Impact of a tobacco cessation intervention on adherence to tobacco use treatment guidelines among village health workers in Vietnam

Community health workers (in Vietnam referred to as village health workers) have the potential to play a key role in expanding access to evidence-based tobacco use treatment. We conducted a cluster randomized controlled trial in community health centers in Vietnam that compared the effect of provider advice and cessation assistance (i.e. brief counseling and patient education materials) (BC) vs. BC + three sessions of in-person counseling delivered by a village health worker (BC+R) on providers’ and village health workers’ adherence to tobacco use treatment guidelines. All village health workers and health care providers received training. This paper presents data on the effect of the intervention on village health workers’ adherence to tobacco use treatment guidelines, including asking about tobacco use, advising smokers to quit, offering assistance and their attitude, norms, and self-efficacy related to tobacco use treatment. We examined changes in adherence to tobacco use treatment guidelines before and 12 months after the intervention among 89 village health workers working in the 13 community health centers enrolled in the BC+R study condition. Village health workers’ adherence to tobacco use treatment guidelines increased significantly. Village health workers were more likely to ask about tobacco use (3.4% at baseline, 32.6% at 12 months), offer advice to quit (4.5% to 48.3%) and offer assistance (1.1% to 38.2%). Perceived barriers to treating tobacco use decreased significantly. Self-efficacy and attitudes towards treating tobacco use improved significantly. Increased adherence to tobacco use treatment guidelines was associated with positive attitudes towards their role in delivering tobacco use treatment and increasing awareness of the community health center smoke-free policy. The findings suggest that, with training and support systems, village health workers can extend their role to include smoking cessation services. This workforce could represent a sustainable resource for supporting smokers who wish to quit.

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Tobacco cessation in Vietnam: Exploring the role of village health workers

Global Public Health ◽

10.1080/17441692.2017.1360376 ◽

2017 ◽

Vol 13 (9) ◽

pp. 1265-1275 ◽

Cited By ~ 4

Author(s):

Nam Nguyen ◽

Trang Nguyen ◽

Jessica Chapman ◽

Linh Nguyen ◽

Pritika Kumar ◽

...

Keyword(s):

Tobacco Cessation ◽

Health Workers ◽

Village Health Workers ◽

Village Health

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Training Intervention on TB Knowledge Among Lesotho Village Health Workers

Journal of Health and Medical Sciences ◽

10.31014/aior.1994.02.02.36 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Regina M. Thetsane ◽

◽

Maseabata V. Ramathebane ◽

Motšelisi C. Mokhethi ◽

Tiisetso Makatjane

Keyword(s):

Health Workers ◽

Training Intervention ◽

Village Health Workers ◽

Village Health

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Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

BMC Public Health ◽

10.1186/s12889-021-11502-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elizeus Rutebemberwa ◽

Kellen Nyamurungi ◽

Surabhi Joshi ◽

Yvonne Olando ◽

Hadii M. Mamudu ◽

...

Keyword(s):

Tobacco Use ◽

Tobacco Cessation ◽

Health Workers ◽

High Volume ◽

Health Facilities ◽

Hospital Treatment ◽

Management Support ◽

Tobacco Use Cessation ◽

Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

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