IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i3p2730-d1056767.html
   My bibliography  Save this article

Changes in Substance Use Treatment Providers’ Delivery of the 5A’s for Non-Cigarette Tobacco Use in the Context of a Comprehensive Tobacco-Free Workplace Program Implementation

Author

Listed:
  • Ammar D. Siddiqi

    (Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
    Department of Biosciences, Rice University, 6100 Main St., Houston, TX 77005, USA)

  • Tzuan A. Chen

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
    HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA)

  • Maggie Britton

    (Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
    Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

  • Isabel Martinez Leal

    (Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
    Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

  • Brian J. Carter

    (Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
    Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

  • Virmarie Correa-Fernández

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

  • Anastasia Rogova

    (Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
    Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

  • Bryce Kyburz

    (Integral Care, 1430 Collier St., Austin, TX 78704, USA)

  • Teresa Williams

    (Integral Care, 1430 Collier St., Austin, TX 78704, USA)

  • Kathleen Casey

    (Integral Care, 1430 Collier St., Austin, TX 78704, USA)

  • Lorraine R. Reitzel

    (Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA
    Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA)

Abstract

Tobacco use treatment is not prioritized in substance use treatment centers (SUTCs), leading to tobacco-related health inequities for patients with substance use disorders (SUDs) and necessitating efforts to enhance providers’ care provision. Training providers on how to treat tobacco use increases their intervention on patients’ smoking, but limited work addresses its effects on their non-cigarette tobacco use intervention provision. This study redressed this gap using data from 15 unaffiliated SUTCs in Texas (serving 82,927 patients/year) participating in a tobacco-free workplace program (TFWP) that included provider education on treating tobacco use, including non-cigarette tobacco use. SUTC providers completed surveys before (n = 259) and after (n = 194) TFWP implementation. Past-month screening/intervention provision for non-cigarette tobacco use (the 5A’s; ask, advise, assess, assist, arrange) and provider factors theoretically and practically presumed to underlie change [i.e., beliefs about concurrently treating tobacco use disorder (TUD) and other SUDs, self-efficacy for tobacco use assessment (TUA) delivery, barriers to treating tobacco dependence, receipt of tobacco intervention training] were assessed. Generalized linear or linear mixed models assessed changes over time from before to after TFWP implementation; low vs. high SUTC-level changes in provider factors were examined as moderators of changes in 5A’s delivery. Results indicated significant improvement in each provider factor and increases in providers’ asking, assisting, and arranging for non-cigarette tobacco use over time ( p s < 0.04). Relative to their counterparts, SUTCs with high changes in providers’ beliefs in favor of treating patients’ tobacco use had greater odds of advising, assessing, assisting, and arranging patients, and SUTCs with greater barrier reductions had greater odds of advising and assisting patients. Results suggest that TFWPs can address training deficits and alter providers’ beliefs about treating non-tobacco TUD during SUD care, improve their TUA delivery self-efficacy, and reduce intervention barriers, ultimately increasing intervention provision for patients’ non-cigarette tobacco use. SUTCs with the greatest room for improvement in provider beliefs and barriers to care provision seem excellent candidates for TFWP implementation aimed at increasing non-cigarette tobacco use care delivery.

Suggested Citation

  • Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Brian J. Carter & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Changes in Substance Use Treatment Providers’ Delivery of the 5A’s for Non-Cigarette Tobacco Use in the Context of a Comprehensive Tobacco-Free Workplace Program Implementation," IJERPH, MDPI, vol. 20(3), pages 1-16, February.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:2730-:d:1056767
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/3/2730/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/20/3/2730/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Midhat Z. Jafry & Sean M. Reuven & Maggie Britton & Tzuan A. Chen & Isabel Martinez Leal & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Mayuri Patel & Lorraine R. Reitzel, 2022. "Providers’ Non-Cigarette Tobacco Use Intervention Practices in Relation to Beliefs about Patients, Prioritization of and Skills for Intervention, and Referral Knowledge in Texas Healthcare Centers Pro," IJERPH, MDPI, vol. 19(21), pages 1-12, November.
    2. Isabel Martinez Leal & Matthew Taing & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Kathy Le & Litty Koshy & Tzuan A. Chen & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & , 2021. "Addressing Smoking Cessation among Women in Substance Use Treatment: A Qualitative Approach to Guiding Tailored Interventions," IJERPH, MDPI, vol. 18(11), pages 1-25, May.
    3. Williams, J.M. & Steinberg, M.L. & Griffiths, K.G. & Cooperman, N., 2013. "Smokers with behavioral health comorbidity should be designated a tobacco use disparity group," American Journal of Public Health, American Public Health Association, vol. 103(9), pages 1549-1555.
    4. Vijay Nitturi & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Kelli Drenner & Bryce Kyburz & Teresa Williams & Ezemenari M. Obasi & Maggie Britton & Molly Howard & Rogelio Rangel , 2021. "Implementation and Outcomes of a Train-the-Trainer Program at Behavioral Health Treatment Centers as a Mechanism to Maintain Organizational Capacity to Address Tobacco Use Disorder," IJERPH, MDPI, vol. 18(21), pages 1-15, November.
    5. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Matthew Taing & Daniel P. O’Connor & Lorraine R. Re, 2021. "Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(19), pages 1-16, October.
    6. Isabel Martinez Leal & Jayda Martinez & Maggie Britton & Tzuan A. Chen & Virmarie Correa-Fernández & Bryce Kyburz & Vijay Nitturi & Ezemenari M. Obasi & Kelli Drenner & Teresa Williams & Kathleen Case, 2022. "Collaborative Learning: A Qualitative Study Exploring Factors Contributing to a Successful Tobacco Cessation Train-the-Trainer Program as a Community of Practice," IJERPH, MDPI, vol. 19(13), pages 1-19, June.
    7. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Haleem A. Brown & Daniel P. O’Connor & Lorraine R. , 2021. "Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(14), pages 1-14, July.
    8. Cassidy R. LoParco & Tzuan A. Chen & Isabel Martinez Leal & Maggie Britton & Brian J. Carter & Virmarie Correa-Fernández & Bryce Kyburz & Teresa Williams & Kathleen Casey & Anastasia Rogova & Hsien-Ch, 2022. "Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance," IJERPH, MDPI, vol. 19(19), pages 1-13, September.
    9. Delvon T. Mattingly & Luis Zavala-Arciniega & Jana L. Hirschtick & Rafael Meza & David T. Levy & Nancy L. Fleischer, 2021. "Trends in Exclusive, Dual and Polytobacco Use among U.S. Adults, 2014–2019: Results from Two Nationally Representative Surveys," IJERPH, MDPI, vol. 18(24), pages 1-12, December.
    10. Matthew Taing & Bryce Kyburz & Isabel Martinez Leal & Kathy Le & Tzu-An Chen & Virmarie Correa-Fernandez & Teresa Williams & Daniel P. O’Connor & Ezemenari M. Obasi & Kathleen Casey & Litty Koshy & Lo, 2020. "Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed," IJERPH, MDPI, vol. 17(17), pages 1-15, August.
    11. Matthew Taing & Vijay Nitturi & Tzuan A. Chen & Bryce Kyburz & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & Litty Kos, 2021. "Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers," IJERPH, MDPI, vol. 19(1), pages 1-17, December.
    12. Silvano Gallus & Elisa Borroni & Anna Odone & Piet A. van den Brandt & Giuseppe Gorini & Lorenzo Spizzichino & Roberta Pacifici & Alessandra Lugo, 2021. "The Role of Novel (Tobacco) Products on Tobacco Control in Italy," IJERPH, MDPI, vol. 18(4), pages 1-10, February.
    13. Ammar D. Siddiqi & Maggie Britton & Tzuan A. Chen & Brian J. Carter & Carol Wang & Isabel Martinez Leal & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Mayuri Patel & Lorraine R. Reitzel, 2022. "Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment," IJERPH, MDPI, vol. 19(15), pages 1-15, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brian J. Carter & Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Educating Substance Use Treatment Center Providers on Tobacco Use Treatments Is Associated with Increased Provision of Counseling and Medication to Patients Who Use Tobacco," IJERPH, MDPI, vol. 20(5), pages 1-17, February.
    2. Cassidy R. LoParco & Tzuan A. Chen & Isabel Martinez Leal & Maggie Britton & Brian J. Carter & Virmarie Correa-Fernández & Bryce Kyburz & Teresa Williams & Kathleen Casey & Anastasia Rogova & Hsien-Ch, 2022. "Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance," IJERPH, MDPI, vol. 19(19), pages 1-13, September.
    3. Ammar D. Siddiqi & Maggie Britton & Tzuan A. Chen & Brian J. Carter & Carol Wang & Isabel Martinez Leal & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Mayuri Patel & Lorraine R. Reitzel, 2022. "Tobacco Screening Practices and Perceived Barriers to Offering Tobacco Cessation Services among Texas Health Care Centers Providing Behavioral Health Treatment," IJERPH, MDPI, vol. 19(15), pages 1-15, August.
    4. Maggie Britton & Isabel Martinez Leal & Midhat Z. Jafry & Tzuan A. Chen & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Lorraine R. Reitzel, 2023. "Influence of Provider and Leader Perspectives about Concurrent Tobacco-Use Care during Substance-Use Treatment on Their Tobacco Intervention Provision with Clients: A Mixed-Methods Study," IJERPH, MDPI, vol. 20(7), pages 1-21, March.
    5. Matthew Taing & Vijay Nitturi & Tzuan A. Chen & Bryce Kyburz & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & Litty Kos, 2021. "Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers," IJERPH, MDPI, vol. 19(1), pages 1-17, December.
    6. Isabel Martinez Leal & Jayda Martinez & Maggie Britton & Tzuan A. Chen & Virmarie Correa-Fernández & Bryce Kyburz & Vijay Nitturi & Ezemenari M. Obasi & Kelli Drenner & Teresa Williams & Kathleen Case, 2022. "Collaborative Learning: A Qualitative Study Exploring Factors Contributing to a Successful Tobacco Cessation Train-the-Trainer Program as a Community of Practice," IJERPH, MDPI, vol. 19(13), pages 1-19, June.
    7. Vijay Nitturi & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Kelli Drenner & Bryce Kyburz & Teresa Williams & Ezemenari M. Obasi & Maggie Britton & Molly Howard & Rogelio Rangel , 2021. "Implementation and Outcomes of a Train-the-Trainer Program at Behavioral Health Treatment Centers as a Mechanism to Maintain Organizational Capacity to Address Tobacco Use Disorder," IJERPH, MDPI, vol. 18(21), pages 1-15, November.
    8. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Matthew Taing & Daniel P. O’Connor & Lorraine R. Re, 2021. "Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(19), pages 1-16, October.
    9. Jayda Martinez & Midhat Z. Jafry & Tzuan A. Chen & Michael S. Businelle & Darla E. Kendzor & Maggie Britton & Maya Vijayaraghavan & Lorraine R. Reitzel, 2022. "Guest Support for Outdoor Smoke-Free Policies within a Homeless Shelter," IJERPH, MDPI, vol. 19(4), pages 1-15, February.
    10. Midhat Z. Jafry & Sean M. Reuven & Maggie Britton & Tzuan A. Chen & Isabel Martinez Leal & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Mayuri Patel & Lorraine R. Reitzel, 2022. "Providers’ Non-Cigarette Tobacco Use Intervention Practices in Relation to Beliefs about Patients, Prioritization of and Skills for Intervention, and Referral Knowledge in Texas Healthcare Centers Pro," IJERPH, MDPI, vol. 19(21), pages 1-12, November.
    11. Isabel Martinez Leal & Matthew Taing & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Kathy Le & Litty Koshy & Tzuan A. Chen & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & , 2021. "Addressing Smoking Cessation among Women in Substance Use Treatment: A Qualitative Approach to Guiding Tailored Interventions," IJERPH, MDPI, vol. 18(11), pages 1-25, May.
    12. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Haleem A. Brown & Daniel P. O’Connor & Lorraine R. , 2021. "Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(14), pages 1-14, July.
    13. Haleem A. Brown & Rachel D. Roberts & Tzuan A. Chen & Michael S. Businelle & Ezemenari M. Obasi & Darla E. Kendzor & Lorraine R. Reitzel, 2022. "Perceived Disease Risk of Smoking, Barriers to Quitting, and Cessation Intervention Preferences by Sex Amongst Homeless Adult Concurrent Tobacco Product Users and Conventional Cigarette-Only Users," IJERPH, MDPI, vol. 19(6), pages 1-14, March.
    14. Tomas Vaičiūnas & Monika Žemaitaitytė & Shannon Lange & Mindaugas Štelemėkas & Leila Oja & Janina Petkevičienė & Anna Kowalewska & Iveta Pudule & Jaanika Piksööt & Kastytis Šmigelskas, 2022. "Trends in Adolescent Substance Use: Analysis of HBSC Data for Four Eastern European Countries, 1994–2018," IJERPH, MDPI, vol. 19(23), pages 1-12, November.
    15. Claire Adams Spears & Dina M. Jones & Scott R. Weaver & Terry F. Pechacek & Michael P. Eriksen, 2016. "Use of Electronic Nicotine Delivery Systems among Adults with Mental Health Conditions, 2015," IJERPH, MDPI, vol. 14(1), pages 1-14, December.
    16. Andrea C. Villanti & Olivia A. Wackowski & S. Elisha LePine & Julia C. West & Elise M. Stevens & Jennifer B. Unger & Darren Mays, 2022. "Effects of Vaping Prevention Messages on Electronic Vapor Product Beliefs, Perceived Harms, and Behavioral Intentions among Young Adults: A Randomized Controlled Trial," IJERPH, MDPI, vol. 19(21), pages 1-18, October.
    17. Aarooran Sritharan & Uchechukwu L. Osuagwu & Manjula Ratnaweera & David Simmons, 2021. "Eight-Year Retrospective Study of Young Adults in a Diabetes Transition Clinic," IJERPH, MDPI, vol. 18(23), pages 1-11, December.
    18. Pooja Agrawal & Matthew Taing & Tzu-An Chen & Sean M. Reuven & Michael S. Businelle & Darla E. Kendzor & Eric H. Bernicker & Lorraine R. Reitzel, 2020. "Understanding the Associations between Smoking-Related Risk Perception, Interest in Quitting Smoking, and Interest in Lung Cancer Screening among Homeless Adult Smokers," IJERPH, MDPI, vol. 17(23), pages 1-11, November.
    19. Friedman, Abigail S., 2020. "Smoking to cope: Addictive behavior as a response to mental distress," Journal of Health Economics, Elsevier, vol. 72(C).
    20. Catherine O. Egbe & Portia Nevhungoni & Mukhethwa Londani, 2024. "Disparities in Tobacco Smoking by Sex and Employment Status: Results from South Africa’s First Global Adult Tobacco Survey," Social Sciences, MDPI, vol. 13(10), pages 1-15, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:2730-:d:1056767. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.