TY - JOUR
T1 - A multilevel intervention in pediatric primary care for youth tobacco control
T2 - Outcomes of implementing an Ask, Advise, and Connect model
AU - Mays, Darren
AU - Macisco, Joseph M.
AU - Hawkins, Kirsten B.
AU - Sleiman, Marcelo M.
AU - RoseYockel, Mary
AU - Xie, Shoulong
AU - Phan, Lilianna
AU - Luta, George
AU - Lobo, Tania
AU - Abraham, Anisha
AU - Prokhorov, Alexander V.
AU - Tercyak, Kenneth P.
N1 - Publisher Copyright:
© Society of Behavioral Medicine 2024. All rights reserved.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Multilevel interventions in healthcare settings (e.g. Ask, Advise, and Connect; AAC) can reduce tobacco product use among adult patients: their effectiveness in pediatric practice is largely unknown. We implemented an AAC model in pediatric primary care to deter children's tobacco use, and evaluated its effectiveness in a single-arm trial. At wellness visits, young patients (ages 12-17) completed a tablet-based assessment (Ask) of lifetime and current tobacco use. These data were made available within the electronic health record to pediatric primary care providers for preventive counseling (Advise). Providers then referred patients to an e-health evidence-based tobacco control intervention (Connect). Tobacco control outcomes were examined in the clinic population (N = 2219) and in a sample of patients (N = 388, 62% female, 39% non-White, M age = 15) over time, along with intervention engagement. Population use of tobacco products decreased following introduction of AAC (more than 2-fold). At the patient level, most children (80.9%) engaged with the intervention: those who were Black or African American, who never used tobacco products/were not susceptible to use, and who used fewer non-cigarette tobacco products were more likely to engage, but only after multiple prompts versus a single prompt. Engagement was positively associated with lowering children's susceptibility to using tobacco at follow-up. A pediatric AAC model holds promise in deterring youth tobacco use, including among historically marginalized populations who may require additional support.
AB - Multilevel interventions in healthcare settings (e.g. Ask, Advise, and Connect; AAC) can reduce tobacco product use among adult patients: their effectiveness in pediatric practice is largely unknown. We implemented an AAC model in pediatric primary care to deter children's tobacco use, and evaluated its effectiveness in a single-arm trial. At wellness visits, young patients (ages 12-17) completed a tablet-based assessment (Ask) of lifetime and current tobacco use. These data were made available within the electronic health record to pediatric primary care providers for preventive counseling (Advise). Providers then referred patients to an e-health evidence-based tobacco control intervention (Connect). Tobacco control outcomes were examined in the clinic population (N = 2219) and in a sample of patients (N = 388, 62% female, 39% non-White, M age = 15) over time, along with intervention engagement. Population use of tobacco products decreased following introduction of AAC (more than 2-fold). At the patient level, most children (80.9%) engaged with the intervention: those who were Black or African American, who never used tobacco products/were not susceptible to use, and who used fewer non-cigarette tobacco products were more likely to engage, but only after multiple prompts versus a single prompt. Engagement was positively associated with lowering children's susceptibility to using tobacco at follow-up. A pediatric AAC model holds promise in deterring youth tobacco use, including among historically marginalized populations who may require additional support.
KW - children
KW - implementation
KW - pediatrics
KW - tobacco use prevention
UR - http://www.scopus.com/inward/record.url?scp=85188538425&partnerID=8YFLogxK
U2 - 10.1093/tbm/ibae002
DO - 10.1093/tbm/ibae002
M3 - Article
C2 - 38330454
AN - SCOPUS:85188538425
SN - 1869-6716
VL - 14
SP - 241
EP - 248
JO - Translational Behavioral Medicine
JF - Translational Behavioral Medicine
IS - 4
ER -