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Int. J. Environ. Res. Public Health 2015, 12(4), 4060-4075; doi:10.3390/ijerph120404060

Health Care Workers’ Knowledge, Attitudes and Practices on Tobacco Use in Economically Disadvantaged Dominican Republic Communities

1
Department of Public Health Sciences, University of Rochester, Medical Center, Rochester, NY 14642, USA
2
Department of Clinical Sciences, School of Medicine, Temple University, Philadelphia, PA 19140, USA
3
Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
4
Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
5
Centro de Atención Primaria Juan XXIII, Santiago, Dominican Republic
6
Hospital Regional Universitario José María Cabral y Báez, Santiago, Dominican Republic
*
Author to whom correspondence should be addressed.
Academic Editor: Adriana Blanco Marquizo
Received: 23 October 2014 / Revised: 6 April 2015 / Accepted: 7 April 2015 / Published: 13 April 2015
(This article belongs to the Special Issue Tobacco Control)
View Full-Text   |   Download PDF [691 KB, uploaded 13 April 2015]

Abstract

Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR. View Full-Text
Keywords: tobacco cessation; low-middle income country; primary health care; socioeconomic status; global health tobacco cessation; low-middle income country; primary health care; socioeconomic status; global health
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Prucha, M.G.; Fisher, S.G.; McIntosh, S.; Grable, J.C.; Holderness, H.; Thevenet-Morrison, K.; de Monegro, Z.Q.; Sánchez, J.J.; Bautista, A.; Díaz, S.; Ossip, D.J. Health Care Workers’ Knowledge, Attitudes and Practices on Tobacco Use in Economically Disadvantaged Dominican Republic Communities. Int. J. Environ. Res. Public Health 2015, 12, 4060-4075.

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