Factors Affecting Adoption of Tobacco Education in Dental Hygiene Programs Margaret S. Stockdale Joan M. Davis Martha Cropper Elaine M. Vitello Southern Illinois University Carbondale This research was supported by a grant from the American Cancer Society, Illinois Division; PSB-#12

Study Rationale Brief chair-side interventions by health care professionals significantly increases successful cessation. 50% of smokers visit dentists annually, and spend 30 minutes with dental hygienists Tobacco education in dental/DH programs is minimal and educators do not feel adequately prepared to integrate comprehensive tobacco education in their curriculum. Current study examined the factors influencing DH faculty coverage of tobacco-related topics in their curriculum.

Theory of Planned Behavior Attitudes Subjective Norms Perceived Behavioral Control IntentionsBehavior

Current study Attitudes Toward Tobacco Education Social Influences On teaching Tobacco education Self Confidence To Teach Tobacco Education Current Tobacco Education Practices Control of External Barriers to Tobacco Education Demographic Variables ?

Methods Participants 86 DH faculty in Illinois (12 Community College Programs) 11 DH faculty attending ADEA conference Procedure Survey distributed in program meetings or by mail

Measures: TPB variables VariableSample Item Reliability (  ) ATE: Attitudes toward teaching tobacco education Covering pharmacological approaches to tobacco cessation in a dental hygiene curriculum is (not at all important to very important).96 SN: Subjective norms for teaching tobacco education Increasing the time spent on tobacco education will impress accreditation visitors.80 Self Confidence: Self confidence for teaching tobacco education With regard to overcoming dental hygiene students’ resistance to engaging in tobacco control activities, I feel (not at all confident to very confident).88 External Control: External control for teaching tobacco education I have good resources that I can use to teach all aspects of tobacco education.77

Measures: Criteria VariableSample ItemResponse Code Curriculum CoverageIs “Reviewing general diseases related to tobacco use” covered in your curriculum? 0=not covered;.5=not sure; 1=covered Teach CurriculumWho teaches…reviewing general diseases related to tobacco use? 0=other faculty; 1=I or I and other faculty cover it Clinic AssessIs…following the 5A’s and 5R’s for conducting tobacco cessation counseling assessed in clinic? 0=no; 1=yes

Results: Means, SDs, Correlations VariableMSDabcdef a. ATE b. SN ** c. Self Confidence ** 0.32 ** d. External Control ** 0.39 ** e. Curr. Coverage * 0.16 f. Teach Curr ** 0.35 ** g. Clinic Assess * ** 0.20

Results: Means, SDs, Correlations VariableMSDabcdef a. ATE b. SN ** c. Self Confidence ** 0.32 ** d. External Control ** 0.39 ** e. Curr. Coverage * 0.16 f. Teach Curr ** 0.35 ** g. Clinic Assess * ** 0.20

Results: Multiple Regression  p<.10; * p<.05 Variable  R 2  sr 2 I. Demographics.06 2 Part-Fulltime Exp. Tob. Cess.24 *.04 II. TPB Variables.07 ATE SN Self Confidence External Control Curriculum Coverage

Results: Multiple Regression * p<.05 Variable  R 2  sr 2 I. Demographics.14 2 Part-Fulltime.27 *.07 Exp. Tob. Cess II. TPB Variables.12 * ATE SN Self Confidence External Control.33 *.08 Teach Curriculum

Results: Multiple Regression + p<.10; * p<.05 Variable  R 2  sr 2 I. Demographics.21 *** Part-Fulltime Exp. Tob. Cess.39 ***.13 II. TPB Variables.02 ATE SN Self Confidence External Control Clinic Assessment

Summary Although DH faculty had positive attitudes toward tobacco education, self confidence and control over external barriers were only moderately strong. Self confidence was related to the number of tobacco topics covered in the curriculum, but this was explained by prior tobacco cessation counseling (TCC) experience. Full-time employees and those who could control external barriers were more likely to teach tobacco curricula. Part-timers and those with prior TCC experience were more likely to report that tobacco competencies were assessed in clinic.

Conclusions DH faculty need to be confident and be able to control external barriers in order to teach tobacco curriculum. Experience with providing TCC may be critical A comprehensive, flexible curriculum that builds self confidence and reduces barriers may be part of the solution.