Abstract
Objective: Consumers with serious mental illness smoke more and are at higher risk for smoking-related illness. We examined provider and consumer factors influencing the implementation of the evidence-based "5 A's" (ask, advise, assess, assist, arrange) in six community mental health centers in greater Baltimore. Methods: Data collected as part of a larger study examining the effectiveness of delivery of the 5 A's at patient visits. First, we examined responses to a survey administered to 49 clinicians on barriers and attitudes toward delivering the 5 A's. Second, we used multilevel models to examine variance between patients (n = 228), patient factors, and variance between their psychiatrists (n = 28) in the delivery of the 5 A's (and first 3 A's). Results: The most strongly endorsed barrier was perceived lack of patient interest in smoking cessation. Psychiatrists and patients both accounted for significant variance in the delivery of the 5 A's and 3 A's. Patient "readiness to change" predicted delivery of the full 5 A's, while smoking severity predicted delivery of the first 3 A's. Conclusions: There is a critical need for creative and collaborative solutions, policies, and clinician training to address actual and perceived obstacles to the delivery of evidence-based smoking cessation treatment in the mental health care setting.
Original language | English |
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Pages (from-to) | 145-150 |
Number of pages | 6 |
Journal | Journal of Dual Diagnosis |
Volume | 11 |
Issue number | 2 |
DOIs | |
State | Published - Apr 3 2015 |
Bibliographical note
Publisher Copyright:© 2015 Copyright Taylor & Francis Group, LLC.
Funding
Funders | Funder number |
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National Institute on Drug Abuse | R01DA014393 |
Keywords
- Barriers to treatment
- Implementation research
- Serious mental illness
- Smoking cessation
ASJC Scopus subject areas
- Psychiatry and Mental health