Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses

Objective. We prospectively examined whether training home health care nurses is associated with changes in attitudes towards smoking cessation counseling and counseling behaviors. Methods. We trained 98 home health care nurses to deliver cessation counseling to their patients. Measures were administered at pre-training, post-training, and 6 months later. This was part of a larger study conducted in Providence, RI, USA (1998–2002). Results. Compared with pre-training, at post-training, nurses reported significantly higher levels of self-efficacy to counsel, positive outcome expectations, optimism that patients would follow their advice, perceived worth of smoking counseling, perceived importance of quitting smoking, and perceived organizational support. These training effects were maintained 6 months later. Between the end of training and the 6-month follow-up, nurses reported significant increases in their perceived effectiveness to counsel smokers and confidence to encourage behavior change. Compared with pre-training, at 6 months of follow-up, nurses were significantly more likely to ask about smoking status, assess readiness to quit, advise to quit, assist with quitting, and arrange follow-up. Nurses spent significantly more time counseling smokers at 6 months than at pre-training, and were less likely to selectively counsel. Conclusions. Brief training facilitates both short- and long-term changes in nurse attitudes and behaviors regarding smoking cessation counseling.