Health Care Workers’ Knowledge, Attitudes and Practices on Tobacco Use in Economically Disadvantaged Dominican Republic Communities

International Journal of Environmental Research and Public Health

Michael G. Prucha¹  Susan G. Fisher⁵  Scott McIntosh¹  John C. Grable⁶  Heather Holderness¹  Kelly Thevenet-Morrison¹  Zahíra Quiñones de Monegro⁴  José Javier Sánchez⁴  Arisleyda Bautista³  Sergio D໚z²  Deborah J. Ossip¹ 

[1] Department of Public Health Sciences, University of Rochester, Medical Center, Rochester, NY 14642, USA; E-Mails:;Hospital Regional Universitario José María Cabral y Báez, Santiago, Dominican Republic; E-Mail:;Centro de Atención Primaria Juan XXIII, Santiago, Dominican Republic; E-Mail:;Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic; E-Mails:;Department of Clinical Sciences, School of Medicine, Temple University, Philadelphia, PA 19140, USA; E-Mail:;Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; E-Mail:

关键词: tobacco cessation;    low-middle income country;    primary health care;    socioeconomic status;    global health;   

DOI  :  10.3390/ijerph120404060

来源: mdpi

【 摘 要 】

Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.