Outcomes of the Intervention, Stratified by Counseling Activity (5A Framework)
| Adjusted Affirmative Response Rate | |||||||
|---|---|---|---|---|---|---|---|
| Counseling Activity | Study Outcome | Question on Exit Questionnaire | ICCa | Control Group, %b | Intervention Group, %c | Difference, % (95% CId) | P Value |
| 5As = ask (A1), advise (A2), assess (A3), assist (A4), and arrange (A5); ICC = intracluster correlation coefficient; CI = confidence interval. | |||||||
| a Estimate of the intracluster correlation. | |||||||
| b Nine practices with denominators of n = 3,848 patients for A1 and n = 588 smokers for A2–5. | |||||||
| c Nine practices with denominators of n = 2,881 patients for A1 and n = 561 smokers for A2–5. | |||||||
| d The 95% lower confidence interval. | |||||||
| e Defined as an affirmative response to the question addressing A2, the question addressing A3–5, or both. | |||||||
| Ask (A1) | Proxy for intervention | “Did a nurse or doctor ask you today if you smoke?” | |||||
| All patients | 0.040 | 26.3 | 66.0 | 39.7 (35.5 to ∞) | <.001 | ||
| Smokers | 0.065 | 49.4 | 79.5 | 30.1 (24.0 to ∞) | <.001 | ||
| Nonsmokers | 0.045 | 22.7 | 62.8 | 40.1 (35.3 to ∞) | <.001 | ||
| Counseling (A2–5) | Main outcomee | (Either or both of below.) | 0.063 | 53.4 | 61.9 | 8.6 (0.8 to ∞) | .04 |
| Advice (A2) | Secondary outcome | “If you smoke, did your doctor advise you today to stop smoking?” | 0.064 | 51.5 | 59.9 | 8.4 (0.7 to ∞) | .04 |
| Discussion (A3–5) | Secondary outcome | “If you smoke, did your doctor talk with you today about ideas or plans to help you quit smoking?” | 0.061 | 29.3 | 32.5 | 3.3 (–2.9 to ∞) | .18 |