Integrating tobacco dependence counseling into electronic dental records: a multi-method approach.

Dentistry has historically seen tobacco dependence as a medical problem. As a consequence, dentistry has not adopted or developed effective interventions to deal with tobacco dependence. With the expanded use of electronic dental records, the authors identified an opportunity to incorporate standardized expert support for tobacco dependence counseling during the dental visit.

Computer-assisted guidance for dental office tobacco-cessation counseling: a randomized controlled trial.

Background: Decreases in smoking prevalence from recent decades have slowed, and national goals to reduce tobacco use remain unmet. Healthcare providers, including those in physician and dental teams, have access to evidence-based guidelines to help patients quit smoking. Translation of those guidelines into practice, however, remains low.

A comparison of dental restoration outcomes after placement by restorative function auxiliaries versus dentists.

Objectives: To compare the outcomes of restorations placed by restorative function auxiliaries (RFAs) with those placed by dentists.

Methods: Between July 1, 2007, and June 30, 2008, we matched 455 restorations placed by RFAs working at HealthPartners Dental Group with the same number placed by dentists. Restorations were matched by tooth number, American Dental Association procedure code, and patient age-group.

The effect of electronic health records on the use of clinical care guidelines for patients with medically complex conditions.

Background: The emergence of health information technology provides an opportunity for health care providers to improve the quality and safety of dental care, particularly for patients with medically complex conditions.

Methods: The authors randomized each of 15 dental clinics (HealthPartners, Bloomington, Minn.) to one of three groups to evaluate the impact of two clinical decision support (CDS) approaches during an 18-month study period.

A randomized controlled trial of Telephone Counseling with smokeless tobacco users: the ChewFree Minnesota study.

Although a considerable body of evidence supports telephone quit lines for smoking cessation, much less is known about the effectiveness of proactive Telephone Counseling with smokeless tobacco (ST) users. We conducted a randomized controlled trial comparing Telephone Counseling with the distribution of a self-help manual for ST cessation. We recruited 406 adult ST users throughout the state of Minnesota and randomized them to receive either: (a) a self-help manual (Manual only) or (b) a self-help manual plus proactive telephone-based cessation counseling (Telephone Counseling).

Measuring practice systems for chronic illness care: accuracy of self-reports from clinical personnel.

Background: Purchasers, plans, and clinical practices involved in quality improvement initiatives are increasingly interested in measuring practice systems, particularly in relation to clinical quality and as part of pay-for-quality initiatives. The validity of self-reports of the use of practice systems was examined.

Methods: In 11 medical groups in Minnesota, the Physician Practice Connections Readiness Survey, which was developed on the basis of the concepts and evidence base of the Chronic Care Model, was used to survey office practice personnel about practice systems.

Oral health program preferences among pregnant women in a managed care organization.

Objective: The purpose of the study was to understand the oral health information preferences of pregnant women and new mothers.

Methods: This study was conducted at a Minnesota managed care organization. A random sample of 250 women with public program insurance and 250 privately insured women was selected from the population of pregnant women in the claims systems.

Young adult smokers: are they different?

Objective: To compare smoking-cessation interest and behaviors in younger and older smokers to develop better smoking-cessation strategies for younger smokers.

Study Design: Mail survey with phone follow-up of age-stratified members of a large Midwestern health plan to identify current and former smokers, followed by a second follow-up survey of this subgroup 12 months later.

Methods: The follow-up survey asked about change in smoking status, quit attempts, interest in quitting, and experience with various aids to quitting.

Evaluating strategies and costs to recruit smokeless tobacco users.

We recruited smokeless tobacco users throughout Minnesota to participate in a trial testing telephone counseling versus a written self-help manual for cessation. This paper describes the recruitment strategies applied on a state-wide basis. We established a recruitment tracking system to monitor weekly rates of screened callers and returned consents, allowing us to adjust future recruitment efforts.

Smoking and cessation behaviors among young adults of various educational backgrounds.

Objectives: We sought to determine whether the educational backgrounds of young adult smokers (aged 18 to 24 years) affect their cessation attitudes or behaviors in ways that could be used to improve smoking interventions.

Methods: We surveyed 5580 members of the HealthPartners health plan and conducted a follow-up survey 12 months later of current and former smokers. Respondents were divided into subgroups according to educational level.

Practice systems for chronic care: frequency and dependence on an electronic medical record.

Objectives: To document the presence and functioning of different practice systems in a small sample of medical groups in Minnesota and to examine the relationship between the presence of practice systems and prior adoption of an electronic medical record (EMR).

Study Design: Descriptive study of the frequency of practice systems in 11 medical groups.

Methods: We recruited 11 medical groups for the study.