Dental Tobacco Control.Net:Improving Practice

Study Overview
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Brief Summary
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This is a randomized, controlled trial (RCT) to test the efficacy of an internet continuing dental education intervention designed to increase tobacco cessation counseling in dental practices. The intervention involves surveying practices regarding preventive care, surveying adult patients about their tobacco habits and preventive care provided by dental practice and training/educating the dentist and office staff on tobacco cessation. With patients who smoke and indicate that they have quit, we followed up with testing their saliva for the presence of cotinine. We have enrolled general dentists and periodontists who practice in the Southeastern United States.

Detailed Description
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Tobacco use has been described as the number one behavioral health problem of our time with a projected 8.4 million total smoking related deaths worldwide by the year 2020. Current clinical practice guidelines entitled Treating Tobacco Use and Dependence provide a summary of evidence-based recommendations. Despite the evidence of tobacco risk and the efficacy of tobacco control interventions, 30% of current smokers report that they have never been advised to stop smoking by a healthcare provider. Nearly half (47.9%) of dentists report they have never intervened to assist tobacco users in quitting. Our intervention is designed to improve the rate of tobacco cessation advice delivered in dental practices. This proposal is in response to the request for applications Translational Research in Dental Practice-based Tobacco Control Interventions (RFA: DE-03-007). Our exploration of barriers and facilitators will assist in clarifying processes that influence translation of tobacco-related knowledge into clinical dental practice. Our trial will integrate theoretically grounded methods of provider behavior change, medical informatics, and tobacco control research to translate guidelines into dental clinical practice. We will avoid a one-size-fits-all approach by tailoring strategies for tobacco cessation counseling to individual practices. The intervention will be longitudinal, with updates and continuous access for dentists and dental staff over 2 years. Our evaluation will extend from processes of care to patient outcomes. Ancillary analyses will assess differences in tobacco counseling rates associated with practice, provider, and patient-level variables including disparities in counseling by race. To assess the relative impact of various components of the multi-modal intervention, we will conduct secondary analyses of the association of amount of use of each specific component with frequency of tobacco cessation counseling within the intervention group.

Official Title
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Dental Tobacco Control.Net:Improving Practice

Conditions
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Tobacco Use Disorder

Intervention / Treatment
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* Behavioral: Internet-delivered continuing professional development
* Other: No intervention arm


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: general dental practices that have internet access Periodontal practices that have internet access patients of participating dental or periodontal practices Exclusion Criteria: patients who were 18 years of age and younger

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Intervention group (dental practices) that received the interactive motivational website for patient tobacco cessation | Behavioral: Internet-delivered continuing professional development<br>* Interactive motivational website for dentists and hygienists with practice improvement resources, discussion forum, and educational cases on cessation counseling with email reminders.<br>* Other names: Tobacco Use Cessation;|
| Placebo Comparator: 2<br>Control group (dental practices) that did not receive any materials or resources on tobacco cessation. This is a wait-list control. | Other: No intervention arm<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Our primary outcome measures are patient-reported provider delivered tobacco screening and tobacco cessation advice. |  | Baseline, 8-months post-intervention, and 24-months post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Point prevalence smoking cessation |  | six-months after index visit for patients who smoke | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Tobacco control, Tobacco cessation, Tobacco use