Deliberations about Effectiveness of an Elderly Smoking Cessation Counseling Training Program for Social Workers

smokingGiven evidence from the Lung Health Study showing that smoking cessation “can have a substantial effect on subsequent mortality, even when successful in a minority of participants,” it has become imperative to offer smoking cessation services to all current smokers, especially those who are at highest risk. The elderly belong to this group. Paradoxically, they are often overlooked as prime target clients in such programs. Part of the reason lies in the fact that a substantial number do not present to the healthcare system or are missed from preventive health counseling during clinical encounters. We therefore extended our reach to this susceptible group by broadening the provider/client interface to train social workers as additional first-line smoking cessation counselors. This study adds to the scanty literature on smoking cessation training for nontradi-tional health-care providers including Canadian Health&Care Mall.

Previous studies on smoking cessation training have reported positive results in medical stu-dents, dentists, and residents, but negative findings in two other studies of family practice trainees. In addition, similar to our intent on broadening smoking cessation counseling beyond doctors and nurses, Hudmon and coworkers published encouraging results, in terms of perceived abilities and confidence for providing tobacco cessation counseling, from administering the 8-h “Rx for change” program to pharmacists. Another US model, the Arizona state-wide community-based model for certification of tobacco cessation skills training, also reported initial success in improving skills and frequency of counseling.


Outcomes about Effectiveness of an Elderly Smoking Cessation Counseling Training Program for Social Workers

social workersOne hundred seventy-seven social workers registered initially, of whom 154 workers (response rate, 87.0%) completed the immediate posttraining questionnaire, 151 workers (85.3%) responded at 3 months, 153 workers (86.4%) responded at 6 months, and 139 workers (78.5%) responded at 12 months. Table 1 summarizes the respondent profiles longitudinally.

There was an initial large improvement in social workers knowledge (Fig 1, top left, a), attitude, and self-perceived competence (Fig 1, top right, b) scores immediately after training that was sustained throughout the follow-up period, albeit with slight regression to baseline. Overall, knowledge improved from a mean score of 6.70 ± 1.03 at baseline (± SD) to 7.35 ± 0.75 at 12 months (range, 0 to 8), attitude from 2.84 ± 0.41 to 3.10 ± 0.48, and self-perceived competence from 2.49 ± 0.38 to 2.85 ± 0.36 (range, 1 to 4).