Implementing multimodal smoking cessation interventions in adult primary care

Purpose of Project: The purpose of this study was to implement multimodal smoking cessation interventions in a primary care setting. Methodology: This DNP project used a mixed methods participatory inside action research approach, to implement multimodal smoking cessation interventions using the 5A’s and the 5R’ s of smoking cessation, in a primary care setting. The DNP student investigator organized learning circle meetings to educate the healthcare team, to develop the implementation and adaptation of these interventions, and to leave a sustainable workflow for smoking cessation interventions for the practice to use. Chart reviews were performed to assess for adherence to interventions and force field analysis of the potency and amenability to change of the CFIR constructs. Results: The results showed multiple barriers, facilitators, and unexpected findings, which guided the adaptation of workflows and the implementation plan. Evaluation of the data showed that adherence to asking about smoking status was 100%, and the rate of assisting patients in quitting smoking was 72%. The rest of the interventions had much lower adherence rates due to multiple barriers. The increase in potency and amenability to change of the CFIR constructs were in direct correlation to the adaptation of interventions to the practice. These results cannot be generalized, but they indicate that participatory inside action research had partial success in implementing smoking cessation interventions in a primary care setting. Implications for Practice: Progress towards the patient’s quality of care and safety was obtained after the implementation of smoking cessation in the primary care office, but further work needs to be done to increase adherence. Further education is needed to be provided for the primary care providers to acquire a high level of skill set to apply interventions that are more time consuming, such as motivational interviewing.DNPIncludes bibliographical reference