Cognitive mapping tobacco control advice for dentistry: a dental PBRN study

Abstract

Objective: To identify facilitative strategies that could be used in developing a tobacco cessation program for community dental practices.

Methods: Nominal group technique (NGT) meetings and a card-sort task were used to obtain formative data. A cognitive mapping approach involving multidimensional scaling and hierarchical cluster analysis was used for data analysis.

Results: Three NGT meetings conducted with 23 dental professionals yielded 27 nonredundant facilitative strategies. A 2-dimensional 4-cluster cognitive map provided an organizational framework for understanding these strategies.

Conclusion: Views of the target population solicited in a structured format provided clear direction for designing a tobacco cessation intervention.

Figure 1. Cognitive Map of Tobacco Cessation Strategies

Note: The enclosure shapes and colors are used only to distinguish strategies within each derived cluster. Numbers Representing 27 Strategies Used for Multidimensional Scaling 1 Educate dentists about smoking cessation programs that they can develop for implementation in their practice 2 Involve the ADA in developing a marketing campaign that informs the public about the expertise of dental providers in tobacco cessation efforts 3 Include a tobacco use question on health history form 4 Provide materials that impress upon dentists the importance of oral cancer screenings 5 Provide practitioners with regular updates of statistics as they relate to tobacco-related pathologies 6 Require mandatory continuing education regarding tobacco use 7 Have staff and dentists work as a team for tobacco screening 8 Provide practices with models, materials, and computer programs to show consequences of tobacco use to patients 9 Provide practices with resources about available tobacco cessation programs for treatment or referral 10 Display graphical material throughout the office to inform patient of tobacco-related problems 11 Assign tobacco screening efforts to hygienist as part of patient recall, recare scheduling 12 Use cancer screening as an opportunity to discuss tobacco use with patients 13 Assign tobacco screening/counseling to hygienist and other dental staff 14 Provide practices with tobacco screening material that they could have patients complete at home 15 Develop TV and public awareness campaign informing the public of tobacco cessation efforts that can be provided by dentists 16 Have an oral cancer screening day 17 Provide practices with waiting room material regarding tobacco/oral cancer screening 18 Provide practices with a waiting room video that can show consequences of tobacco use 19 Cue dentists about the legal consequences of failing to screen and document patient tobacco use 20 Ensure it is “profitable” for the practice to screen and document patient tobacco use 21 Conduct tobacco cessation education programs for all dental providers 22 Make tobacco screening activities reimbursable 23 Develop a smoking cessation certification program for dental providers 24 Inform practices about tobacco cessation efforts through lunch and learn programs 25 Have the dental board monitor dental practices to ensure that tobacco cessation efforts are being conducted 26 Encourage drug companies to support dental provider efforts in smoking cessation 27 Provide practices with smoking cessation products that can be given to patients