Abstract
Following guideline recommendations to promote tobacco prevention in adolescent primary care, we developed a patient-facing clinical support tool. The electronic tool screens patients for use and susceptibility to conventional and alternative tobacco products, and promotes patient–provider communication. The purpose of this paper is to describe the iterative stakeholder engagement process used in the development of the tool. During the pre-testing phase, we consulted with scientists, methodologists, clinicians, and Citizen Scientists. Throughout the development phase, we engaged providers from three clinics in focus groups. Usability testing was conducted via in-depth, cognitive interviewing of adolescent patients. Citizen Scientists (n = 7) played a critical role in the final selection of educational content and interviewer training by participating in mock-up patient interviews. Cognitive interviews with patients (n = 16) ensured that systems were in place for the feasibility trial and assessed ease of navigation. Focus group participants (n = 24) offered recommendations for integrating the tool into clinical workflow and input on acceptability and appropriateness, and anticipated barriers and facilitators for adoption and feasibility. Engaging key stakeholders to discuss implementation outcomes throughout the implementation process can improve the quality, applicability, and relevance of the research, and enhance implementation success.
Highlights
The US Preventive Services Task Force and the American Academy of Pediatrics (AAP)recommend that primary care providers (PCP) use interventions such as patient education or brief counseling to prevent tobacco use in adolescents [1,2]
The decision to integrate tobacco screening into the health risk assessment in the the patient portal and validated by stakeholder feedback throughout the intervention development patient(Figure portal2).and the process of developing the tool key stakeholder process
We deliberately engaged multiple stakeholders in the development of a clinical support tool using a combination of traditional methods and more novel resources (Implementation Science Studio and Citizen Scientists)
Summary
Recommend that primary care providers (PCP) use interventions such as patient education or brief counseling to prevent tobacco use in adolescents [1,2]. Children 2018, 5, 170 initiation and nicotine addiction in their patients, identify current tobacco use in both adolescents and parents, and initiate or refer for treatment [7]. Despite consensus regarding tobacco prevention recommendations, many PCPs do not routinely assess and counsel adolescents about tobacco use [8]. Reasons cited for this practice gap include lack of clear clinical practice guidelines, lack of training, and perception of low self-efficacy in delivering effective interventions [9]. The probability of developing nicotine dependence and tobacco-related diseases increases with younger initiation and longer use [2]
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