Exploring primary care providers' interest in using patient navigators to assist in the delivery of tobacco cessation treatment to low income, ethnic/racial minority patients Journal Article


Authors: Lubetkin, E. I.; Lu, W. H.; Krebs, P.; Yeung, H.; Ostroff, J. S.
Article Title: Exploring primary care providers' interest in using patient navigators to assist in the delivery of tobacco cessation treatment to low income, ethnic/racial minority patients
Abstract: We examined attitudes and practices regarding tobacco cessation interventions of primary care physicians serving low income, minority patients living in urban areas with a high smoking prevalence. We also explored barriers and facilitators to physicians providing smoking cessation counseling to determine the need for and interest in deploying a tobacco-focused patient navigator at community-based primary care practice sites. A self-administered survey was mailed to providers serving Medicaid populations in New York City's Upper Manhattan and areas of the Bronx. Provider counseling practices were measured by assessing routine delivery (≥80% of the time) of a brief tobacco cessation intervention (i.e., "5 A's"). Provider attitudes were assessed by a decisional balance scale comprising 10 positive (Pros) and 10 negative (Cons) perceptions of tobacco cessation counseling. Of 254 eligible providers, 105 responded (41%). Providers estimated 22% of their patients currently use tobacco and nearly half speak Spanish. A majority of providers routinely asked about tobacco use (92%) and advised users to quit (82%), whereas fewer assisted in developing a quit plan (32%) or arranged follow-up (21%). Compared to providers reporting <80% adherence to the "5 A's", providers reporting ≥80% adherence tended to have similar mean Pros and Cons scores for Ask, Advise, and Assess but higher Pros and lower Cons for Assist and Arrange. Sixty four percent of providers were interested in providing tobacco-related patient navigation services at their practices. Although most providers believe they can help patients quit smoking, they also recognize the potential benefit of having a patient navigator connect their patients with evidence-based cessation services in their community. © 2010 Springer Science+Business Media, LLC.
Keywords: adult; middle aged; young adult; united states; methodology; clinical practice; organization and management; physician's practice patterns; smoking cessation; questionnaires; health service; questionnaire; psychological aspect; utilization review; feasibility study; feasibility studies; new york city; attitude of health personnel; general practitioner; minority health; ethnic group; primary care; health care delivery; health personnel attitude; community care; ethnic groups; ethnology; minority groups; minority group; poverty; health services accessibility; healthcare providers; patient navigation; tobacco cessation; directive counseling; health auxiliary; community health aides; community health services; physicians, primary care; urban health services
Journal Title: Journal of Community Health
Volume: 35
Issue: 6
ISSN: 0094-5145
Publisher: Springer  
Date Published: 2010-12-01
Start Page: 618
End Page: 624
Language: English
DOI: 10.1007/s10900-010-9251-8
PUBMED: 20336355
PROVIDER: scopus
PMCID: PMC4097305
DOI/URL:
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: JCMHB" - "Source: Scopus"
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  1. Jamie S Ostroff
    344 Ostroff
  2. Paul Krebs
    11 Krebs