Integrating "performance coaching" into the design and delivery of multi-component tobacco treatment interventions significantly increases rates of tobacco dependence treatment by primary care clinicians. In a cluster-randomized controlled trial, 15 primary care practices, including 166 primary care clinicians and 1,990 patients, were randomly assigned to one of two interventions. Both interventions helped teams implement the 5As model of treating tobacco use (Ask, Advise, Assess, Assist and Arrange) in the context of 10 best practices for delivering tobacco treatment. One intervention group also provided a 1.5-hour coaching session and an individualized performance report for family physicians and nurse practitioners. Both groups increased rates of tobacco dependence treatment delivery, however clinicians who received performance coaching had statistically higher rates of providing three elements of the 5 As: asking patients about their smoking status, assisting patients ready to quit by developing a quit plan, and arranging follow-up support. In sensitivity analysis, rates of tobacco cessation advice were greater among clinicians who attended a coaching session. There were no differences in tobacco cessation outcomes between the two groups. According to the authors, this study supports the integration of performance coaching into multi-component interventions to further increase the delivery of tobacco treatment, particularly among low-performing clinicians.
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From Good to Great: The Role of Performance Coaching in Enhancing Tobacco-Dependence Treatment Rates
Sophia Papadakis, PhD, et al
University of Ottawa Heart Institute, Ottawa, Ontario, Canada
The Annals of Family Medicine