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Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

Received June 29, 2007; revised August 30, 2007; accepted September 26, 2007. Drs. Prochaska, Fromont, Leek, Louie, Jacobs, and Hall are affiliated with the Department of Psychiatry at the University of California in San Francisco; Dr. Fromont is also affiliated with the Alta Bates Summit Medical Center in Berkeley, Calif.; Dr. Hudmon is affiliated with Purdue University School of Pharmacy and Pharmaceutical Sciences in West Lafayette, Ind. Address correspondence to Judith J. Prochaska, Ph.D., M.P.H., University of California, San Francisco, 401 Parnassus Ave – TRC 0984, San Francisco, CA 94143-0984; JProchaska{at}ucsf.edu (e-mail).

OBJECTIVE: Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. METHODS: The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. RESULTS: The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. CONCLUSION: The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers.

This article has been cited by other articles:

				J. J. Prochaska, S. C. Fromont, K. S. Hudmon, and J. K. Cataldo Designing for Dissemination: Development of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Training Programs. Journal of the American Psychiatric Nurses Association, January 1, 2009; 15(1): 24 - 31. [Abstract] [PDF]

				S. I. Kramer Where There's Smoke, Can There be Fire? Acad Psychiatry, November 1, 2008; 32(6): 458 - 459. [Full Text] [PDF]

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