Implementing point of care "e-referrals" in 137 clinics to increase access to a quit smoking internet system: The Quit-Primo and National Dental PBRN HI-QUIT Studies

Rajani S. Sadasivam, Timothy P. Hogan, Julie E. Volkman, Bridget M. Smith, Heather L. Coley, Jessica H. Williams, Kathryn DeLaughter, Midge N. Ray, Gregg H. Gilbert, Daniel E. Ford, Jeroan J. Allison, Thomas K. Houston

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Integrating electronic referral systems into clinical practices may increase use of web-accessible tobacco interventions. We report on our feasibility evaluation of using theory-driven implementation science techniques to translate an e-referral system (ReferASmoker.org) into the workflow of 137 community-based medical and dental practices, including system use, patient registration, implementation costs, and lessons learned. After 6 months, 2,376 smokers were e-referred (medical, 1,625; dental, 751). Eighty-six percent of the medical practices [75/87, mean referral = 18.7 (SD = 17.9), range 0-105] and dental practices [43/50, mean referral = 15.0 (SD = 10.5), range 0-38] had e-referred. Of those smokers e-referred, 25.3 registered [mean smoker registration rate-medical 4.9 (SD = 7.6, range 0-59), dental 3.6 (SD = 3.0, range 0-10)]. Estimated mean implementation costs are medical practices, US$429.00 (SD = 85.3); and dental practices, US$238.75 (SD = 13.6). High performing practices reported specific strategies to integrate ReferASmoker.org; low performers reported lack of smokers and patient disinterest in the study. Thus, a majority of practices e-referred and 25.3 % of referred smokers registered demonstrating e-referral feasibility. However, further examination of the identified implementation barriers is important as of the estimated 90,000 to 140,000 smokers seen in the 87 medical practices in 6 months, only 1,625 were e-referred.

Original languageEnglish (US)
Pages (from-to)370-378
Number of pages9
JournalTranslational Behavioral Medicine
Volume3
Issue number4
DOIs
StatePublished - Dec 1 2013
Externally publishedYes

Keywords

  • Dental practice public health informatics
  • Family practice
  • General practice
  • Health services research
  • Online behavior change systems
  • Randomized controlled trial
  • Smoking cessation

ASJC Scopus subject areas

  • Applied Psychology
  • Behavioral Neuroscience

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    Sadasivam, R. S., Hogan, T. P., Volkman, J. E., Smith, B. M., Coley, H. L., Williams, J. H., DeLaughter, K., Ray, M. N., Gilbert, G. H., Ford, D. E., Allison, J. J., & Houston, T. K. (2013). Implementing point of care "e-referrals" in 137 clinics to increase access to a quit smoking internet system: The Quit-Primo and National Dental PBRN HI-QUIT Studies. Translational Behavioral Medicine, 3(4), 370-378. https://doi.org/10.1007/s13142-013-0230-3