Final Model for the Multi-Level Analysis of Clinic-, Clinician-, and Patient-Level Characteristics Associated With Rates of Clinician Delivery of the 3 A’s (Ask, Advise, Act)
| Parameter | Ask | Advise | Act to Assist With Cessation | |
|---|---|---|---|---|
| Time, AOR (95% CI) | ||||
| Preintervention (reference) | 1.00 | 1.00 | 1.00 | |
| Postintervention | 2.07 (1.77–2.43) | 2.32 (1.95–2.76) | 2.49 (2.09–2.97) | |
| Clinic-level variables, AOR (95% CI) | ||||
| Presence of a physician champion | ||||
| No (reference) | 1.00 | 1.00 | 1.00 | |
| Yes | 1.66 (1.13–2.44) | |||
| Provider-level variables, AOR (95% CI) | ||||
| Importance of cessationa | ||||
| Low (reference) | 1.00 | 1.00 | 1.00 | |
| High | 1.25 (1.02–1.53) | 1.35 (1.10–1.64) | ||
| Patient-level variables, AOR (95% CI) | ||||
| Age, y | ||||
| 18–24 (reference) | 1.00 | 1.00 | 1.00 | |
| 25–39 | 1.11 (0.80–1.54) | 1.55 (1.10–2.19) | ||
| 40–54 | 1.31 (0.95–1.81) | 1.85 (1.33–2.58) | ||
| 55–64 | 1.55 (1.09–2.20) | 1.85 (1.30–2.64) | ||
| ≥65 | 1.53 (1.05–2.25) | 1.69 (1.14–2.49) | ||
| Formal education | ||||
| <High school (reference) | 1.00 | 1.00 | 1.00 | |
| High school | 0.77 (0.50–1.18) | |||
| University | 0.66 (0.43–1.02) | |||
| Graduate school | 0.54 (0.32–0.90) | |||
| Smoking-related illnessb | ||||
| No (reference) | 1.00 | 1.00 | 1.00 | |
| Yes | 1.28 (1.07–1.53) | 1.26 (1.02–1.54) | ||
| Cigarettes per day, No. | ||||
| <15 (reference) | 1.00 | 1.00 | 1.00 | |
| 15–25 | 1.38 (1.14–1.67) | 1.52 (1.25–1.84) | ||
| >25 | 1.25 (0.89–1.78) | 1.62 (1.14–2.29) | ||
| Time to first morning cigarette | ||||
| >30 min (reference) | 1.00 | 1.00 | 1.00 | |
| <30 min | 1.23 (1.05–1.45) | 1.23 (1.02–1.49) | 1.31 (1.08–1.59) | |
| Readiness to quitc | ||||
| Not ready in next 30 d (reference) | 1.00 | 1.00 | 1.00 | |
| Ready in next 30 d | 1.29 (1.10–1.53) | 1.50 (1.25–1.80) | 1.60 (1.33–1.92) | |
| Self-efficacy with quittingd | ||||
| Low (reference) | 1.00 | 1.00 | 1.00 | |
| High | 1.36 (1.06–1.74) | |||
| Purpose of visit | ||||
| Follow-up (reference) | 1.00 | 1.00 | 1.00 | |
| Annual exam | 2.79 (2.26–3.45) | 1.98 (1.59–2.46) | 1.84 (1.49–2.27) | |
| Random Variance, Variance (SE) | ||||
| Provider | 0.214 (0.068) | 0.128 (0.059) | 0.088 (0.058) | |
| Clinic | 0.154 (0.060) | 0.087 (0.043) | 0.083 (0.041) | |
| Model fit statistics | ||||
| Akaike information criterion | 3,921.93 | 3,123.72 | 3,001.19 | |
| Bayesian information criterion | 3,939.52 | 3,150.10 | 3,030.50 | |
Note: Models are adjusted for clinic- and provider-level clustering effects and all other variables in the column.
↵a “As a practitioner, how would you describe the importance you place personally on helping your patients quit smoking?” (Responses: 1–5 Likert scale, 1 = not important, 5 = extremely important)
↵b “Do you have... heart disease/ stroke/ heart failure/ cancer/ chronic obstructive pulmonary disease (COPD)?” (1 = yes, 0 = no for each condition)
↵c “Which of the following best describes your feelings about smoking right now?” (Responses: 1 = Ready to quit in next 30 days, 0 = Ready to quit in next 6 months or not ready to quit.)
↵d “On a scale of 1 to 10, how confident are you that you would be able to quit smoking at this time?” (1 = Not at all confident, 10 = Extremely confident.)