Electronic Heath Record Prompts May Increase Screening for Secondhand Smoke Exposure

Area of Science:

• Public Health
• Pediatrics
• Health Services Research

Background:

• The American Academy of Pediatrics recommends pediatricians promote smoking cessation among caregivers.
• Clinical practice often shows inconsistencies in addressing caregiver smoking and secondhand smoke exposure (SHSe).

Purpose of the Study:

• To compare the effectiveness of three intervention methods in increasing pediatrician screening for SHSe.
• To identify optimal strategies for integrating SHSe screening into pediatric primary care.

Main Methods:

• Pediatricians were randomized into three groups: no intervention (control), electronic health record (EHR) changes only, or a lecture combined with EHR changes.
• Data on SHSe documentation rates were compared across the three groups using a 1-way analysis of variance.

Main Results:

• The group receiving both a lecture and EHR changes (G3) showed significantly higher SHSe documentation compared to the other two groups (P < .01).
• The group with EHR changes only (G1) also demonstrated significantly greater SHSe documentation than the lecture-only group (G2) (P < .05).

Conclusions:

• A combination of a brief lecture and EHR prompts is an effective and simple method to enhance SHSe screening in pediatric primary care.
• Integrating educational components with technological prompts in EHR systems can improve adherence to clinical recommendations for SHSe assessment.