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Exploring Primary Care Providers’ Interest in Using Patient Navigators to Assist in the Delivery of Tobacco Cessation Treatment to Low Income, Ethnic/Racial Minority Patients

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Abstract

We examined attitudes and practices regarding tobacco cessation interventions of primary care physicians serving low income, minority patients living in urban areas with a high smoking prevalence. We also explored barriers and facilitators to physicians providing smoking cessation counseling to determine the need for and interest in deploying a tobacco-focused patient navigator at community-based primary care practice sites. A self-administered survey was mailed to providers serving Medicaid populations in New York City’s Upper Manhattan and areas of the Bronx. Provider counseling practices were measured by assessing routine delivery (≥80% of the time) of a brief tobacco cessation intervention (i.e., “5 A’s”). Provider attitudes were assessed by a decisional balance scale comprising 10 positive (Pros) and 10 negative (Cons) perceptions of tobacco cessation counseling. Of 254 eligible providers, 105 responded (41%). Providers estimated 22% of their patients currently use tobacco and nearly half speak Spanish. A majority of providers routinely asked about tobacco use (92%) and advised users to quit (82%), whereas fewer assisted in developing a quit plan (32%) or arranged follow-up (21%). Compared to providers reporting <80% adherence to the “5 A’s”, providers reporting ≥80% adherence tended to have similar mean Pros and Cons scores for Ask, Advise, and Assess but higher Pros and lower Cons for Assist and Arrange. Sixty four percent of providers were interested in providing tobacco-related patient navigation services at their practices. Although most providers believe they can help patients quit smoking, they also recognize the potential benefit of having a patient navigator connect their patients with evidence-based cessation services in their community.

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Acknowledgments

This research was supported by grants from the National Cancer Institute #U54CA13778/U54CA132378 CCNY/MSKCC Partnership and T32CA009461. The authors appreciate the feedback provided by Jack Burkhalter on an earlier draft of this manuscript.

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Authors and Affiliations

  1. Department of Community Health and Social Medicine, The Sophie Davis School of Biomedical Education at The City College of New York, 160 Convent Avenue, H400, New York, NY, 10031, USA

    Erica I. Lubetkin, Wei-Hsin Lu & Howa Yeung

  2. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA

    Paul Krebs & Jamie S. Ostroff

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  1. Erica I. Lubetkin
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  2. Wei-Hsin Lu
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Correspondence to Erica I. Lubetkin.

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Lubetkin, E.I., Lu, WH., Krebs, P. et al. Exploring Primary Care Providers’ Interest in Using Patient Navigators to Assist in the Delivery of Tobacco Cessation Treatment to Low Income, Ethnic/Racial Minority Patients. J Community Health 35, 618–624 (2010). https://doi.org/10.1007/s10900-010-9251-8

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