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Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

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Abstract

Objective

Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness.

Methods

The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California.

Results

The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review.

Conclusion

The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers.

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Authors and Affiliations

  1. Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave - TRC 0984, San Francisco, CA, 94143-0984, USA

    Judith J. Prochaska Ph.D., M.P.H.,  Sebastien C. Fromont M.D.,  Desiree Leek B.S.,  Alan K. Louie M.D.,  Marc H. Jacobs M.D. &  Sharon M. Hall Ph.D.

  2. Alta Bates Summit Medical Center, Berkeley, Calif., USA

    Sebastien C. Fromont M.D.

  3. Purdue University School of Pharmacy and Pharmaceutical Sciences, West Lafayette, Ind., USA

    Karen Suchanek Hudmon Dr.P.H., R.P.H.

Authors
  1. Judith J. Prochaska Ph.D., M.P.H.
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  2. Sebastien C. Fromont M.D.
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  3. Desiree Leek B.S.
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  4. Karen Suchanek Hudmon Dr.P.H., R.P.H.
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  5. Alan K. Louie M.D.
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  6. Marc H. Jacobs M.D.
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  7. Sharon M. Hall Ph.D.
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Corresponding author

Correspondence to Judith J. Prochaska Ph.D., M.P.H..

Additional information

Manuscripts authored by an editor of Academic Psychiatry or by a member of its editorial board undergo the same editorial review process, including blinded peer review, applied to all manuscripts. Additionally, the Editor is recused from any editorial decision-making.

This work was supported by the State of California Tobacco-Related Disease Research Program (#13KT-0152) and the National Institute on Drug Abuse (#K23 DA018691 and #P50 DA09253). We acknowledge our expert advisory group members Neal Benowitz, M.D., Stuart Eisendrath, M.D., Mark Myers, Ph.D., Victor Reus, M.D., Steven Schroeder, M.D., and Doug Ziedonis, M.D., who provided valuable input on identification of the curriculum’s content. We thank David Goldberg, M.D., for the opportunity to work with psychiatry residents training at the California Pacific Medical Center and thank Kevin Delucchi, Ph.D., for his statistical consultation.

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Prochaska, J.J., Fromont, S.C., Leek, D. et al. Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs. Acad Psychiatry 32, 484–492 (2008). https://doi.org/10.1176/appi.ap.32.6.484

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  • DOI: https://doi.org/10.1176/appi.ap.32.6.484

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