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Prucha MG , Fisher SG , McIntosh S , Grable JC , Holderness H , Thevenet-Morrison K , de Monegro ZQ , Sanchez JJ , Bautista A , Diaz S , Ossip DJ
Health care workers' knowledge, attitudes and practices on tobacco use in economically disadvantaged dominican republic communities
Int J Environ Res Public Health. 2015 Apr;12(4) :4060-75
PMID: 25872018    PMCID: PMC4410233   
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Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR.
1660-4601 Prucha, Michael G Fisher, Susan G McIntosh, Scott Grable, John C Holderness, Heather Thevenet-Morrison, Kelly de Monegro, Zahira Quinones Sanchez, Jose Javier Bautista, Arisleyda Diaz, Sergio Ossip, Deborah J R01 CA132950/CA/NCI NIH HHS/United States TL1 RR024135/RR/NCRR NIH HHS/United States Journal Article Research Support, N.I.H., Extramural Switzerland Int J Environ Res Public Health. 2015 Apr 13;12(4):4060-75. doi: 10.3390/ijerph120404060.