Partnering with Health Care Systems to Assess Tobacco Treatment Practices and Beliefs Among Clinicians: Evaluating the Process

BACKGROUND: Tobacco is a major cause of preventable illness and death. However, clinician use of an evidence-based guideline for treatment of tobacco use is low. This case study describes the process for conducting a pre-intervention assessment of clinician practices and beliefs regarding treatment of tobacco use. COMMUNITY CONTEXT: Louisiana State University Health System, one of the largest safety-net public hospital systems in the United States, consists of 10 facilities in population centers across the state of Louisiana. The system serves a large proportion of the state’s underinsured and uninsured, low-income, and racial/ethnic minority populations, groups that have high rates of tobacco use. METHODS: Activities included 1) partnering with hospital administrators to generate support for conducting a clinician assessment, 2) identifying and adapting a survey tool to assess clinicians’ practices and beliefs regarding treatment of tobacco use, 3) developing a survey protocol and obtaining approval from the institutional review board, and 4) administering the survey electronically, using the hospital’s e-mail system. OUTCOME: Existing partnerships and system resources aided survey administration. Use of the hospital’s internal e-mail system and distribution of an online survey were effective means to engage clinicians. Following notification, 43.6% of 4,508 clinicians opened their e-mail containing the invitation letter with a Web link to the survey; of these, 83.1% (1,634) completed the survey. INTERPRETATION: Partnering with stakeholders and using existing resources within the health care system are essential to successful implementation of a system-wide survey of clinician practices and beliefs regarding treatment of tobacco use.