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Factors influencing implementation of smoking cessation treatment within community mental health centers.

Brown, Clayton H; Medoff, Deborah; Dickerson, Faith B; Fang, Li Juan; Lucksted, Alicia; Goldberg, Richard W; Kreyenbuhl, Julie; Himelhoch, Seth; Dixon, Lisa B.
J Dual Diagn; 11(2): 145-50, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25985201


Consumers with serious mental illness smoke more and are at higher risk for smoking-related illness. We examined provider and consumer factors influencing the implementation of the evidence-based "5 A's" (ask, advise, assess, assist, arrange) in six community mental health centers in greater Baltimore.


Data collected as part of a larger study examining the effectiveness of delivery of the 5 A's at patient visits. First, we examined responses to a survey administered to 49 clinicians on barriers and attitudes toward delivering the 5 A's. Second, we used multilevel models to examine variance between patients (n = 228), patient factors, and variance between their psychiatrists (n = 28) in the delivery of the 5 A's (and first 3 A's).


The most strongly endorsed barrier was perceived lack of patient interest in smoking cessation. Psychiatrists and patients both accounted for significant variance in the delivery of the 5 A's and 3 A's. Patient "readiness to change" predicted delivery of the full 5 A's, while smoking severity predicted delivery of the first 3 A's.


There is a critical need for creative and collaborative solutions, policies, and clinician training to address actual and perceived obstacles to the delivery of evidence-based smoking cessation treatment in the mental health care setting.
Selo DaSilva