Abstract
ABSTRACTBackgroundThe World Health Organisation (WHO) strongly recommends that brief tobacco interventions should be routinely offered in primary care. However, medical doctors do not consistently and effectively intervene during their encounters with cigarette smokers. There is a paucity of studies assessing the effect of training on the tobacco intervention competency of primary care doctors in Nigeria.AimTo evaluate the effectiveness of online training in improving competency in brief tobacco interventions among primary care doctors in Delta State, Nigeria.MethodsA cluster-randomised controlled trial was conducted among eligible doctors working in government-owned facilities. The 22 eligible Local Government Areas (LGAs) served as clusters. The intervention group received a WHO six-hour online course on brief tobacco cessation intervention, delivered via Zoom. The control group received no intervention. A structured questionnaire was sent to participants via WhatsApp before and six months after the training. The primary outcome variables were scores for knowledge, attitude, self-efficacy, and practice. Differences in change of scores between intervention and control groups were assessed witht-test. To adjust for clustering, these inter-group differences were further analysed using linear mixed-effects regression modelling with study condition modelled as a fixed effect, and LGA of practice entered as a random effect.ResultsThe intervention group had a significantly higher mean of change in scores for knowledge (effect size 0.344) and confidence (effect size 0.52).ConclusionThe study shows that training, even online, positively affects clinician competency in brief tobacco intervention. This is important for primary care systems in developing countries. Mandatory in-service training and promotion of the WHO modules are recommended.
Publisher
Cold Spring Harbor Laboratory
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