Abstract 7363: Providers’ beliefs, perceived skill, and perception of organizational norms relate to their delivery of cigarette smoking intervention to patients seen in healthcare centers serving rural and medically underserved areas of Texas
Authors: Ammar D. Siddiqi, Maggie Britton, Tzuan A. Chen, Isabel Martinez Leal, Abigail Bergey, Tarik Goulbourne, Terra Ousley, Teresa Williams, Kathleen Casey, Lorraine R. Reitzel
Journal: Cancer Research (2025)

Abstract Rural and medically underserved populations have elevated smoking rates, yet evidence-based cessation care is not often provided in healthcare settings serving these communities, leading to a greater burden of smoking-related cancers. Social cognitive theory (SCT) factors - cognitive, behavioral, and environmental - influence providers’ smoking intervention delivery. Here, we examine the veracity of these relations in a novel setting, healthcare centers serving rural and medically underserved areas of Texas, to inform workplace capacity building to improve care for smokers and prevent cancers. Providers (N=347) from 19 healthcare centers took an e-survey and reported on 1) their beliefs about smoking: whether their patients a) are concerned about smoking and b) want to quit (cognitive); 2) perceived treatment skills: whether they a) have the skills to help their patients quit smoking and b) are knowledgeable about referral options (behavioral); and 3) workplace norms: whether tobacco cessation counseling is an important part of their center’s mission (environmental). Smoking intervention practices (the 5A’s: Ask, Advise, Assess, Assist, Arrange) for past-month patient contacts were self-reported. Linear mixed models tested for associations between SCT constructs and the 5A’s, controlling for center type. Overall, 31.41% of providers believed their patients were concerned about smoking and 29.11% thought they wanted to quit; 48.99% endorsed treatment skills and 53.89% were knowledgeable of referral options; and 48.99% endorsed that tobacco treatment was an important part of their center’s mission. Providers Asked 68.31% of patients about their smoking status; of the smokers seen, providers Advised 58.68% to quit, Assessed interest in quitting among 51.90%, Assisted 35.87% to quit, and Arranged follow-ups for 22.79%. Relative to those who did not, providers who believed patients wanted to quit Asked a greater proportion of their patients about their smoking status. Providers who reported having the skills to help patients quit smoking or knowing about referral options delivered Ask to more patients and Advise, Assess, Assist, and Arrange to more smokers. Providers who believed that tobacco cessation was an important part of their center’s mission delivered Ask to more patients and Advise and Assess to more smokers. All ps &amp;lt;0.02. Workplace interventions providing education to improve the accuracy of providers’ smoking-related beliefs, training to bolster their smoking treatment and referral skills, and efforts to reflect the importance of a shared smoke-free mission may reduce gaps between the current and the recommended best practices in smoking care provision in centers serving patients in rural and medically underserved areas of Texas. Citation Format: Ammar D. Siddiqi, Maggie Britton, Tzuan A. Chen, Isabel Martinez Leal, Abigail Bergey, Tarik Goulbourne, Terra Ousley, Teresa Williams, Kathleen Casey, Lorraine R. Reitzel. Providers’ beliefs, perceived skill, and perception of organizational norms relate to their delivery of cigarette smoking intervention to patients seen in healthcare centers serving rural and medically underserved areas of Texas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7363.