Integrating the "Ottawa Model" for Smoking Cessation Into Primary Care Practice

Integrating the "Ottawa Model" for Smoking Cessation Into Routine Primary Care Practice: A Cluster Randomized Controlled Trial

This proposal outlines the design of a cluster randomized controlled trial to compare the effectiveness of a new approach to integrating smoking cessation services into routine interactions with patients in the primary care setting using an adaptation of the Ottawa Model for Smoking Cessation (OMSC). The OMSC aims to systematically identify the smoking status of all patients, provide brief cessation advice, and offer evidence-based cessation support to those interested in embarking on a quit attempt. This study will provide important new evidence to assist with the development of a more comprehensive cessation system in the province of Ontario and across Canada.

A multi-component intervention has been designed to facilitate the uptake of the OMSC using best evidence regarding the integration of smoking cessation intervention into primary care practice. The secondary objective of the study is to examine the incremental value of providing tailored performance feedback to primary care practitioners when delivered as part of the OMSC intervention program.

Practice Inclusion Criteria:

• Is a primary care practice (family health team, family health group, family health network, community health centre);
• Has a minimum of five full time physicians on staff or sees an average of 50 patients per day;
• All physicians within the practice are willing to participate in the study.

Practice Exclusion Criteria:

• Primary care practices with less than 5 family physicians in a shared clinic space will be excluded.
• Clinics who have already implemented the OMSC will also be excluded.

Patient Inclusion Criteria:

• Current smoker (>5 cigarette per day on most days of the week);
• 18 years of age or older;
• Scheduled for an annual exam or non-urgent medical appointment with a physician or nurse practitioner;
• Able to read and understand English or French;
• Has a home or mobile telephone which can be used to receive follow-up telephone counselling calls;
• Has the mental capacity to provide informed consent and complete study protocols.

Patient Exclusion Criteria:

• Unable to read and understand English or French;
• Do not have a home or mobile telephone which can be used to receive follow-up calls;
• Do not have the mental capacity to provide informed consent and complete study protocols.