Hispanic physicians' tobacco intervention practices: a cross-sectional survey study Page: 7
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ditional Hispanic value, and smoking patients may be
more willing to follow the advice of a physician not to
smoke at home or around family members when it is pre-
sented within the context of familismo or family.
The principal barriers to smoking cessation intervention
identified in this study include: perceived lack of receptiv-
ity by patients, time, lack of training, and lack of eco-
nomic reimbursement for counseling. These barriers are
similar to those found in other studies [17,19,20]. These
results indicate that both systematic and individual
approaches need to be incorporated into training pro-
grams.
Interventions should also consider whether physicians
have access to resources for assisting smoking patients. In
this study, almost half of the participants indicated that
they were not sure about the availability of community
resources for smoking cessation, one fourth felt they did
not have access to programs and support, and three-
fourths were simply not sure or did not have in-office
access to all of the materials they needed for educating
smokers. Most participants indicated the need for bilin-
gual materials and cessation programs. The qualitative
study supported these results. None of the physicians who
were interviewed knew about the state tobacco control
program in NM.
Finally, almost all respondents indicated a preference for
educating themselves about interventions and skills
through articles published in scientific/professional jour-
nals. This is a significant finding, as most health profes-
sionals subscribe to scientific journals. While research
papers do not generally discuss the practical applicability
of the results, journals interested in contributing to edu-
cating professionals on tobacco intervention should
require authors to discuss the link between research and
practice. The second preferred choice was "other written
materials" (brochures, pamphlets, etc.). Only 37.7% (n =
17) selected continuing education courses.
Limitations
A number of limitations of this study should be men-
tioned. First, the sample size was small, although it repre-
sents approximately 15% of the Hispanic physician
population in NM [3]. Additionally, all participants were
members of a professional organization, which may have
influenced their responses. In addition, survey data were
self-reported, and, although the survey instrument dem-
onstrated good validity and reliability, providers' self-
reported practices may be less valid than data obtained
from other sources [23]. Additionally, self-reported prac-
tices may be more positive among respondents than
among non-respondents. Finally, due to the small sample
size of the study, results must be interpreted cautiouslywhen generalizing to the general Hispanic physician pop-
ulation. Considering these limitations, the implementa-
tion of a follow-up national study with a larger sample
and a more diverse participant population is recom-
mended. It would be useful to compare the perceptions,
opinions, and practices of Hispanic physicians of diverse
nationalities and educational backgrounds. A larger and
more comprehensive study would provide valuable infor-
mation that could potentially be used to inform the devel-
opment of interventions to educate Hispanic physicians
about tobacco assessment, counseling, and follow-up.
Conclusion
To the knowledge of these investigators, this is the most
comprehensive study that has explored the tobacco inter-
vention practices of U.S. Hispanic physicians. In addition
to the results of the qualitative and quantitative studies,
another positive outcome of this investigation was the
development of a survey instrument that showed good
validity and reliability. This instrument should prove to
be of interest to federal health agencies and managed care
organizations, for investigating Hispanic physicians'
tobacco intervention practices. According to the literature,
standard procedures for collecting data on physicians'
tobacco education and smoking cessation practices
present several methodological challenges. These include
the use of survey instruments that have not undergone the
necessary processes to demonstrate their validity and reli-
ability. The use of such instruments may compromise the
internal validity and results of an investigation [21,22].
Furthermore, the instrument developed for this study
includes questions not generally found in other surveys
which make the instrument more appropriate for assess-
ing the characteristics of Hispanic physicians, including
items related to level of acculturation, language profi-
ciency and training needs.
In summary, although the literature has consistently
reported on physicians' low level of compliance with
smoking cessation guidelines and recommendations, this
study suggests that Hispanic physicians may be in greater
need of training and resources than other groups. The
results of this study compare negatively with data from
national studies on physicians in general. Regarding "best
practices" for delivering training initiatives to Hispanic
physicians, the results of this study point to self-education
through professional/scientific journals. However, this
result must be further investigated. It could be that His-
panic physicians prefer to learn about tobacco interven-
tion by reading scientific journals, but it may turn out that
this approach is not conducive to increased tobacco inter-
vention. Connecting research and practice is an issue of
concern in health education, and journal articles will cer-
tainly not provide adequate training if researchers do notPage 7 of 8
(page number not for citation purposes)BMC Public Health 2005, 5:120
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Mas, Francisco G. Soto; Papenfuss, Richard L.; Jacobson, Holly E.; Hsu, Chiehwen Ed; Urrutia-Rojas, Ximena & Kane, William M. Hispanic physicians' tobacco intervention practices: a cross-sectional survey study, article, November 14, 2005; [London, United Kingdom]. (https://digital.library.unt.edu/ark:/67531/metadc122160/m1/7/: accessed April 19, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT College of Education.