Clinician compliance with primary prevention of tobacco use: the impact of social contingencies

Prev Med. 1997 Jan-Feb;26(1):44-52. doi: 10.1006/pmed.1996.9994.

Abstract

Background: This study evaluated clinicians' compliance with delivering written advice and information against tobacco use (prevention prescriptions) to adolescent patients.

Methods: Clinicians in 77 orthodontic offices were trained (and asked) to provide anti-tobacco counseling and prescriptions to 10- to 18-year-olds for 2 years. Each of eight prescriptions was provided for distribution to adolescent patients. Information concerning prescription-tracking methods and operant learning theory variables such as modeling and feedback was obtained using a cross-sectional interview of clinical staff. The proportion of prescriptions written was regressed on possible "determinants." Analyses were replicated for two time periods.

Results: Mean anti-tobacco prescription compliance was 66 and 73% for two separate time periods. Multiple regression analyses were computed for the first (R = 0.45, F(7,63) = 2.29, P < 0.001) and second (R = 0.48, F(7,63) = 2.76, P < 0.001) time periods. Prescription tracking and praise from patients were significant correlates for the first time period; praise and modeling were significant for the second time period. Twenty and twenty-three percent, respectively, of the variance in office prescription rate was explained.

Conclusions: Results suggest that compliance with primary prevention procedures may be influenced by feedback from patients, staff modeling, and formal office tracking information.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • California
  • Child
  • Cross-Sectional Studies
  • Drug Prescriptions
  • Humans
  • Least-Squares Analysis
  • Linear Models
  • Orthodontics*
  • Patient Education as Topic*
  • Practice Patterns, Physicians'*
  • Social Support
  • Tobacco Use Disorder / prevention & control*