James, Noemi and Lee, Eunyoung and Cole, Carey and Farris, Barbara and Wright, Pamela Improving Chronic Health Diseases Through Structured Smoking Cessation Education in a Rural Free Clinic. 2021. Radford University, Dissertation. Radford University Scholars' Repository.
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Abstract
Significance: Smoking is the leading cause of preventable death and contributes to many chronic health diseases. A strong correlation exists between cigarette smoking and its negative impact on chronic diseases. However, quitting smoking is challenging. The annual quit success rates remain low at roughly 7%. A high prevalence of smokers with chronic disease is prominent among the underserved population due to limited access to care and lack of health literacy, leading to poor health outcomes. Purposes/Methods: A quasi-experimental one-group pilot study with a pre and post-test design was conducted as a part of a quality improvement project at a rural Free Clinic to improve smoking cessation and chronic disease management. Two 20-minute structured individual smoking cessation education sessions were provided. Pharmacotherapy was offered as free through a medication assistance program and based on provider-patient shared decisions as part of their traditional smoking cessation care for smokers at the Free Clinic. Outcome measurements included: (a) readiness to quit smoking, (b) nicotine dependence, (c) pharmacotherapy use rate, (d) smoking cessation success rate, and (e) chronic disease health outcomes. Pairwise paired t-test, Cochran Q and Friedman's test were used to compare initial, one-month, and three-month study results of demographic, nicotine dependence, laboratory data, intention to quit smoking, and perceived quality of life. Findings: 32 smokers initially participated in this study, but attrition occurred with 43.8% (n=14) at 3-month follow-up visits. About 20% of smokers chose to use pharmacotherapy, especially heavy smokers. One participant (5%) successfully quit smoking by a three-month follow-up. However, this small sample size limited to measure the statistical significance. Our intervention was shown to improve readiness to quit, reduce nicotine dependency, and decrease the amount of tobacco smoked. Fagerström test was conducted to have higher sensitivity to measure the improvement of nicotine dependence (p =0.0001) from baseline to three-month follow-up, compared with CAGE questionnaires. Clinical Implication/Conclusions: Underserved, low-income populations tend to have less accessibility and affordability to health care resources for quitting smoking and endure several comorbidities with poor health outcomes related to smoking. Despite the small sample size limitation, this pilot study demonstrated the feasibility and effectiveness of increasing motivation and reducing smokers' nicotine dependence in a rural Free Clinic. Keywords: smoking cessation, education, chronic disease, health outcome, behavioral therapy, pharmacotherapy, rural population, free clinic
| Item Type: | Dissertation |
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| Uncontrolled Keywords: | smoking cessation, education, chronic disease, health outcome, behavioral therapy, pharmacotherapy, rural population, free clinic |
| Subjects: | H Social Sciences > HT Communities. Classes. Races L Education > L Education (General) R Medicine > RT Nursing |
| Divisions: | Radford University > School of Nursing |
| Date Deposited: | 16 Nov 2021 01:38 |
| Last Modified: | 19 Apr 2023 17:06 |
| URI: | http://wagner.radford.edu/id/eprint/736 |
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