scholarly journals Improving Health Outcomes for People With Cancer in Rural and Regional Areas by Embedding Evidence-Based Smoking-Cessation Strategies Into Usual Care: A Study Protocol

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 95s-95s
Author(s):  
A. Ugalde ◽  
S. Aranda ◽  
C. Paul ◽  
L. Orellana ◽  
I. Plueckhahn ◽  
...  
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Service ◽  
Health Services ◽  
General Practitioners ◽  
Smoking Status ◽  
Routine Care ◽  
Evidence Based ◽  
Diagnosis Of Cancer ◽  
Care Costs

Background: Smoking following a diagnosis of cancer is a powerful clinical risk indicator, with known poorer health outcomes and associated health care costs. In Australia, smoking rates are higher in rural and regional areas. There are established and effective interventions to promote smoking cessation after a diagnosis of cancer yet these are not in routine practice. Aim: This protocol paper reports on a study that aims to embed evidence-based smoking cessation strategies for people with cancer who are current smokers into routine care, resulting in in system wide improvements, an implemented program and model for further dissemination. Methods: Across three rural/regional sites, and with partners Quit Victoria and Western Alliance, this study employs a variety of methodologies to embed smoking cessation support to improve outcomes for people with cancer who currently smoke. Specifically, the project will embed a system of responsibilities and training in rural and regional health services to routinely engage people with cancer who smoke in support services. The program will: · Promote routine delivery of smoking cessation care by trained oncology staff (oncologists/nurses/ allied health) · Establish referral pathways to Quitline · Correspond with general practitioners, to: i) outline the benefits of quitting in this context, ii) promote access to nicotine replacement therapy and iii) support quitting in the community. · Improve routine recording of smoking status and documentation of provision of brief intervention (personalised advice given, resources provided) and outcomes. Participants: are oncology staff and general practitioners across three health services: Ballarat Health Service, East Grampians Health Service (Ararat), Wimmera Health Care Group (Horsham), all located in Victoria, Australia. Data collection will occur across four sources: 1) Oncology staff: qualitative and quantitative data collection understanding confidence and views on provision on cessation advice; 2) Monitoring Quitline calls, 3) Interview with local general practitioners and 4) Medical record reviews to explore frequency of recording of smoking status. Data will be collected pre/postintervention. Results: The project is underway with the intervention manuals in development. The project is due for completion in 2020. Conclusion: This project takes a health services approach to integration of smoking cessation support in routine care for people with cancer in rural and regional areas. This program of work has capacity to determine best approaches to integrate smoking cessation into routine care, resulting in reduced mortality and morbidity, improved effectiveness of anticancer treatments, and reduced health care costs; by establishing internationally relevant, embedded health care interventions.

scholarly journals The experience of general practitioners with Very Brief Advice in the treatment of tobacco addiction

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Onno C. P. van Schayck ◽  
Lynn Bindels ◽  
Ancka Nijs ◽  
Bo van Engelen ◽  
Adrienne van den Bosch ◽  
...  
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
General Practitioners ◽  
Premature Death ◽  
Routine Care ◽  
Positive Experience ◽  
Telephone Interviews ◽  
Stop Smoking ◽  
Tobacco Addiction ◽  
Brief Advice

Abstract Although tobacco smoking is the world’s most important preventable cause of many chronic diseases (including COPD and asthma) and premature death, many physicians do not routinely apply smoking cessation in the daily health care of their patients. Two widely felt important concerns of physicians are that smoking cessation as part of a treatment is time-consuming and may jeopardize their relationship with patients. Very Brief Advice (VBA) is a non-confrontational method, which could assist general practitioners (GPs) as a simple, quick first step in getting patients to stop smoking. In this study, we investigated the opinions and experiences of GPs with VBA in their routine care in two rounds of telephone interviews with 19 GPs. The interviews were recorded and transcribed and subsequently analysed with NVivo12. We observed that the GPs had a very positive experience with using VBA. They found the method to be efficient as to the time involved, patient-friendly and easy to implement.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

scholarly journals Converging perspectives of providers and student users on extending a patient portal into a university-based mental health service: A qualitative study

2020 ◽  
Author(s):  
N Gasteiger ◽  
Theresa Fleming ◽  
K Day
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Qualitative Study ◽  
Health Services ◽  
Mental Health Care ◽  
Patient Portal ◽  
Patient Portals

© 2020 The Authors Background: Patient portals have the potential to increase access to mental health services. However, a lack of research is available to guide practices on extending patient portals into mental health services. This study explored stakeholder (student service users' and health providers') expectations and perceptions of extending patient portals into a New Zealand university-based mental health service. Materials and methods: This qualitative study explored the perspectives of 17 students and staff members at a university-based health and counselling service on an Internet-based patient portal through a software demonstration, two focus groups and 13 interviews. Data were analyzed thematically. Results: Staff and students perceived the patient portal as useful, easy to use and expected it to help make mental health care more accessible. Staff were most concerned with the portal's ability to support their triage processes and that it might enable students to ‘counselor hop’ (see multiple counselors). Staff recommended extension into services that do not require triage. Most students expected the portal to enhance patient-counselor contact and rapport, through continuity of care. Students were concerned with appointment waiting times, the stigmatization of poor mental health and their capacity to seek help. They considered the portal might assist with this. Students recommended extension into all services, including urgent appointments. After viewing findings from initial student and staff groups, staff concluded that extending a patient portal into their counseling services should be prioritized. Conclusion: This research suggests that there is value in extending patient portals into mental health care, especially into low-risk services. Future research should explore opportunities to support triage and appointment-making processes for mental health services, via patient portals.

scholarly journals Canada's Progress to Make Smoking Cessation a First-Line Cancer Treatment

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 90s-90s
Author(s):  
M. Halligan ◽  
D. Keen
Keyword(s):  
Smoking Cessation ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Smoking Status ◽  
Scale Up ◽  
Evidence Based ◽  
First Line ◽  
Quit Smoking ◽  
Substantial Progress ◽  
Oncology Practice

Background: Evidence indicates that smoking cessation improves the effectiveness of treatment and likelihood of survival among all cancer patients, not just those with tobacco-related disease, yet smoking is rarely addressed in oncology practice. Prior to 2016, only 3 provinces in Canada (out of a total of 10 provinces and three territories) reported implementation of smoking cessation for ambulatory cancer patients. Aim: Based on this evidence, the Canadian Partnership Against Cancer (CPAC) implemented a systems change initiative to promote adoption of evidence-based smoking cessation within provincial and territorial cancer systems across Canada. Methods: In 2016, CPAC funded seven provinces and two territories over a 15-month period to plan, implement or evaluate integration of evidence-based smoking cessation for ambulatory cancer patients within cancer systems. Funds were used to plan (2 provinces and 2 territories), implement (3 provinces) or evaluate (2 provinces) systematic, evidence-based approaches to smoking cessation within ambulatory cancer care settings (e.g., establishing routine systems for identification of smoking cancer patients and system to support patients to quit). Funds could not be used for direct service delivery (e.g., cessation counseling). Results: After 15-months of funding from CPAC, 6 provinces reported implementation of smoking cessation for ambulatory cancer patients. The remaining province and 2 territories funded by CPAC reported development of plans for adoption of smoking cessation for cancer patients in the future. Within provinces reporting implementation of smoking cessation for cancer patients, between 65%-97% of ambulatory cancer patients were screened for smoking status; 22%-80% of these patients were offered a referral to cessation services, and 21%-45% of cancer patients accepted a referral. Conclusion: Despite provincial and territorial variations in readiness to uptake evidence-based smoking cessation for cancer patients, CPAC's approach has led to substantial progress in adoption of this approach across Canada. While progress has been made, adoption of smoking cessation and relapse prevention by cancer systems is not yet widespread in Canada. Scale-up to remaining provinces and territory, and spread within existing provinces and territories is required to reach all cancer patients and families who require support to quit smoking. Framing smoking cessation as a therapeutic intervention, not prevention, and a routine part of cancer treatment will be critical for sustainability of this work.

scholarly journals Sykepleiestudenters læringsutbytte belyst gjennom to kunnskapsbaserte samarbeidsprosjekter. Fagutviklingsarbeid med studenter i hjemmesykepleiepraksis

2015 ◽  
Vol 11 (2) ◽  
pp. 163
Author(s):  
Bente Bjørsland ◽  
Reidun Hov
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Pain Relief ◽  
Health Services ◽  
Learning Outcomes ◽  
Evidence Based Practice ◽  
Health Workers ◽  
Evidence Based ◽  
Next Of Kin ◽  
Evaluation Form

Health services are constantly met by greater demands on offering the best treatment and care based on quality and research. For that reason health workers and teachers in health care institutions and universities are working evidence-based. Hedmark University College and Hamar municipality have collaborated in two projects. The aim of this article is to illuminate the students’ learning outcomes in palliative care after participated in two evidence-based projects. Different written guides for conversations with patients, next of kin and staff, a log-book and an evaluation form were developed. Results show that the students learned about the significance of continuity in patients’ pain relief, spiritual and existential needs, and about palliative care in the municipality. The students concluded that they in some areas experienced greater learning outcomes from working with evidence-based practice than in their ordinary practice in the municipality.

scholarly journals Health Services Use and Health Care Costs of Obese and Nonobese Individuals

2004 ◽  
Vol 164 (19) ◽  
pp. 2135 ◽  
Author(s):  
Marsha A. Raebel ◽  
Daniel C. Malone ◽  
Douglas A. Conner ◽  
Stanley Xu ◽  
Julie A. Porter ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Costs ◽  
Health Services Use ◽  
Care Costs ◽  
Services Use

Indian Health Services, Continued

PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 756-756
Author(s):  
Daniel P. Kohen ◽  
Gerald Yost ◽  
Jerry Lyle
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Service ◽  
Health Services ◽  
American Indian ◽  
Indian Population ◽  
Health Needs ◽  
Indian Health Service ◽  
American Indian Population ◽  
Indian Health

We applaud Dr. Edward Mortimer's Commentary on the health status of the American Indian population (Pediatrics, 51:1065, 1973). Public statements that "Indian health care is inadequate because it is inadequately funded" and ". . . less than the minimum (money) is provided" are long overdue, and we concur completely with the necessity for us all to help Indians express and fulfill their health needs. We wish, however, to take issue with several remarks regarding the quality and scope of care provided in and through the Indian Health Service.

Smoking Cessation Counseling: Attitude in the Background of Poor Practice Compliance among Palestinian Primary Health Care Physicians: A cross sectional study

2020 ◽  
Author(s):  
Beesan Maraqa ◽  
Zaher Nazzal ◽  
Jurouh Jabareen
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Primary Health Care ◽  
General Practitioners ◽  
Positive Attitude ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Smoking Cessation Counseling ◽  
Cross Sectional ◽  
Primary Health

Abstract Background: Health-care systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that provision of smoking cessation advice to patients in primary health care is suboptimal. This study aimed at assessing Palestinian PHC physicians' compliance and attitude towards smoking cessation counseling and their determinants.Methods: the study utilized a cross-sectional study design using a self-reported questionnaire targeted general practitioners, family medicine doctors, obstetrics & gynecologists and dentists working at PHC Centers in Palestine in the period between April to September,2019. Proportionate stratified random sampling method was used. Sociodemograpic, medical experience, if received any training in smoking cessation counseling, smoking history, practice compliance, knowledge, confidence and attitude were assessed. Results: 294 PHC physicians' participated in the study with high response rate. More than a half (53%) were between 31-45 years of age. Most of them (76.5%) were general practitioners seeing more than 30 patients per day (66%) and only 15% (n=40) get training about smoking cessation counseling. Practice compliance was low; only 39 (13.3%) reported compliance to smoking cessation practice. Attitude level among the participant physicians was good as the overall attitude score mean was 75.1 ± 9.6. Positive attitude, assigned as any score ≥65, was observed in 87.7% (n=258) of physicians. Job title, experience and knowledge are predictors of positive attitude towards smoking cessation counseling.Conclusion: Building supportive environment, improving physicians’ capabilities will reflect on their self-efficacy and their con­fidence level and will improve their practice in smoking cessation counseling.

Barriers to and facilitators of health services utilisation by refugees in resettlement countries: an overview of systematic reviews

2020 ◽  
Vol 44 (1) ◽  
pp. 132 ◽  
Author(s):  
Jamuna Parajuli ◽  
Dell Horey
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Health Service Utilisation ◽  
Barriers And Facilitators ◽  
Service Utilisation ◽  
Knowledge And Skills ◽  
Overview Of Systematic Reviews

Objective The aim of this study was to provide an overview of the previously reviewed research literature to identify barriers and facilitators to health service utilisation by refugees in resettlement countries. Methods An overview of systematic reviews was conducted. Seven electronic databases (Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, ProQuest Central, Scopus, EBSCO and Google Scholar) were searched for systematic reviews of barriers and facilitators to health-seeking behaviour and utilisation of health services by refugees following resettlement. The two authors independently undertook data selection, data extraction and quality assessment using a validated tool. Results Nine systematic reviews covered a range of study areas and refugee populations. Barriers to health service utilisation fell into three broad areas: (1) issues related to refugees, including refugee characteristics, sociocultural factors and the effects of previous experiences; (2) issues related to health services, including practice issues and the knowledge and skills of health professionals; and (3) issues related to the resettlement context, including policies and practical issues. Few facilitators were identified or evaluated, but these included approaches to care, health service responses and behaviours of health professionals. Conclusions Barriers to accessing health care include refugee characteristics, practice issues in health services, including the knowledge and skills of health professionals, and the resettlement context. Health services need to identify barriers to culturally sensitive care. Improvements in service delivery are needed that meet the needs of refugees. More research is needed to evaluate facilitators to improving health care accessibility for these vulnerable groups. What is known about the topic? Refugee health after resettlement is poor, yet health service use is low. What does this paper add? Barriers to accessing health services in resettlement countries are related not only to refugees, but also to issues regarding health service practices and health professionals’ knowledge and skill, as well as the context of resettlement. Few facilitators to improving refugee access to health services have been identified. What are the implications for practitioners? The barriers associated with health professionals and health services have been linked to trust building, and these need to be addressed to improve accessibility of care for refugees.

Sign in / Sign up

Export Citation Format

Share Document