Background on Provider Education
What are provider education strategies?
- Interventions that train qualified health care professionals to counsel or provide advice to individuals to avoid starting to use tobacco, reduce exposure to environmental tobacco smoke, or stop using tobacco.
- This type of intervention is geared towards health care providers working in clinical settings including physicians, nurses, dentists, dieticians, etc.
- These interventions can enhance health care providers’ knowledge and skills related to counseling individuals about tobacco use. This training offers health care providers access to information and resources about:
- the risks of tobacco use (to the user and those close to them);
- how to improve culturally competent communication between individuals and health care providers;
- the health benefits of tobacco use reduction; and
- ways to decrease tobacco use by offering support and reducing barriers.
How can provider education impact tobacco related behaviors?
- Health care providers are a primary and respected source of health information. Many individuals and families seek out the advice of health care providers to maintain their health and quality of life on a regular basis. Therefore, health care providers are ideally suited to have an ongoing influence on individuals’ decisions to avoid or reduce tobacco use.
What are provider reminder strategies and how can they be used in tobacco interventions?
- Provider reminder interventions can be developed as part of provider training. Provider reminder interventions provide cues or prompts to increase the likelihood that health care providers will discuss tobacco use with individuals. Provider reminder interventions utilize various strategies to identify individuals who use tobacco and to remind providers to discuss cessation with these individuals, including changes to the individual’s chart (e.g., stickers, colored folders), changes in the physical environment (e.g., posters in exam rooms) or personal prompts (e.g., laminated pocket-sized information sheets).
What types of settings are appropriate for provider education strategies?
- These provider education interventions are usually offered to health care providers in public or private health care settings, including a provider’s office, hospital, health department, or assisted living facility. However, health care providers without specialized medical training can participate in provider education interventions training for nontraditional settings, including communities (e.g., mobile clinics), schools (e.g., school nurses), worksites (e.g., health screening), faith-based settings (e.g., health ministry) or homes.
Where are opportunities for interventions in during patient visits?
- As part of their interaction with individuals, health care providers typically provide the following:
- An assessment of an individual’s behaviors related to tobacco use and readiness to make behavior changes. This assessment allows the provider to provide personally relevant information to the individual about their health and tobacco use. This information may be intended to increase knowledge or awareness, change attitudes, teach skills or provide social support.
- An opportunity for the individual can ask questions or clarify what they have been told. This exchange with the provider can help to ensure that the individual understands the information and recommendations that they have been provided.
- Resources or referrals to resources within the community to assist the individual in reducing tobacco use. For example, the provider can give the individual quit line phone numbers.
- Subsequent visits with the health care provider generally include a reassessment of the individual’s health and tobacco use as well as a discussion of challenges, benefits and advice for continuing to avoid tobacco use or maintain tobacco use cessation.
What are the best methods for educating health care providers?
- Provider education training works best if it is hands-on and practical. This may include discussions among health care professionals about how to counsel or provide advice to specific individuals (e.g., those with special health care needs, those who show no change over time), how to respond to individual barriers to tobacco use cessation (e.g., weight gain, stress), how to reach high risk populations, how to work in different settings, and how to integrate effective practice strategies into different practice styles.
- Previous studies also suggest that it is important to consider longer-term education strategies, tailor provider education about tobacco use to specific behaviors, and train providers on community and policy influences on these behaviors in addition to the more traditional focus on individual services. It is also useful to share methods for individual tracking, repeat counseling and referrals as appropriate. Interventions should be accomplishable in a quick and succinct manner.
What are the barriers to implementing provider education interventions?
- It is difficult to understand the effectiveness of these interventions because the interaction between the provider and individual is unique for each individual, short in duration (often less than 5 minutes), may involve recommendations for multiple behaviors at once (e.g., increase physical activity and quit smoking), or may lack institutional support for sharing this type of information during a visit (e.g., policies, procedures, training, or incentives).