Quality smoking cessation counseling guidelines (5 A model). A cross-sectional fax survey design was used. Of the 250 CF care centers nationwide, 203 completed surveys (81% response rate). Descriptive statistics and multiple logistic regression analyses were used to examine associations between independent variables (clinic and demographic characteristics, capacity items) and the dependent variable (adoption of 5 A model). Results identified important gaps in adoption of tobacco user identification systems and importance given to the environmental assessment. Personal characteristics such as age, smoking status, and position were found to be predictive of guideline adoption. Results revealed that clinics having a greater capacity and support to train team members in guideline implementation, purchase program materials, and have time dedicated to incorporating program updates were predictive of model adoption. Conversely, clinics with resources to determine oversight of guideline implementation, designate a program champion, have space for program material storage, as well as provide continuing medical education offerings in smoking cessation counseling, were less likely to adopt the guidelines ( p < .05).

ProQuest Publication Number

Document on ProQuest

ProQuest ID

3101585

ISBN

978-0-496-49172-8

Comments

PhD

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