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Abstract

<h3>PURPOSE</h3> We report on the effectiveness of the Ottawa Model for Smoking Cessation (OMSC), a multicomponent knowledge translation intervention, in increasing the rate at which primary care providers delivered smoking cessation interventions using the 3 A’s model—<i>Ask</i>, <i>Advise</i>, and <i>Act</i>, and examine clinic-, provider-and patient-level determinants of 3 A’s delivery. <h3>METHODS</h3> We examined the effect of the knowledge translation intervention in 32 primary care practices in Ontario, Canada, by assessing a cross-sectional sample of patients before the implementation of the OMSC and a second cross-sectional sample following implementation. We used 3-level modeling (clinic, clinician, patient) to examine the main effects and predictors of 3 A’s delivery. <h3>RESULTS</h3> Four hundred eighty-one primary care clinicians and more than 3,500 tobacco users contributed data to the evaluation. Rates of delivery of the 3 A’s increased significantly following program implementation (<i>Ask</i>: 55.3% vs 71.3%, <i>P</i> &lt;.001; <i>Advise</i>: 45.5% vs 63.6%, <i>P</i> &lt;.001; <i>Act</i>: 35.4% vs 54.4%, <i>P</i> &lt;.001). The adjusted odds ratios (AOR) for the delivery of 3 A’s between the pre- and post-assessments were AOR = 1.94; (95% CI, 1.61–2.34) for <i>Ask</i>, AOR = 1.92; (95% CI, 1.60–2.29) for <i>Advise</i>, and AOR = 2.03; (95% CI, 1.71–2.42) for <i>Act</i>. The quality of program implementation and the reason for clinic visit were associated with increased rates of 3 A’s delivery. <h3>CONCLUSIONS</h3> Implementation of the OMSC was associated with increased rates of smoking cessation treatment delivery. High quality implementation of the OMSC program was associated with increased rates of 3 A’s delivery.