OBJECTIVES: The goal of this research project was to test the potential efficacy of face-to-face academic detailing to promote the incorporation of tobacco cessation activities into dental practice. METHODS: Dentists participating in the Aetna Managed Care Organization in four northeastern states were randomly assigned to either an intervention or control condition (practice as usual). The intervention consisted of a one-hour educational program, followed by three additional office visits at approximately one-month intervals. At the conclusion of the academic detailing program, twelve months after its initiation all dentist subjects, assigned to either the intervention or control condition, were mailed a second questionnaire. RESULTS: There are substantial differences between responses of dentists assigned to the control and intervention groups. Sixty-five percent of dentists in the intervention group discussed setting specific quit dates with patients vs. 35% in the control group. Differences in setting specific strategies for quitting were 84% in the intervention group and 52% in the control group. Dentists involved in a program that involved substantial burdens, i.e., the intervention group, were more likely to perceive barriers, e.g., reimbursement (68% vs. 47%), staff resistance (42% vs. 10%), and the amount of time required (73% vs. 69%). On the other hand, "intervention dentists" were less concerned about the availability of referral resources (50% vs. 89%), knowledge level (46% vs. 73%), and effectiveness of incorporating tobacco cessation activities into practice (65% vs. 78%) than their "control colleagues." CONCLUSIONS: It seems likely that, to some extent, face-to-face academic detailing can increase tobacco cessation activities in dentists' offices. Barriers to success may be associated with perceived burdens to the dentist-subjects associated with the use of academic detailing and difficulties associated with incorporating innovative procedures into clinical practice.
This research was funded by the Robert Wood Johnson Foundation.