Addressing childrens tobacco smoke exposure: How are pediatric residents trained and how does the electronic health record facilitate that objective?
Date survey distributed to APPD membership (eg., 3/2015):
Portion of APPD membership surveyed (eg., Program Directors and Associate Program Directors):
Response rate (eg., 50%; 99/198):
Summary of main findings:
44/205 responded (22% response rate): 80% were PDs, 13% Associate PDs, 7% faculty/chief residents. 31% were from small, 33% from medium and 36% from large programs. All 8 APPD regions were represented. All respondents felt it was very important (76%) or important (24%) for residents to learn to address TSE in clinical practice. Resident training was provided in the health consequences of TSE (77%), addressing smoking/cessation with patients (81%) and parents (81%), preventing thirdhand exposure (74%), non-cigarette tobacco use (67%), and pharmacological management of nicotine dependence (only 37%). Residents were deemed very (33%) or somewhat (62%) able to address parental smoking and very (21%) or somewhat (79%) able to address adolescent smoking. Two themes were associated with resident ability in both cases: having systems in place and opportunities for practice. 77% of respondents EHRs had prompts to address TSE at home; 19% smoke exposure in cars, 45% parent/caregiver interest in quitting, 40% quitline referral, 21% nicotine replacement Rx. Of those with prompts, <50% felt residents used prompts some/all of the time or that the EHR facilitated resident screening for TSE. Of respondents identifying residents as very able to address TSE with adolescents, 89% endorsed EHR use some/all of the time. For those very able to address TSE with parents/caregivers, 64% used EHR some/all of the time.
AAP NCE 2019 meeting (Section on Tobacco Control)
Currently planning to submit for presentation at APPD spring meeting; preparing manuscript for publication including this survey and a subsequent, similar survey sent to pediatric residents through the AAP Section on Pediatric Trainees listserv. Results of the two surveys together provide insight into current resident training and opportunities in addressing tobacco smoke/tobacco smoke exposure.