Working Together to Treat Tobacco Dependence Among Smokers With Serious Mental Illness

Sunday, 30 July 2017: 10:35 AM

Rhonda Schwindt, DNP
School of Nursing, Indiana University School of Nursing, Indianapolis, IN, USA
Karen Hudmon, DrPH, MS
College of Pharmacy, Purdue University College of Pharmacy, Indianapolis, IN, USA
Kathy Lay, PhD
School of Social Work, Indiana University, Indianapolis, IN, USA
Angela McNelis, PhD, RN, FAAN, CNE, ANEF,
School of Nursing, George Washington University School of Nursing, Washington, D.C., DC, USA
Jon Agley, PhD
School of Public Health, Indiana University School of Public Health, Bloomington,, IN, USA

Purpose: The prevalence of tobacco use among persons with mental illness exceeds the prevalence in the general population by a factor of 2 to 4. Despite strong evidence that tobacco cessation counseling by a health professional can approximately double patients’ odds of quitting, clinicians across disciplines are reluctant to offer these individuals effective means by which to quit smoking. The purpose of this pilot study was to estimate the impact of an interprofessional tobacco education program on the perceived self-efficacy and self-rated counseling abilities of graduate health professions students to provide tobacco cessation counseling and their perceptions of interprofessional collaborative practice.

Methods:  Investigators used a 1-group, pre/post-test design with quantitative and qualitative analysis. All health professions students (N=36 [n=13 nursing, n=9 pharmacy, and n=14 social work]) completed pre-test-post-test surveys, 5 hours of tobacco education training consisting of a 2-hour online module and a 3-hour interprofessional live training session, a simulation experience with a standardized patient, and a post-simulation debriefing session. Data were analyzed using descriptive statistics, correlations, paired t-tests, and qualitative analysis techniques. Results: Participants’ perceived self-efficacy (t=-9.92, df = 35, p<0.001), self-rated counseling abilities (t=-7.36, df = 35, p<0.001), intention to ask about tobacco (t=-3.16, df = 35, p=0.003), and to provide counseling for tobacco cessation (t=-4.35, df = 35, p<0.001) were significantly improved at post-test. In addition, all participants reported high perceived ability to engage in collaborative care and work as part of an interprofessional team. Emergent themes from qualitative analyses of open-field queries were valuing simulations, demystifying disciplines, reflecting on and building skills, critiquing practice, and lessons learned.

Results: Participants’ perceived self-efficacy (t=-9.92, df = 35, p<0.001), self-rated counseling abilities (t=-7.36, df = 35, p<0.001), intention to ask about tobacco (t=-3.16, df = 35, p=0.003), and to provide counseling for tobacco cessation (t=-4.35, df = 35, p<0.001) were significantly improved at post-test. In addition, all participants reported high perceived ability to engage in collaborative care and work as part of an interprofessional team. Emergent themes from qualitative analyses of open-field queries were valuing simulations, demystifying disciplines, reflecting on and building skills, critiquing practice, and lessons learned.

Conclusion: Teaching health professions students an interprofessional collaborative approach to treating tobacco dependence for persons with serious mental illness appears to be an effective approach to improve perceived self-efficacy and self-rated counseling abilities and to positively impact their perceptions of interprofessional collaborative practice. These findings have the potential to inform the ways in which students across the spectrum of health professions are educated to provide tobacco cessation counseling. Larger studies are recommended to validate results of this pilot study.

See more of: Improving Health in the Psychiatric Patient
See more of: Research Sessions: Oral Paper & Posters