Barriers to Integrating Tobacco Dependence Treatment into Lung Cancer Screening: A Qualitative Assessment.

Introduction/objective: We qualitatively assessed current practices and perceived barriers surrounding the integration of tobacco dependence treatment (TDT) into lung cancer screening (LCS). Methods: Informed by the Practical, Robust Implementation and Sustainability Model, we conducted semi-structu...

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Publicado en:Journal of Primary Care & Community Health Vol. 16; pp. 1 - 8
Autores principales: Pestka, Deborah L., Campbell, Megan E., Schmulewitz, Naomi A., Melzer, Anne C.
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 2/24/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2/24/2025
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Barriers to Integrating Tobacco Dependence Treatment into Lung Cancer Screening: A Qualitative Assessment.
      aug:
        au:
          Pestka, Deborah L.
          Campbell, Megan E.
          Schmulewitz, Naomi A.
          Melzer, Anne C.
        affil: University of Minnesota, Minneapolis, MN, USA
      sug:
        subj:
          Smoking Therapy
          Lung Neoplasms Prevention and Control
          Cancer Screening
          Practice Patterns Evaluation
          Health Care Delivery, Integrated
          Attitude of Health Personnel Evaluation
          Personnel, Health Facility Psychosocial Factors
          Hospitals, Veterans
          Human
          Qualitative Studies
          Semi-Structured Interview
          Decision Making, Shared
          Reminder Systems
          Dashboard Systems
          Feedback
          Outcomes (Health Care)
          Referral and Consultation
          Quality Improvement
          Implementation Science
          Conceptual Framework
          Purposive Sample
          Interview Guides
          Descriptive Statistics
          Data Analysis Software
          Psychologists
          Registered Nurses
          Nurse Practitioners
          Social Workers
          Physicians, Family
          Pulmonologists
          Leaders
          Physicians
          Government Regulations
          Patient Participation
          Smoking Cessation
          Funding Source
      ab: Introduction/objective: We qualitatively assessed current practices and perceived barriers surrounding the integration of tobacco dependence treatment (TDT) into lung cancer screening (LCS). Methods: Informed by the Practical, Robust Implementation and Sustainability Model, we conducted semi-structured interviews with clinicians (n = 18) at 6 Veterans Affairs medical centers in the Midwest. Results: TDT was usually addressed at an initial shared decision-making visit but often not with subsequent rounds of screening or nodule follow-up. No site was aware that any TDT-related outcomes were tracked within their program. While the LCS clinical reminders included some aspects of tobacco use (eg, tobacco pack-years), they did not support clinicians in offering TDT or capture outcomes and were perceived as "checkboxes to nowhere." This was contrasted with other clinical reminders linked to dashboards that provide rolling feedback for important clinical outcomes (eg, diabetes care). Interviewees reported competing demands and limited expertise in motivational interventions as additional barriers. A dedicated team for TDT and a "one-click referral" were perceived as key success factors. Conclusions: TDT remains poorly integrated into LCS. Addressing identified barriers will require considerable investment in TDT resources and improvements to LCS tools to support the provision of cessation support.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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