Abstract for: Using Dynamics Modeling to Promote Effective Tobacco Treatment Practices in Community-Based Primary Care Settings

This paper describes formative field research to develop and test the utility of a system dynamics modeling intervention intended to promote evidence-based tobacco treatment practices in community-based primary care settings. Brief counseling interventions by primary care providers have been shown to effectively promote tobacco cessation among patients who smoke, yet many physicians are inconsistent in the way they intervene with their patients. Too little time, poor training, lack of third-party reimbursement, competing clinical problems, and the belief that their patients are not able to change explain, in part, why some physicians do not adhere to evidence-based guidelines for treating tobacco use and dependence. Via a protocol for conducting on-site office visits to small primary care practices located in medically underserved urban communities, we tested the hypothesis that providers exposed to the simulation tool would demonstrate better understanding and progress towards full implementation of the US Public Health Service Guideline for Treating Tobacco Use and Dependence. Results indicate that simulated output that reflects the dynamics of providers’ unique practice environment is associated with stronger behavioral intent than other forms of feedback information, such as patient chart reviews.