1. Alcohol, Smoking and Abuse
Screening Project
By
Donna Clarke-McMullen, PHN
Feb 19, 2007

2. Screening Project Outline
Developed 1 page screen & resource
package for primary care providers
Piloted screen & resource package
Academic detailing
Pre-test questionnaire
Post-test visits & questionnaire
Evaluation results

3. Screening Project Objectives
Identify “at-risk” women
Primary care providers incorporate
these tools into their practice
Standardize Ask-Advise-Assist
Evaluate clinical use of tool by
primary care providers
Assess detailing approach

4. Pre-test Resource Package
Alcohol, smoking and abuse screens
Backgrounders on T-ACE, Smoking
Cessation & RUCS
Related resource pamphlets
Posters
Resource order sheet
Pre-test

7. Target Audience
Total Visits Pre-test Post-test
Family
178 137 56 32
physicians
Nurse
7 6 6 1
practitioners
Midwives 5 5 5 5
Total hcp 190 148 67 38

8. Pre-test Results
It is appropriate to screen all my
female patients.
100%
8%
16%
80%
Percentage
33%
of health Agree
60%
care
providers 91%
Strongly Agree
40% 79%
51%
20%
0%
Tobacco Abuse

9. Pre-test Results
I am comfortable asking my female
patients about…
100% 8%
21%
Percentage 80%
of health Agree
care 60%
36%
providers 93%
Strongly Agree
40% 73%
20% 36%
0%
Tobacco Abuse

10. Pre-test Screening Behaviour
Screen 90+ % of female patients…
100
87
80
66
Percentage
60
of health
care
40
providers
20 14
0
Tobacco Alcohol Abuse

11. Post-test Resource Package
Pre-test results
Brief Interventions Work
Women Abuse is a Health Issue
Article on intimate partner violence
Article on brief intervention for alcohol
problems
Stages of change for smoking card
Clinical Tobacco Intervention Bulletin

12. Post-test Response
57% response rate from pre-test
group
Harder to visit the second time
28% of hcp visited responded to the
pre and post test

13. Screening Practices
Percentage of health care providers
who reported screening 90+ % of
patients.
100
87
90
80
70 66 69
60
Percentage Pre-test
50
40 Post-test
27
30
20 14
10
0
Tobacco Alcohol Abuse

14. Tool Use
Percentage of health care providers
who used the tool or used the same
questions.
62 61
60
58
58
Percentage 56
54
54
52
50
Tobacco Alcohol Abuse

15. Health Professionals Comments
Just over half intend to use T-ACE
(56%) and RUCS (54%)
Increase in community program
referrals
Some really liked the tool
Most didn’t want an extra piece of
paper
Anecdotally, some “at risk”
identification stories shared

16. Academic Detailing
Our experience
66% found academic detailing useful
66% read the resource package
Lessons learned

17. Secondary Gains
Promoted primary care providers
resource catalogue
Larson prenatal screen
CPNP program using screens
Increased resource requests

18. Q&A
www.healthunit.on.ca
-”What’s New” section
go to “Upcoming Events”
Donna Clarke-McMullen
dclarkemcmullen@healthunit.on.ca
Tel. 613-549-1232, ext. 529