{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:39:34Z","timestamp":1784659174561,"version":"3.55.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Mayo Clinic, and Pfizer Independent Grants for Learning and Change","award":["25678023"],"award-info":[{"award-number":["25678023"]}]},{"name":"Ministry of Business and Knowledge from the Government of Catalonia","award":["2021SGR00906"],"award-info":[{"award-number":["2021SGR00906"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CB19\/06\/00004"],"award-info":[{"award-number":["CB19\/06\/00004"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Instituto Carlos III","award":["BA22\/00021"],"award-info":[{"award-number":["BA22\/00021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This study measured changes in healthcare professionals\u2019 (HCPs) performance in tobacco cessation intervention before and 6 months after a health system intervention. The intervention involved exposure to online training for staff and the implementation of a structured organizational change-level practice model that included some strategies, comprising establishing tobacco cessation steering groups with champions in each hospital, developing tailored protocols and guidelines within each organization, conducting on-site workshops for clinicians, and creating posters and pocket materials summarizing the intervention. Pre\u2013post evaluation in four hospitals in Barcelona province (Catalonia, Spain). We assessed the knowledge, attitudes, behaviors, and organizational factors (KABO) and the performance of each of the components of the 5As Model for Treating Tobacco Use according to a scale from 0 (\u201cNever\u201d) to 10 (\u201cAlways\u201d) among HCPs. We performed Wilcoxon signed-rank tests for paired samples and assessed changes in performance by performing linear regression. A total of 255 HCPs completed the pre\u2013post evaluation. All components of the 5As Model increased, with \u201cAssist\u201d and \u201cArrange a follow-up\u201d showing the greatest improvement. Several KABO dimensions significantly increased, including individual skills (mean score: 3.3\u20135.7, P &amp;lt; .001), attitudes and beliefs (4.8\u20135.4, P &amp;lt; .001), individual commitment (5.9\u20136.6, P &amp;lt; .001), and perception of having positive organizational support (4.3\u20134.7, P &amp;lt; .001). An increase in each point in individual skills and support of the organization was associated with increased rates of 5As delivery, with the greatest associations found for \u201cAssist\u201d (0.60 and 0.17, respectively) and \u201cArrange a follow-up\u201d (0.71 and 0.18, respectively). The intervention was successful in increasing HCPs individual skills, attitudes and beliefs, individual commitment, and perception of having positive organizational support and the performance of all components of the 5As. Future research should focus on strategies that promote organizational support, a dimension that is essential to increasing Assist and Arrange, which were less implemented at baseline.<\/jats:p>","DOI":"10.1093\/tbm\/ibae016","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T10:01:35Z","timestamp":1719309695000},"page":"549-560","source":"Crossref","is-referenced-by-count":1,"title":["Improving tobacco cessation interventions in hospitals: Pre\u2013post evaluation of an innovative health systems intervention in Catalonia (Spain)"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0108-3288","authenticated-orcid":false,"given":"Cristina","family":"Mart\u00ednez","sequence":"first","affiliation":[{"name":"Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Tobacco Control Research Group, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge-IDIBELL , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES) , Madrid , Spain"},{"name":"Policy Studies Institute, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco, CA 94118 , USA"},{"name":"Department of Public Health, Mental Health and Maternity Health, School of Nursing, University of Barcelona, Campus Bellvitge (Hospitalet de Llobregat) , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Feliu","sequence":"additional","affiliation":[{"name":"Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Tobacco Control Research Group, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge-IDIBELL , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Enriquez","sequence":"additional","affiliation":[{"name":"Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Tobacco Control Research Group, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge-IDIBELL , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ant\u00f3n","sequence":"additional","affiliation":[{"name":"Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Tobacco Control Research Group, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge-IDIBELL , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Castellano","sequence":"additional","affiliation":[{"name":"Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Tobacco Control Research Group, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge-IDIBELL , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assumpta","family":"Company","sequence":"additional","affiliation":[{"name":"E-oncologia, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Romero","sequence":"additional","affiliation":[{"name":"E-oncologia, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Ripoll","sequence":"additional","affiliation":[{"name":"Occupational Health Department, Consorci Sanitari Integral , L\u2019Hospitalet de Llobregat, Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angels","family":"Ruz","sequence":"additional","affiliation":[{"name":"Occupational Health Department, Consorci Sanitari Integral , L\u2019Hospitalet de Llobregat, Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Papadakis","sequence":"additional","affiliation":[{"name":"Division of Prevention and Rehabilitation, University of Ottawa Heart Institute , Ottawa , Canada"},{"name":"Social and Family Medicine, School of Medicine, University of Crete , Greece"},{"name":"National Centre for Smoking Cessation and Training , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteve","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Catal\u00e0 d\u2019Oncologia-ICO , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Tobacco Control Research Group, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge-IDIBELL , L\u2019Hospitalet de Llobregat, Barcelona , Spain"},{"name":"Center for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES) , Madrid , 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