A recent U.S. study in Health News reported that many health care providers are not receiving adequate training in tobacco intervention, stating that 87% to 93% of doctors and other health care providers receive less than five hours of training.

The results of this recent study are not surprising to the Tobacco Cessation Resource Center (TCRC). As noted by other researchers, providers are increasingly pressed for time with patients and have even less time to devote to education that relates to preventive medicine. Given the increasing prevalence of chronic conditions and the impact tobacco use can have on these conditions, finding an appropriate and creative way to reach providers with this information is crucial.  TCRC has addressed these challenges, working with the Washington State Department of Health to develop innovative and sustainable approaches to offer training to health care providers.

The Tobacco Cessation Resource Center (TCRC) is a Washington State Department of Health program run by Free & Clear. TCRC offers training, resources and outreach to health care providers with a goal of increasing the number of Health Care Providers who effectively intervene with their patients who use tobacco. TCRC’s comprehensive approach to training and outreach includes sustainable tools and resources like a centralized provider website, online trainings, provider toolkits, webinars, and a regional approach to provider outreach and systems work.

In 2007, the Washington State Department of Health (WA DOH) asked TCRC to evaluate current training methods. Results showed that fewer providers were receiving training than expected. TCRC and WA DOH gathered feedback from both the trainers and the providers and sought to build a new approach to training.

The new approach needed to allow providers to access training on their own time. It needed to provide standard educational material, but allow providers to customize their learning to find out more about a topic if desired. The new approach needed to be sustainable. It needed to utilized resources effectively and efficiently.

TCRC and WA DOH determined that an online training program would provide a good solution. A recent article in JAMA found that online learning is an effective tool for health care provider education (Cook et. al, 2008).  The benefits of an online training program included the ability to reach providers on their own time with a standard and consistent training message. Any provider in the state could access the training as many times as needed. In addition, it allowed WA DOH to use field resources for other projects.

In 2008, TCRC launched the 2A &R Online Training. The program is designed to train Health Care Providers in the brief tobacco intervention. The focus is on the 2A&R (Ask, Advise and Refer), which is recommended by the Public Health Services Guidelines Treating Tobacco Use and Dependence. With the little time that many providers have to spend with patients, the 2A&R intervention is a brief, but effective way that providers can tell patients they care about their health and refer them to a resource to help them quit.

As stated in the Health News article, 70% of smokers report that they would like to quit and 30% are more likely to quit if they receive help from their health care provider. Washington’s experience has demonstrated that online training is an effective tool to educate providers about tobacco cessation interventions.

For questions about the Tobacco Cessation Resource Center or the work Free & Clear has done with Washington State, contact Gillian Schauer at gillian.schauer@freeclear.com.