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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
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    References listed on IDEAS

    as
    1. 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.
    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. 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.
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    6. 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.
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    10. 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.
    11. 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.
    12. 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.
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