PT  - JOURNAL ARTICLE
AU  - Sophia Papadakis
AU  - Adam G. Cole
AU  - Robert D. Reid
AU  - Roxane Assi
AU  - Marie Gharib
AU  - Heather E. Tulloch
AU  - Kerri-Anne Mullen
AU  - George Wells
AU  - Andrew L. Pipe
TI  - From Good to Great: The Role of Performance Coaching in Enhancing Tobacco-Dependence Treatment Rates
AID  - 10.1370/afm.2312
DP  - 2018 Nov 01
TA  - The Annals of Family Medicine
PG  - 498--506
VI  - 16
IP  - 6
4099  - http://www.annfammed.org/content/16/6/498.short
4100  - http://www.annfammed.org/content/16/6/498.full
SO  - Ann Fam Med2018 Nov 01; 16
AB  - PURPOSE The purpose of this study was to examine the incremental effect of performance coaching, delivered as part of a multicomponent intervention (Ottawa Model for Smoking Cessation [OMSC]), in increasing rates of tobacco-dependence treatment by primary care clinicians.METHODS In a cluster-randomized controlled trial, 15 primary care practices were randomly assigned to 1 of the following active-treatment conditions: OMSC or OMSC plus performance coaching (OMSC+). All practices received support to implement the OMSC. In addition, clinicians in the OMSC+ group participated in a 1.5-hour skills-based coaching session and received an individualized performance report. All clinicians and a cross-sectional sample of their patients were surveyed before and 4 months after introduction of the interventions. The primary outcome measure was rates of tobacco-dependence treatment strategy (Ask, Advise, Assist, Arrange) delivery. Secondary outcomes were patient quit attempts and smoking abstinence measured at 6 months’ follow-up.RESULTS Primary care clinicians (166) and patients (1,990) were enrolled in the trial. Clinicians in the OMSC+ group had statistically greater rates of delivery for Ask (adjusted odds ratio [AOR] = 1.69; 95% CI, 1.05-2.72), Assist (AOR = 1.64; 95% CI, 1.08-2.49), and Arrange (AOR = 2.01; 95% CI, 1.22-3.31). Sensitivity analysis found that the rate of delivery for Advise was greater only among those clinicians who attended the coaching session (AOR = 1.65; 95% CI, 1.10-2.49; P = .02). No differences were documented between groups for cessation outcomes.CONCLUSIONS Performance coaching significantly increased rates of tobacco-dependence treatment by primary care clinicians when delivered as part of a multicomponent intervention.