Assessment on the impact of smoking cessation counseling service and related influencing factors under comprehensive community-based intervention programs about the community medical staff in Hangzhou city

Abstract

To evaluate the short-term impact of comprehensive community-based intervention programs on smoking cessation counseling services provided by community medical staff and related influencing factors in three districts of Hangzhou city. Within the framework of Community Interventions for Health (CIH) Program, a community trial was conducted in two districts (Xiacheng and Gongshu) and a district (Xihu) as control, by a parallel comparison and random grouping based quasi-experimental design. Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the impact of intervention. There were 299 and 141 medical staff in the areas of intervention and 'control', respectively. For the intervention area, the quantity of available resources increased from 2 to 3 and the quantity of used resources increased from 1 to 3 (both P < 0.001), while the area of control had a downward trend for both quantities. For the ratios of well-readiness for smoking counseling, in the intervention area were 35.5% , 52.0% before and after intervention (P < 0.001), while the 'controlled' area they were 28.1%, 39.3%, respectively (P = 0.162). A slight increase was seen in the intervention area for the proportion of the medical staff who had been provided smoking cessation counseling, as ≥ 90% patients (including asking smoking status, announcing risks related to the risks of smoking and advising smoking cessation programs etc.), while the proportion decreased in the area of 'control'. The improvement of preparedness would promote medical staff to ask their patients about smoking status (OR = 1.43, P = 0.007), while all factors as a whole would not influence the medical staff to inform patients about the danger of smoking and advice patients to quit smoking. Comprehensive community-based interventions could increase the opportunities for medical staff to acquire and utilize smoking cessation resources to some extent, as well as promote those staff's preparedness. However, intervention itself might fail to improve the behavior of providing such services. Support that came from the policy or from the institutions also need to be strengthened.