Eleni Giannopoulos1, Janet Papadakos1,2,3, Erin Cameron4, Janette Brual1, Rebecca Truscott4, William K Evans5, Meredith Elana Giuliani1,6,7. 1. Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada. 2. Patient Education, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada. 3. Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, ON M5T 1P8, Canada. 4. Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 1X3, Canada. 5. Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada. 6. Radiation Medicine Program and Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada. 7. Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada.
Abstract
BACKGROUND: In response to evidence about the health benefits of smoking cessation at time of cancer diagnosis, Ontario Health (Cancer Care Ontario) (OH-CCO) instructed Regional Cancer Centres (RCC) to implement smoking cessation interventions (SCI). RCCs were given flexibility to implement SCIs according to their context but were required to screen new patients for tobacco status, advise patients about the importance of quitting, and refer patients to cessation supports. The purpose of this evaluation was to identify practices that influenced successful implementation across RCCs. METHODS: A realist evaluation approach was employed. Realist evaluations examine how underlying processes of an intervention (mechanisms) in specific settings (contexts) interact to produce results (outcomes). A realist evaluation may thus help to generate an understanding of what may or may not work across contexts. RESULTS: The RCCs with the highest Tobacco Screening Rates used a centralized system. Regarding the process for advising and referring, three RCCs offered robust smoking cessation training, resulting in advice and referral rates between 80% and 100%. Five RCCs surpassed the target for Accepted Referral Rates; acceptance rates for internal referral were highest overall. CONCLUSION: Findings highlight factors that may influence successful SCI implementation.
BACKGROUND: In response to evidence about the health benefits of smoking cessation at time of cancer diagnosis, Ontario Health (Cancer Care Ontario) (OH-CCO) instructed Regional Cancer Centres (RCC) to implement smoking cessation interventions (SCI). RCCs were given flexibility to implement SCIs according to their context but were required to screen new patients for tobacco status, advise patients about the importance of quitting, and refer patients to cessation supports. The purpose of this evaluation was to identify practices that influenced successful implementation across RCCs. METHODS: A realist evaluation approach was employed. Realist evaluations examine how underlying processes of an intervention (mechanisms) in specific settings (contexts) interact to produce results (outcomes). A realist evaluation may thus help to generate an understanding of what may or may not work across contexts. RESULTS: The RCCs with the highest Tobacco Screening Rates used a centralized system. Regarding the process for advising and referring, three RCCs offered robust smoking cessation training, resulting in advice and referral rates between 80% and 100%. Five RCCs surpassed the target for Accepted Referral Rates; acceptance rates for internal referral were highest overall. CONCLUSION: Findings highlight factors that may influence successful SCI implementation.
Authors: Graham W Warren; James R Marshall; K Michael Cummings; Benjamin Toll; Ellen R Gritz; Alan Hutson; Seyedeh Dibaj; Roy Herbst; Carolyn Dresler Journal: J Thorac Oncol Date: 2013-05 Impact factor: 15.609
Authors: John R Goffin; William M Flanagan; Anthony B Miller; Natalie R Fitzgerald; Saima Memon; Michael C Wolfson; William K Evans Journal: JAMA Oncol Date: 2015-09 Impact factor: 31.777
Authors: Lei Wu; Yao He; Bin Jiang; Fang Zuo; Qinghui Liu; Li Zhang; Changxi Zhou; Miao Liu; Hongyan Chen; K K Cheng; Sophia S C Chan; Tai Hing Lam Journal: BMC Public Health Date: 2016-01-22 Impact factor: 3.295
Authors: Sandjar Djalalov; Lisa Masucci; Wanrudee Isaranuwatchai; William Evans; Alice Peter; Rebecca Truscott; Erin Cameron; Nicole Mittmann; Linda Rabeneck; Kelvin Chan; Jeffrey S Hoch Journal: Cancer Med Date: 2018-07-17 Impact factor: 4.452