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Integration of Tobacco Dependence Education Southern Illinois University Carbondale Dental Hygiene Program Joan M Davis, RDH,CTTS,PhD 1
Integration of Tobacco Dependence Education
Southern Illinois University Carbondale Dental Hygiene Program
Joan M Davis, RDH,CTTS,PhD
1
Southern Illinois University Carbondale, Dental Hygiene 2
SIUC 19,000 students
Dental Hygiene Program • Four year baccalaureate degree
• 120 students, 20 faculty, 36 dental chairs
• Research, public health, advanced periodontics
SIUC’s tobacco Dependence Education (TDE) Integration
• 2nd yr First Semester – brief motivational overview, health history assessment
• 2nd yr Second Semester – BMI reinforced, online self-instruction module
• 3rd yr First Semester – clinical competency, pharmacology
• 3rd yr Second Semester – clinical competency, lecture on application
• 4th yr First & Second Semester – case studies, clinical application, mentoring
Southern Illinois University Carbondale, Dental Hygiene
3
2nd Year, First Semester
• Orientation – 2hr brief motivational interviewing(BMI) overview,
video and role play (2hr) • OHI • Nutritional counseling • Tobacco dependence training
Southern Illinois University Carbondale,
Dental Hygiene 4
2nd Year, Second Semester
• Vital Signs – Reviewing the health history, tobacco dependence
assessed, BMI reinforced w/video (2hr)
• Prevention Course – Tobacco Free! Curriculum – comprehensive online
self-study educational system (six modules, unit quizzes and activities)
– Tobacco Cessation, Ch 18, Primary Preventive Dentistry, 7th ed.
Southern Illinois University Carbondale, Dental Hygiene
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• INTRODUCTION: OVERVIEW OF THE TRAINING PROGRAM • MODULE ONE: TOBACCO USE – PAST, PRESENT, AND FUTURE • MODULE TWO: TOBACCO USE – ADDICTION, DEPENDENCE, AND DISEASE • MODULE THREE: TOBACCO USE – CESSATION & PREVENTION • MODULE FOUR: TOBACCO USE – PHARMACOTHERAPY • MODULE FIVE: TOBACCO USE – THEORY TO PRACTICE–CLINICAL APPLICATION • MODULE SIX: TOBACCO USE – ADVOCACY AND PREVENTION IN THE COMMUNITY
http://www.sah.siuc.edu/tobacco Southern Illinois University Carbondale,
Dental Hygiene 6
3nd Year, First Semester
• Clinic Seminar
– Review of TDE, importance to treat all tobacco using patients
– Focused presentation of SIUC’s TDE program, forms and quitline fax referral system
– Overview of tobacco dependence medications
– Review of BMI, brief role play
– Formal clinical competency
Southern Illinois University Carbondale, Dental Hygiene
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3nd Year, Second Semester
• Second formal clinical competency
– Faculty actively role model TDE and assist students w/their interventions
• Pharmacology
– In-depth discussion and application of pharmacotherapies, when to seek medical consults or refer when patient presents w/co-morbidities
Southern Illinois University Carbondale, Dental Hygiene
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4nd Year, First & Second Semester
• All tobacco using patients are assessed and provided appropriate and on-going tobacco interventions
• Students now see TDE as a normal component of
patient care • The Advanced Periodontics
– Approx 50%-60% tobacco users – Mentoring system
Southern Illinois University Carbondale, Dental Hygiene
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Focused, Short & long-term Progress of integration
• Grant: SIUC received $900,000 from the CDC to start a campus-wide tobacco-free initiative
• I was asked to develop a curriculum for the DH clinic – 1 semester • Over time, I learned more, developed Tobacco Free!, evaluated it (3
publications) • One other faculty was interested, now all but one supervising
dentist is actively prescribing • It has taken 8 years of steady and focused integration
Southern Illinois University Carbondale, Dental Hygiene
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Reflections
• Though a ‘champion’ first moved TDE forward, it took the whole faculty to see the value and practicality – and benefits tobacco interventions
• We may have the passion, but we need to see our goal as program-wide integration in order for TDE to be sustained once our funding or we are no longer there.
Southern Illinois University Carbondale, Dental Hygiene
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Thank you!
Contact information – Joan M Davis, RDH, CTTS, PhD
Southern Illinois University
618-453-8874
Southern Illinois University Carbondale, Dental Hygiene
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SIU Saluki
Resources and Strategies to Implement Tobacco Dependence Education: An Interdisciplinary
Approach Indiana University
Laura Romito, DDS, MS
Tobacco Free Initiatives Program
ADEA 3/16/2011
IUSD Goals
Integrate TDE into all IUSD programs
Integrate TDE vertically and horizontally into all years / phases of each
program
Engage in tobacco related-research,
including educational scholarship and TDE
assessment
Have clinical component to TDE
&
clinical competency
Dental Assisting TDE Components
• 1 yr program
– (31 credit hrs in two 16wk semesters)
• A141 Preventive Dentistry and Nutrition
• A113 Oral Pathology
• Clinical seminar (2 hours TDE)
Dental Hygiene TDE Components
• 2 yr Associate degree / 4 yr BS degree
• Didactic courses
• Tobacco Dependence Online Module
• TDE competency
• Clinical Tobacco Dependence
Dental Hygiene
• DH 311 Year 2 Fall – Class room lectures
– Text
– Online tobacco module
• DH 311 Year 2 Spring – Tobacco dependence competency
• Clinical work
DDS Program TDE Components
• Didactic courses
• Problem Based Learning (PBL)
– D1 & D2 fall & spring
• Tobacco Dependence Online Program
• Clinical TDE component
Dental: Year 1
• Molecular Cell Biology
• Problem Based Learning Case Fall – Oral cancer
• Systems Approach to the Biomed Sciences I – Immunology, Endocrine, Respiratory,
Cardiovascular, GI
• Problem Based Learning Cases Spring – Endocrine disorders (e.g. diabetic smoker)
– GI – addictions (meth / OH / tobacco)
– Cardio
Dental: Year 1
• Behavioral Sciences: OSCE
– Pretest
– PBL case & coordinating Field trip to Fairbanks Addictions Hospital; Reflection assignment
– OSCE
– Post test
• Pharmacology
– PBL (e.g. varencline)
Dental Year 2
• Systems Approach to the Biomed Sciences II – Hematology, Repro-Urinary, Musculoskeletal,
Dermatology modules • Medicine (e.g. renal cell ca)
• PBL - e.g. RU module: pregnancy & tobacco; renal dx and tobacco use; Intro to Clinics Assessing & charting use in AxiUm
• Periodontics
• Oral Pathology
• Intro to Clinics & Behavioral Sciences
Dental Year 3
• Periodontics
• Preventive Dentistry (caries risk)
• Pedodontics
• Pharmacology
• Introduction to Clinics
– Behavioral sciences module
• Comprehensive interactive online program
Online Tobacco Education Program
• Center for Teaching & Learning grant
• 9 Units including case studies
• Interactive learning activities
• Pre-test /Post-test
• Video
Dental Year 4 & Beyond
• Dental Year 4 – Capstone course: TCC 189 Tobacco Cessation
Counseling
– Emergency Clinic Pilot program
• Undergraduates – Education, Communication, Health, Business
• Graduate Students – Dental, Public health
Lessons Learned
Achieve
Common Ground
on Core
Concepts
Collaborations
TCBG
Other Professions
& Disciplines
Supportive Networks
Admin: needs
assessment helps
Student interest
Challenges
Faculty engagement
$$$$$
Curricular time
Electronic Health
Record ?
Spreading Your Wings Interprofessional Education
• Dental & Medical disciplines • Perio, Pedo, OS, Oral Path/Oral Med, DH
• Dental Behavioral Sciences & Dental Ethics
• ADEA TFI-SIG
• Nursing, Pharmacology, Public Health
• Social / Business disciplines
• Community Resources • ITPC, Health Dept., Lung, Heart Assoc.’s
• ATTUD, SRNT, Mayo Clinic
• Research Communities
Contact Information
Laura Romito, DDS, MS Associate Professor
Director, Nicotine Program
Department of Oral Biology, Rm B19C
Indiana University School of Dentistry
1121 West Michigan Street
Indianapolis, IN 46202
Ph: 317-278-6210
Fax: 317-278-1411
ADEA AS 2011 Interprofessional Education: Teaching and
Learning Together For Better Health
Interdisciplinary Healthcare Providers Collaborative Efforts on the Treatment of
Tobacco Dependency
Questions to ask about integrating curriculum
• Why?
• What?
• When?
• Content
• Venues
• Teaching methods
Interdisciplinary Approach to TDE Tobacco “tie ins” emphasize the widespread impact of tobacco
DH, DS, DDS
Pharmacy
Medical: RN, MD, PA
Mental Health:
counseling, psychology
Dental Specialties:
OS, Perio
•Cessation related health improvements achieved by dental professionals can be seen to reach beyond the mouth •Dentists appreciate improved periodontal health that results when medical professionals help patients quit
University of Detroit Mercy School of Dentistry
Tobacco Prevention and Treatment Progra • Lectures
• Web-Based Training • Small Group Rotations(DH2) • Case Study of the Tobacco User
– Data collection from a patient who currently uses tobacco – Design a “hypothetical” treatment plan to implement, if the
tobacco user did want to quit at some point
• DS/DH student + program coordinator together provide the Tobacco Dependency Treatment service for a dental patient who wants help quitting
• Periodontal Residency Program has semester long course “Tobacco Intervention for Dentistry”
• Advanced Education in General Dentistry Program has a seminar
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How do we teach our students about Tobacco Dependence Treatment?
• DPE 525 Periodontal Residency Program Tobacco Intervention for Dentistry:
Winter Term Course Year 1
• CL 826 Clinical Dental Hygiene lll: Tobacco program requirement for all DH2
• DOM 831 Clinical Oral Diagnosis: Tobacco program requirement for all DS3
• DOM 841 Clinical Oral Diagnosis: Tobacco program requirement for all DS4
*Clinic instruction and supervision for tobacco cessation counseling, case
study presentations, community health education projects, blackboard site
for coursework and testing
• DRD 829 (DS2): Strategies for the Prevention of Oral Diseases
• CL 815 Clinical Dental Hygiene ll clinical rounds tobacco dependency
treatment learning unit rotation (small groups)
• DGP 500 Advanced Education in General Dentistry Seminar
University Of Detroit Mercy
Institute for Advanced Continuing Education Programs and
Faculty Inservice Programs
*Utilizing an interdisciplinary approach should involve all faculty and external experts
UDM CE PROGRAM
2003: ALL THINGS TOBACCO AND HOW THEY RELATE TO THE DENTAL PROFESSIONAL
• History of Tobacco Use
Amanda Holm, MPH
Henry Ford Health Systems
Center for Health Promotion and Disease Prevention
Project Manager
• Three Components of Nicotine Addiction
Arden Christen, DDS, MSD, MA
Professor and Acting Chair, Department of Oral Biology
Co-Director, Indiana University Nicotine Dependence Program
Consultant to ADA Tobacco Education and Control Council on
Access, Prevention and Interprofessional Relations
• Pharmacotherapy Approaches for Tobacco Use Cessation
Choong Foong, PhD
UDM School of Dentistry: Biomedical Sciences
• Youth Tobacco Use/Prevention of Tobacco Use
Tom Peterson, M.D., F.A.A.P.
Medical Director, MMPC
• Tobacco Use Impact on Periodontal Disease and Oral Tissue Health Anthony Neely, DDS, MS, MScD UDM School of Dentistry: Periodontics and Dental Hygiene • Spit Tobacco Joan McGowan, RDH, PhD University of Michigan School of Dentistry: Dental Hygiene • One Dental Office’s Cessation Experiences Scott Farrell, DDS Pontiac, MI • Presenting the US Public Health Service’s Clinical Practice Guideline Sara Gordon, DDS, MSc UDM School of Dentistry: Diagnostic Sciences • Providing the Tobacco Cessation Counseling Service in
Dental Practice Jill Loewen, CDA, R.D.A., MS UDM School of Dentistry: Patient Management
UDM CE PROGRAM
2008: SCIENTIFIC AND CLINICAL ASPECTS OF THE ORAL/SYSTEMIC HEALTH CONNECTION
• The relationship of oral health to systemic health James Winkler, DDS, PhD Professor and Chairperson, Department of Periodontology and Dental Hygiene • Periodontal disease and systemic disease Anthony Neely, DDS, MDentSc, PhD Associate Professor, Department of Periodontology and Dental Hygiene
• Oral Oncology: Detecting oral cancer and three case studies
Lynne Moseley, DDS Director of Oral Oncology, Karmanos Cancer Center • Tobacco Use and Systemic Health: Tobacco Prevention and Cessation Jill Loewen, R.D.A.., NCTAS, MS Clinical Assistant Professor Project Coordinator for Tobacco and Quality Improvement Programs Joan McGowan, RDH, MPH, PhD Associate Professor
UDM CE PROGRAM
2009, 2010: ON THE ROAD TO BETTER ORAL HEALTH: MOVING OUR DENTAL PATIENTS TO SUCCESSFUL BEHAVIOR CHANGE
• Perspectives on Behavioral Change
• Stages of Readiness for Change, Model for Approaches to Behavior Modification (video clips)
• Motivational Interviewing • Dealing with Difficult Patients
(video clip) • Group Activities: 3 Case
Studies and Discussion (small groups: recorder & reporter for each)
• Discussion and Wrap Up
• Jill Loewen, RDA, MS, CTTS Clinical Assistant Professor Project Coordinator for Tobacco and Quality Improvement Programs Teaches Tobacco Use Prevention and Treatment and Quality Improvement
• Kim Werth, RDH, MA Clinical Associate Professor Director of Student Counseling and Wellness Teaches Special Patient Care, Communication Skills, Psychological Aspects of Dentistry
• Steven J. Ceresnie, PhD Adjunct Assistant Professor Teaches Communication Skills, Psychological Aspects of Dentistry
16 Faculty Inservices 2002-2010 Creating a “Culture”
Some Topics Presented:
• Helping Our Patients Become Tobacco Free
• Enhancing Smoking Cessation with the Use of Medications
• Lung Cancer in Peter Jennings and Dana Reeves: What Do We Know About Smokers, the Effects of Smoking and Secondhand Smoke?
• Tobacco Prevention and Cessation Special Needs Patients, Special Products, Special Concerns
• Tobacco Treatment Update DS & DH Student Case Study Project
• Trends That Will Impact Our Opportunities To Help Dental Patients Quit Tobacco Use
• Asking and Answering the Right Questions When Treating the Tobacco Dependent Patient
Project Collaborations
• Training Dental Professionals: Table Clinics and Exhibits – Detroit District Dental Review – Michigan Dental Association Annual Session
• Organized Dental Professional Group Presentations – Michigan Dental Association – Michigan Dental Hygienists Association – Michigan Dental Assistants Association
• Training Others – Michigan Department of Community Health: Tobacco and Oral
Health Sections – Michigan Primary Care Association – Michigan Cancer Consortium – Tobacco Free Michigan – Michigan Oral Health Coalition
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UDMSD Tobacco Program Annual Events
Provide awareness, stress importance to oral health
• Great American Smokeout
• Give Kids a Smile Day
• Kick Butts Day
• World No Tobacco Day
• Michigan Oral Health Conference: exhibit
• Detroit District Dental Review: table clinic and exhibit
• Michigan Dental Association Annual Session: table clinic and exhibit
• Oral Cancer Walk (new in 2007)
Future Plans for TDE
Addictions Studies
Nursing Physician’s Assistant
Counseling
University of Detroit Mercy SOD Tobacco Dependence Education
•Promote our program to other UDM health programs
•Educate that tobacco use is an oral health issue
•Encourage/assist other programs education on oral-systemic health connection(+tobacc0)
•Take lead in collaborative training on tobacco dependence education
Tobacco Interventions • Are more likely to be successful when delivered as
part of a interdisciplinary approach: tobacco dependence is chronic and relapsing
• Are valuable toward enhanced oral and overall health due to the growing burden of chronic disease caused by tobacco use
• Can be systematized with use of the EDR, helping facilitate identification and treatment of tobacco users
• Can be delivered by all interdisciplinary members with the expectation that it will have a powerful impact on motivation to make a quit attempt and on quit rates
Thank You!
