Dental Tobacco Control.Net:Improving Practice

Early Phase 1

Completed

• Conditions: Tobacco Use Disorder
• Interventions: Behavioral: Internet-delivered continuing professional development; Other: No intervention arm

• Registration Number: NCT00627185
• Lead Sponsor: University of Alabama at Birmingham

Brief Summary

This is a randomized, controlled trial (RCT) to test the efficacy of an internet continuing dental education intervention designed to increase tobacco cessation counseling in dental practices. The intervention involves surveying practices regarding preventive care, surveying adult patients about their tobacco habits and preventive care provided by dental practice and training/educating the dentist and office staff on tobacco cessation. With patients who smoke and indicate that they have quit, we followed up with testing their saliva for the presence of cotinine. We have enrolled general dentists and periodontists who practice in the Southeastern United States.

Detailed Description

Tobacco use has been described as the number one behavioral health problem of our time with a projected 8.4 million total smoking related deaths worldwide by the year 2020. Current clinical practice guidelines entitled "Treating Tobacco Use and Dependence" provide a summary of evidence-based recommendations. Despite the evidence of tobacco risk and the efficacy of tobacco control interventions, 30% of current smokers report that they have never been advised to stop smoking by a healthcare provider. Nearly half (47.9%) of dentists report they have never intervened to assist tobacco users in quitting. Our intervention is designed to improve the rate of tobacco cessation advice delivered in dental practices.

This proposal is in response to the request for applications "Translational Research in Dental Practice-based Tobacco Control Interventions" (RFA: DE-03-007). Our exploration of barriers and facilitators will assist in clarifying processes that influence translation of tobacco-related knowledge into clinical dental practice. Our trial will integrate theoretically grounded methods of provider behavior change, medical informatics, and tobacco control research to translate guidelines into dental clinical practice. We will avoid a "one-size-fits-all" approach by tailoring strategies for tobacco cessation counseling to individual practices. The intervention will be longitudinal, with updates and continuous access for dentists and dental staff over 2 years. Our evaluation will extend from processes of care to patient outcomes. Ancillary analyses will assess differences in tobacco counseling rates associated with practice, provider, and patient-level variables including disparities in counseling by race. To assess the relative impact of various components of the multi-modal intervention, we will conduct secondary analyses of the association of amount of use of each specific component with frequency of tobacco cessation counseling within the intervention group.

Study Timeline

• Study Start: 2003-09
• Study First Submitted: 2008-02-14
• Study First Submitted QC: 2008-02-28
• Study First Posted: 2008-02-29
• Primary Completion: 2008-06
• Study Completion: 2008-08
• Status Verified: 2010-08
• Last Update Submitted: 2015-03-05
• Last Update Posted: 2015-03-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 190

Inclusion Criteria

• general dental practices that have internet access
• Periodontal practices that have internet access
• patients of participating dental or periodontal practices

Exclusion Criteria

• patients who were 18 years of age and younger

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Internet-delivered continuing professional development	Intervention group (dental practices) that received the interactive motivational website for patient tobacco cessation
2	No intervention arm	Control group (dental practices) that did not receive any materials or resources on tobacco cessation. This is a wait-list control.

Primary Outcome Measures

Name	Time	Method
Our primary outcome measures are patient-reported provider delivered tobacco screening and tobacco cessation advice.	Baseline, 8-months post-intervention, and 24-months post-intervention

Secondary Outcome Measures

Name	Time	Method
Point prevalence smoking cessation	six-months after index visit for patients who smoke

Trial Locations

Locations (1)

University of Alabama at Birmingham; 🇺🇸 Birmingham, Alabama, United States