1. Factors associated with the implementation of the 5A’s
C Martínez, Y Castellano, A Andrés, M Fu, L Antón, M Ballbè, P Fernández, S Cabrera,
A Riccobene, E Gavilan, T Baena-García, M Margalef y E Fernández
Cristina Martinez Martinez
@CrisMarMar
* No conflcts of interest

2. Background
Several health organizations have adopted the 5A’s model, following evidence-based guidelines for smoking cessation:
“Ask”
“Advice”
“Assess”
“Assist”
“Arrange a follow-up”

3. Aims
Describe the level of implementation of the 5A’s among health workers in Catalonia.
Investigate how several factors interact and potentially predict the implementation of each component of the 5A’s:
Individual
Cognitive
Behavioral
Organizational

4. Methods Design: Cross-sectional study.
Subjects: Professionals from the Catalan Hospitals (n=702).
Questionnaire: 63 questions; tested on 10 subjects
Level of implementation of the 5A’s
Individual factors: sex, profession, smoking consumption, previous training
Cognitive and Behavioral: 1) motivation, 2) knowledge about tobacco cessation, 3) self-efficacy, 4) importance of providing tobacco use interventions, 5) effectiveness of interventions, 6) importance of barriers, and 7) preparedness (Sheffer 2009)
Organizational: having records, systematic protocols, access to tobacco cessation pharmacological aids, using additional resources to intervene .
Items 0=“nothing” a 10=“completely”
Analysis:
Descriptive and bivariate (U Mann-Whitney and Kruskal-Wallis )
Multivariate analysis: Implementation predictors (OR; 95% CI)

5. Results Figure 1: Descripción of the sample (n=702)
Profession*
Doctors
Nurses
Others
Sex *
Men
Women
Age *
< 40 years
≥ 40 years
Experience
< 14 years
≥ 14 years
Smoking consumption *
Smokers
None smokers
Place of work *
Hospital
Other
Training *
Yes No %
* Estadísticamente significativo

6. Figure 2 :Level of implementation of the 5A’s
Score
Reposición: Sólo se tiene información de 752 casos (72% del total de 1.047) de los cuales el 42% es por reposición (mín: 16%, máx: 84%)

7. Figure 2 :Level of implementation of the 5A’s
Score
Doctors
Nurses
Others
Reposición: Sólo se tiene información de 752 casos (72% del total de 1.047) de los cuales el 42% es por reposición (mín: 16%, máx: 84%)
* Statistically significant

8. Figure 3: Implementation of the 5A’s by smoking consumpiton
Score
* Statistically significant

9. Figure 4: Implementation of the 5A’s by training
Score
Yes No
* Statistically significant

10. Figure 5. Correlation between the 5A’s
* Statistically significant

11. Figure 6.1: Predictors of the implementation of each componenent of the 5A’s
Tobacco consumption (Never smoker)
Smoker
Former smoker
Profession (Others)
Doctors
Nurses
Cognitive factors
Motivated to help smokers to quit
Impotence of smoking cessation in his/her work
Self-reported preparedness
Self-reported preparedness with drugs
Competence in helping smokers to quit
Security in motivating patients
Wish more training
It’s part of his/her job
Lack of knowledge and abilities
Behavioral Factors
Uses several resources
See patients with tobacco-related diseases
Familiar with resources (quit lines, Internet, etc )
Previous positive experiences
Organizational factors
It is ask for his/her managers
Organizational support
Has positive support from their supervisors

12. Figure 6.1: Predictors of the implementation of each componenent of the 5A’s
Tobacco consumption (Never smoker)
Smoker
Former smoker
Profession (Others)
Doctors
Nurses
Cognitive factors
Motivated to help smokers to quit
Impotence of smoking cessation in his/her work
Self-reported preparedness
Self-reported preparedness with drugs
Competence in helping smokers to quit
Security in motivating patients
Wish more training
It’s part of his/her job
Lack of knowledge and abilities
Behavioral Factors
Uses several resources
See patients with tobacco-related diseases
Familiar with resources (quit lines, Internet, etc )
Previous positive experiences
Organizational factors
It is ask for his/her managers
Organizational support
Has positive support from their supervisors

13. Limitations Strenghts
Convenience sample (health professionals interested in receiving training)
Self reported data (Compliance bias)
Strenghts
First study about the implementation of the 5A’s in hospitals
Includes several factors described in the literature
Sample size wide for subgroup analysis (n= 702)
Participación de los pacientes: Sólo se tiene información de 752 casos (72% del total de 1.047) de los cuales el 58% son de primera opción (mín: 16%, máx: 84%)

14. Conclusions The 5A’s model is not fully implemented
High level of correlation between (Ask, Advice, Asses) and (Assist and Arrange)
Facilitators of the implementations:
Positive previous experience
Consider oneself as competent
Elements for improvement:
Provide practical training (↑ abilities, ↑ knowledge)
Provide organizational support (recognitions, part of his/her work)

15. Factors associated with the implementation of the 5A’s
C Martínez, Y Castellano, A Andrés, M Fu, L Antón, M Ballbè, P Fernández, S Cabrera,
A Riccobene, E Gavilan, T Baena-García, M Margalef y E Fernández
Cristina Martinez Martinez
@CrisMarMar
* No conflcts of interest