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J Am Board Fam Med. 2018 Nov-Dec;31(6):869-880. doi: 10.3122/jabfm.2018.06.180018.

Interactive Mobile Doctor (iMD) to Promote Patient-Provider Discussion on Tobacco Use among Asian American Patients in Primary Care: A Pilot Study.

Author information

1
From Department of Psychiatry, University of California San Francisco, San Francisco, CA (JYT); Asian Health Services, Oakland (TQ, TBD, ESNP, SMH); Division of General Internal Medicine, University of California San Francisco, San Francisco (CW, TTN); Asian American Research Center on Health, San Francisco (JYT, TQ, CW, TTN). janice.tsoh@ucsf.edu.
2
From Department of Psychiatry, University of California San Francisco, San Francisco, CA (JYT); Asian Health Services, Oakland (TQ, TBD, ESNP, SMH); Division of General Internal Medicine, University of California San Francisco, San Francisco (CW, TTN); Asian American Research Center on Health, San Francisco (JYT, TQ, CW, TTN).

Abstract

INTRODUCTION:

This study examined the feasibility, acceptability, and efficacy of an interactive "Mobile Doctor" intervention (iMD) for Korean and Vietnamese American men, population groups with high smoking prevalence rates.

METHODS:

The iMD delivers 5As (Ask, Advise, Assess, Assist, and Arrange) via tailored in-language video messages on a mobile tablet to Korean and Vietnamese male daily smokers right before a health care visit. A single-group trial was conducted with Korean- and Vietnamese-speaking patients at a federally qualified health center. Outcomes were assessed by self-reported surveys obtained postvisit and 3-month follow-up, and by examining electronic health record (EHR) progress notes from 3 consecutive primary care visits to evaluate impacts.

RESULTS:

Among 47 male daily smokers (87% participation rate), 98% were limited English proficient and 53% had no intent to quit smoking within 6 months. On average, iMD took 12.9 minutes to complete. All participants reported discussing smoking with their providers during the visit, and more than 90% thought iMD was at least somewhat helpful in their decision about quitting and in communicating with their providers. EHR-documented 5As were significantly higher at the iMD visit for Assess (38.3%), Assist (59.6%), and Arrange (36.2%) compared with other visits without iMD. At 3 months, 51% made at least 1 24-hour quit attempt since the intervention. The self-reported 7-day point prevalence abstinence was 19%.

CONCLUSIONS:

iMD is feasible and acceptable to Korean and Vietnamese male smokers, including those who were not intending to quit smoking. It is a promising tool for increasing patient-provider discussion of tobacco use and possibly smoking cessation among Asian American male smokers.

KEYWORDS:

Asian Americans; Delivery of Health Care; Prevalence; Primary Health Care; Self-Report; Smoking Cessation; Tobacco Use

PMID:
30413543
DOI:
10.3122/jabfm.2018.06.180018
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