Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients.
Journal
Applied clinical informatics
ISSN: 1869-0327
Titre abrégé: Appl Clin Inform
Pays: Germany
ID NLM: 101537732
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
entrez:
18
5
2022
pubmed:
19
5
2022
medline:
21
5
2022
Statut:
ppublish
Résumé
Helping parents quit smoking is a public health priority. However, parents are rarely, if ever, offered tobacco use treatment through pediatric settings. Clinical decision support (CDS) systems developed for the workflows of pediatric primary care may support consistent screening, treatment, and referral. This study aimed to develop a CDS system by using human-centered design (HCD) that identifies parents who smoke, provides motivational messages to quit smoking (informed by behavioral science), and supports delivery of evidence-based tobacco treatment. Our multidisciplinary team applied a rigorous HCD process involving analysis of the work environment, user involvement in formative design, iterative improvements, and evaluation of the system's use in context with the following three cohorts: (1) parents who smoke, (2) pediatric clinicians, and (3) clinic staff. Participants from each cohort were presented with scenario-based, high-fidelity mockups of system components and then provided input related to their role in using the CDS system. We engaged 70 representative participants including 30 parents, 30 clinicians, and 10 clinic staff. A key theme of the design review sessions across all cohorts was the need to automate functions of the system. Parents emphasized a system that presented information in a simple way, highlighted benefits of quitting smoking, and allowed direct connection to treatment. Pediatric clinicians emphasized automating tobacco treatment. Clinical staff emphasized screening for parent smoking via several modalities prior to the patient's visit. Once the system was developed, most parents (80%) reported that it was easy to use, and the majority of pediatricians reported that they would use the system (97%) and were satisfied with it (97%). A CDS system to support parental tobacco cessation in pediatric primary care, developed through an HCD process, proved easy to use and acceptable to parents, clinicians, and office staff. This preliminary work justifies evaluating the impact of the system on helping parents quit smoking.
Sections du résumé
BACKGROUND
Helping parents quit smoking is a public health priority. However, parents are rarely, if ever, offered tobacco use treatment through pediatric settings. Clinical decision support (CDS) systems developed for the workflows of pediatric primary care may support consistent screening, treatment, and referral.
OBJECTIVES
This study aimed to develop a CDS system by using human-centered design (HCD) that identifies parents who smoke, provides motivational messages to quit smoking (informed by behavioral science), and supports delivery of evidence-based tobacco treatment.
METHODS
Our multidisciplinary team applied a rigorous HCD process involving analysis of the work environment, user involvement in formative design, iterative improvements, and evaluation of the system's use in context with the following three cohorts: (1) parents who smoke, (2) pediatric clinicians, and (3) clinic staff. Participants from each cohort were presented with scenario-based, high-fidelity mockups of system components and then provided input related to their role in using the CDS system.
RESULTS
We engaged 70 representative participants including 30 parents, 30 clinicians, and 10 clinic staff. A key theme of the design review sessions across all cohorts was the need to automate functions of the system. Parents emphasized a system that presented information in a simple way, highlighted benefits of quitting smoking, and allowed direct connection to treatment. Pediatric clinicians emphasized automating tobacco treatment. Clinical staff emphasized screening for parent smoking via several modalities prior to the patient's visit. Once the system was developed, most parents (80%) reported that it was easy to use, and the majority of pediatricians reported that they would use the system (97%) and were satisfied with it (97%).
CONCLUSION
A CDS system to support parental tobacco cessation in pediatric primary care, developed through an HCD process, proved easy to use and acceptable to parents, clinicians, and office staff. This preliminary work justifies evaluating the impact of the system on helping parents quit smoking.
Identifiants
pubmed: 35584789
doi: 10.1055/s-0042-1748148
pmc: PMC9117010
doi:
Substances chimiques
Tobacco Smoke Pollution
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
504-515Subventions
Organisme : NCI NIH HHS
ID : K08 CA226390
Pays : United States
Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
None declared.
Références
Am J Prev Med. 2013 Dec;45(6):737-41
pubmed: 24237916
J Cogn Eng Decis Mak. 2015 Dec;9(4):329-346
pubmed: 27974881
Inform Prim Care. 2008;16(2):101-9
pubmed: 18713526
Prev Med. 2004 Mar;38(3):359-68
pubmed: 14766120
Nicotine Tob Res. 2010 Jul;12(7):724-33
pubmed: 20507899
Ann Fam Med. 2017 Sep;15(5):419-426
pubmed: 28893811
JAMA Pediatr. 2019 Oct 01;173(10):931-939
pubmed: 31403675
J Dent Educ. 2014 Jan;78(1):31-9
pubmed: 24385522
Cochrane Database Syst Rev. 2018 Jan 31;1:CD001746
pubmed: 29383710
J Am Med Inform Assoc. 2011 Jan-Feb;18(1):38-44
pubmed: 21134975
J Am Med Inform Assoc. 2019 Feb 1;26(2):95-105
pubmed: 30590550
Pediatrics. 2012 Jan;129(1):141-52
pubmed: 22201152
J Am Med Inform Assoc. 2009 Sep-Oct;16(5):660-9
pubmed: 19567793
Appl Clin Inform. 2019 Aug;10(4):735-742
pubmed: 31578046
Cochrane Database Syst Rev. 2019 May 02;5:CD002850
pubmed: 31045250
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Acad Pediatr. 2014 Sep-Oct;14(5):478-84
pubmed: 25169159
J Pediatr. 2012 May;160(5):719-24
pubmed: 22364853
Pediatrics. 2012 Nov;130(5):987-90
pubmed: 23109684
Appl Clin Inform. 2016 May 25;7(2):399-411
pubmed: 27437049
Appl Ergon. 2006 Jan;37(1):55-79
pubmed: 16139236
JAMA Pediatr. 2016 Feb;170(2):138-47
pubmed: 26719991
Appl Clin Inform. 2019 Aug;10(4):693-706
pubmed: 31533171
Pediatrics. 2015 Nov;136(5):1008-17
pubmed: 26504137
J Am Med Inform Assoc. 2020 Aug 1;27(8):1225-1234
pubmed: 32719880
Appl Ergon. 2017 Apr;60:356-365
pubmed: 28166896
Ann Intern Med. 2012 Jul 3;157(1):29-43
pubmed: 22751758
Transl Behav Med. 2020 Oct 8;10(4):1039-1052
pubmed: 31157864
J Am Med Inform Assoc. 2019 Feb 1;26(2):106-114
pubmed: 30517663
Am J Prev Med. 2019 Jul;57(1):32-40
pubmed: 31122792
Pediatrics. 2003 Nov;112(5):1127-33
pubmed: 14595057
Cochrane Database Syst Rev. 2014 Dec 30;(12):CD008743
pubmed: 25547090
Pediatrics. 2020 Jul;146(1):
pubmed: 32571991
MMWR Morb Mortal Wkly Rep. 2018 Dec 07;67(48):1342-1346
pubmed: 30521502
Acad Pediatr. 2021 Jan-Feb;21(1):129-138
pubmed: 32730914
Pediatrics. 2013 Jul;132(1):109-17
pubmed: 23796741
J Biomed Inform. 2019 Jul;95:103208
pubmed: 31078660
Pediatrics. 2016 May;137(5):
pubmed: 27244817
N Engl J Med. 2013 Jan 24;368(4):341-50
pubmed: 23343063
J Biomed Inform. 2004 Feb;37(1):56-76
pubmed: 15016386
Behav Res Methods Instrum Comput. 2003 Aug;35(3):379-83
pubmed: 14587545
BMJ. 2020 Sep 17;370:m3216
pubmed: 32943437
Pediatrics. 2020 Dec;146(6):
pubmed: 33139456
Pediatrics. 2019 Jul;144(1):
pubmed: 31209162
J Am Med Inform Assoc. 2021 Jul 14;28(7):1401-1410
pubmed: 33682004
BMC Health Serv Res. 2021 Sep 16;21(1):973
pubmed: 34530809
Cochrane Database Syst Rev. 2019 Oct 22;10:CD006611
pubmed: 31638271