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Implementing a tobacco assisted referral program in dental practices.

Sally J Little¹, Jack F Hollis, Jeffrey L Fellows

¹Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Avenue, Portland, OR 97227-1110, USA.

Journal of Public Health Dentistry

|February 5, 2009

Summary

Integrating a dental office tobacco cessation program, "Assisted Referral," significantly boosted patient satisfaction and counseling. This system-level intervention shows promise for widespread adoption in dental settings.

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Area of Science:

Public Health
Dental Public Health
Behavioral Science

Background:

Tobacco use remains a significant public health concern, with dental settings offering a unique opportunity for intervention.
Previous tobacco control efforts in dental practices have shown variable success, necessitating system-level approaches.

Purpose of the Study:

To design and implement a system-level tobacco control intervention within a large prepaid dental group practice.
To evaluate the impact of the intervention on dental staff performance and patient satisfaction.

Main Methods:

A randomized controlled trial matched 14 dental facilities, assigning them to either the "Assisted Referral" intervention or usual care.
Intervention staff received training on tobacco use assessment, tailored advice, and encouraging patients to engage with telephone counselors.

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Telephone counselors provided support for quitting, reviewed cessation strategies, and identified next steps for patients.

Main Results:

High rates of tobacco assessment (97%) and advice (93%) were observed in both intervention and control groups.
Intervention patients were significantly more likely to receive additional chair-side counseling (69% vs. 3%) and agree to telephone counseling (11%).
Patients in the intervention group reported higher satisfaction with the dental team's tobacco control efforts compared to controls.

Conclusions:

The "Assisted Referral" approach was successfully integrated into routine dental care, demonstrating feasibility and patient acceptance.
The intervention led to increased patient satisfaction with tobacco control services in the dental setting.
This approach is a practical strategy for dental practices, especially given the availability of free telephone-based cessation support.