Journal Articles

A Qualitative Study of Tobacco Dependence Treatment in 19 US Dental Hygiene Programs.

Anne Koerber et al. — Thu, 15 Nov 2012 12:26:23 PST

INTRODUCTION: The US Public Health Service calls for health professionals to provide tobacco dependence counseling for patients. The purpose of this study was to understand how dental hygiene programs make decisions about and provide training for tobacco dependence counseling to help them graduate more fully competent hygienists.

METHODS: We conducted interviews (N = 32) with mainly program and clinic directors from 19 US dental hygiene education programs for this qualitative case study. We explored fluoride therapy training and tooth whitening training for comparison. Two analysts summarized the transcripts into a case study for each program.

RESULTS: All programs reported a similar process of learning about and choosing a method for teaching the topics explored. The programs used a common process, ADPIE (assess, diagnose, plan, implement, evaluate), to structure students'clinical encounters. Almost all programs train students to ask about tobacco use and to advise quitting, but few programs train students to effectively help patients to quit and only 2 programs evaluated the competence of all students to provide such training. ADPIE shows promise for integrating tobacco dependence treatment more fully into the clinical training of dental hygiene students. Comparison to tooth whitening and fluoride therapy training indicated that complexity of the treatment and alignment with dental hygiene's mission were themes related to training decisions.

CONCLUSION: Full implementation of tobacco dependence counseling into dental hygiene education requires a commitment by dental hygiene educators to train students and faculty in counseling techniques and their evaluation. We identified an existing clinical structure as showing promise for facilitating improvement.

Assessment of Tobacco Dependence Curricula in U.S. Dental Hygiene Programs

Joan M. Davis et al. — Wed, 02 Nov 2011 14:38:09 PDT

Tobacco dependence education (TDE) continues to be a vital component of dental hygiene curricula-made even more important by the fact that tobacco cessation in adults in the United States has stagnated over the past ten years. This study was undertaken to assess the salient characteristics of TDE in U.S. dental hygiene programs. A fifty-one question survey was mailed to the program directors of all 283 accredited dental hygiene programs during the 2007-08 school year (this number does not include the programs in Illinois, which were excluded since they had participated in a previous study). A total of 187 schools returned the survey for a return rate of 66 percent. Curricular content, minutes spent on each topic, existing level of clinical competence measured, expected level of clinical competence, and resources used were assessed. Respondents reported an average of 6.7 hours spent on all identified components of tobacco education. While 77 percent of respondents reported formally assessing whether a student asked if a patient used tobacco, only 26 percent indicated having a formal competency utilizing all of the U.S. Public Health Service's Clinical Practice Guideline 5 As and 5 Rs. In contrast, 72 percent of program directors reported expecting their graduates to be competent in a moderate intervention that included all 5 As. Though there is a clear commitment to TDE among dental hygiene programs in the United States, we recommend training to a more intensive level of TDE in order to facilitate broader adoption of comprehensive, evidence-based guidelines.

Evaluation of a Comprehensive Tobacco Cessation Curriculum for Dental Hygiene Programs

Joan M. Davis RDH, MS et al. — Wed, 02 Nov 2011 14:38:07 PDT

Dental health care providers continue to offer inconsistent and limited tobacco use cessation (TUC) interventions even though smoking-related morbidity and mortality continue to be a substantial health concern. Our purpose was to conduct a comprehensive, three-year (2003-06) TUC curriculum evaluation that included assessment of existing TUC education offered; dental hygiene educators' readiness to incorporate TUC education into the curriculum; and development of a pre-test/post-test assessment instrument and faculty development program. This curriculum study was carried out alongside a research study to evaluate the effectiveness of a peer-reviewed tobacco curriculum (Tobacco Free! Curriculum). Faculty members (baseline n=97; third-year n=42) from the twelve dental hygiene associate degree programs in Illinois participated in the study, which included a pre-treatment survey, six hours of on-site TUC curriculum training, and a post-treatment survey to determine the attitudes, perceived barriers, and current practices in tobacco education. Results showed an average increase of eighty-five minutes spent on tobacco education in the dental hygiene curriculum, a large positive increase in the percentage of faculty members who formally assessed the use of 5As and 5Rs (21 percent to 88 percent), and a dramatic increase (+100) in the percentage of faculty members who taught or included most of the thirteen TUC content areas following the introduction of the curriculum and training program.

The Need for Tobacco Education: Studies of Collegiate Dental Hygiene Patients and Faculty

Joan M. Davis RDH, MS et al. — Wed, 02 Nov 2011 14:36:22 PDT

The need for inclusion of comprehensive tobacco control education/training for health care providers continues to be stressed in publications addressing cessation services. The dental appointment presents an excellent opportunity to provide tobacco interventions to basically healthy people on regular intervals. The purpose of this study was twofold: 1) to assess the need (stage of change and concomitant need for tobacco cessation intervention) of dental hygiene patients at a Midwest dental hygiene clinic, and 2) to assess and compare the level of tobacco intervention education currently being offered by dental hygiene educators in a Midwestern state. Patients (n=426) of a collegiate dental health clinic completed a survey that assessed the level and type of tobacco cessation intervention patients might require. A statewide sample of dental hygiene faculty (n=97) were surveyed to determine the attitudes, perceived barriers, and current practices in tobacco education offered in their programs. Of patients who currently smoked (34.5 percent), 24.7 percent indicated being in the Action stage of change; 14.2 percent were in Preparation; 22.2 percent were in Contemplation; and 29 percent were in Precontemplation. Although faculty indicated tobacco education was very important (5.03 on 1-6 scale), they felt only moderately confident delivering tobacco education (3.18 on a 1-5 scale). Only 16 percent to 35 percent of faculty reported that their curriculum included brief motivational interviewing, pharmacotherapies, or setting-up a private practice tobacco control program. The results strongly suggest the need for a comprehensive, competency-based tobacco curriculum to enhance and expand existing dental hygiene programs.

Tobacco Cessation Counselling: Motivating Clients to Quit

Joan M. Davis — Wed, 02 Nov 2011 13:25:07 PDT