Table 1

Summary of the Multicomponent Knowledge Translation Intervention

Outreach facilitation visitsA trained outreach facilitator worked with each primary care clinic over a 3-month period to do the following:
 • Provide information and recommendations on the integration of evidence-based smoking cessation strategies into clinical practice
 • Facilitate the development of a clinic tobacco control protocol for integrating evidence-based smoking cessation strategies into all clinic appointments
 • Define roles and responsibilities of clinic staff in delivering evidence-based smoking cessation treatments
 • Support communications and training activities for members of the clinic staff
Clinic staff trainingFrontline physicians and nurse practitioners participated in a 3-hour training session that provided information and skills training for addressing tobacco use with patients in a busy primary care practice
Key staff who would be responsible for delivering quit plan visits (typically nurses, nurse practitioners, or pharmacists) attended an intensive 1-day training session that taught them how to conduct the quit plan visit and follow-up visits based on evidence-based practice
Standardized staff and patient toolsAll materials were designed to support 3 A’s delivery and reduce the amount of face-to-face time required. They included the following:
 • A patient tobacco use survey to document smoking history
 • A checklist-style smoking cessation consult form
 • A quit plan booklet for smokers ready to quit
 • A booklet for smokers not ready to quit
 • Clinic waiting room posters and materials
Real time prompts and EMR toolsReal time, point-of-care reminders (eg, standard smoking status questions and prompts to deliver brief advice) were introduced and embedded in vital signs screening forms
Standardized forms were embedded in EMR systems to guide 3 A’s delivery for advice, quit plan, and follow-up visits
Follow-up support and counselingPractices were introduced to a telephone-based Smoker’s Follow-up System for patients ready to quit (5 triage calls over a 2-month period delivered by Interactive Voice Response System) with additional support from trained smoking cessation counselors available for patients struggling with their quit attempts
Audit and feedbackPractices were given feedback reports on the results of pre- and postintervention assessments
They also received audit and feedback regarding implementation activities 1 to 4 months following initiation of intervention program
  • EMR = electronic medical record; 3 A’s = Ask, Advise, Act.