Behavioral health care provider's beliefs, confidence, and knowledge in treating cigarette smoking in relation to their use of the 5A's intervention

Midhat Z Jafry; Jayda Martinez; Tzuan A Chen; Maggie Britton; Isabel Martinez Leal; Anastasia Rogova; Bryce Kyburz; Teresa Williams; Mayuri Patel; Brian J Carter; Lorraine R Reitzel

doi:10.1016/j.abrep.2023.100493

Behavioral health care provider's beliefs, confidence, and knowledge in treating cigarette smoking in relation to their use of the 5A's intervention

Addict Behav Rep. 2023 May 11:17:100493. doi: 10.1016/j.abrep.2023.100493. eCollection 2023 Jun.

Authors

Midhat Z Jafry^{1

2

3}, Jayda Martinez^{3

4

5}, Tzuan A Chen^{3

4}, Maggie Britton^{1

3}, Isabel Martinez Leal^{1

3}, Anastasia Rogova^{1

3}, Bryce Kyburz⁶, Teresa Williams⁶, Mayuri Patel⁷, Brian J Carter^{1

3}, Lorraine R Reitzel^{1

3}

Affiliations

¹ The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, 1400 Pressler Street, Houston, TX 77030, USA.
² University of Houston, Department of Biology and Biochemistry, Science & Research Building 2, 3455 Cullen Blvd Room 342, Houston, TX 77204, USA.
³ University of Houston, Department of Psychological, Health, and Learning Sciences, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA.
⁴ University of Houston, HEALTH Research Institute, 4349 Martin Luther King Blvd., Houston, TX 77204, USA.
⁵ The University of Texas Health Science Center, School of Public Health, 1200 Pressler St., Houston, TX 77030, USA.
⁶ Integral Care, 1430 Collier St., Austin, TX 78704, USA.
⁷ Texas Department of State Health Services, Tobacco Prevention and Control Branch, 1100 West 49th Street, Mail Code 1965, Austin, TX 78756, USA.

Abstract

Introduction: Evidence-based smoking cessation interventions are underused settings where behavioral health treatment is provided, contributing to smoking-related health disparities in this patient group. This study assessed the relationship of provider's beliefs about patients' smoking, perceptions of treatment capability, and knowledge of referral options and their use of the 5A's (Ask, Advise, Assess, Assist, and Arrange) intervention for smoking cessation.

Methods: Surveys were collected from providers in healthcare settings in Texas where patients receive behavioral health care (N = 86; 9 federally qualified health centers, 16 Local Mental Health Authorities (LMHAs), 6 substance use treatment programs in LMHAs, and 55 stand-alone substance use treatment centers). Logistic regression analyses were used to assess the association between provider's beliefs about patients' concern and desire to quit smoking; perceptions of their confidence, skills, and effectiveness in treating smoking; their knowledge of referral options; and their use of the 5A's with patients who smoked.

Results: Providers who believed that patients were concerned about smoking and wanted to quit; who perceived themselves as confident in providing cessation care, having the required skills, and being effective in providing advice; and/or who had greater referral knowledge were more likely to use the 5A's with patients who smoked than their (respective) provider counterparts (ps < 0.05).

Conclusion: Provider-level constructs affect their 5A's provision for patients with behavioral health needs. Future work should train providers to correct misconceptions about patients' interest in quitting, bolster their confidence, and provide referral options to support tobacco provision efforts.

Keywords: 5A’s intervention; Mental health disorders; Provider confidence; Provider knowledge; Smoking cessation; Substance use disorder.