Integrating smoking cessation care in alcohol and other drug treatment settings using an organizational change intervention: a systematic review

Eliza Skelton, Flora Tzelepis, Anthony Shakeshaft, Ashleigh Guillaumier, Sam McCrabb, Billie Bonevski

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)

Abstract

Background and Aims: Organizational change interventions involve systems and cultural change within health-care services to make smoking cessation care delivery part of usual treatment. Six strategies for organizational change have been proposed. This study examined the evidence for organizational change interventions in the alcohol and other drug (AOD) setting on: (a) smoking cessation care; and (b) smoking cessation and cessation-related outcomes. Methods: A systematic review with narrative synthesis was conducted. MEDLINE, PsycINFO, CINAHL, EMBASE and Scopus were searched using keywords and MeSH terms from database inception to 1 June 2018. Interventions were assessed against the six organizational change strategies. Results: Of the 5155 papers identified, 14 publications from seven unique studies were included. Most studies employed four or fewer organizational change strategies. The majority (n = 11) were rated weak to moderate in methodological quality. Nine published papers, four unique studies, examined staff reported provision of smoking cessation care; eight reported an increase, one found no change. Three papers, two unique studies, examined client receipt of care; all found significant increases. Three papers, two unique studies, assessed staff smoking prevalence from pre- to post-intervention. Only one study reported a significant reduction in staff smoking prevalence (35.2 versus 21.8%, P = 0.005). Nine papers, six unique studies, assessed client smoking cessation and smoking-related outcomes. Seven papers reported on client smoking prevalence; two found a significant decrease and five found no change to smoking. Four papers reported on number of cigarettes per day, three found a significant decrease and one found no change. Two papers reported on smoking cessation finding a 10% and a 25% seven-day point prevalence abstinence post-discharge from the AOD service. Conclusions: Organizational change interventions within health-care services to make smoking cessation care delivery part of usual treatment offer promise for increasing smoking cessation care and reducing smoking prevalence.

Original languageEnglish
Pages (from-to)2158-2172
Number of pages15
JournalAddiction
Volume113
Issue number12
DOIs
Publication statusPublished - Dec 2018
Externally publishedYes

Keywords

  • Alcohol and other drug
  • organizational change
  • organizational implementation strategies
  • smoking cessation care
  • systematic review
  • tobacco smoking

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