RT Journal Article
SR Electronic
T1 From Good to Great: The Role of Performance Coaching in Enhancing Tobacco-Dependence Treatment Rates
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 498
OP 506
DO 10.1370/afm.2312
VO 16
IS 6
A1 Papadakis, Sophia
A1 Cole, Adam G.
A1 Reid, Robert D.
A1 Assi, Roxane
A1 Gharib, Marie
A1 Tulloch, Heather E.
A1 Mullen, Kerri-Anne
A1 Wells, George
A1 Pipe, Andrew L.
YR 2018
UL http://www.annfammed.org/content/16/6/498.abstract
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.