Potential impact of a pilot training program on smoking cessation intervention for tuberculosis DOTS providers in Malaysia

Background

The association between tuberculosis (TB) and tobacco smoking is becoming increasingly important. Smoking cessation may yield substantial positive effects on TB treatment outcomes, relapse, and future lung disease. Thus, TB directly observed therapy, short-course (TB DOTS) providers are uniquely positioned to intervene with those TB patients who are smokers. Unfortunately, most health care professionals are inadequately trained to provide such service.

Aim

This study aimed to determine the feasibility of developing and implementing a customized training program related to the delivery of an integrated smoking cessation intervention (SCI) for TB DOTS providers and to evaluate its potential impact on their knowledge, attitudes, and perceived competence.

Method

We developed and delivered a structured training program and materials about treating tobacco use and dependence in TB settings. The training was offered to DOTS providers from six chest clinics in Penang and Wilayah Persekutuan Kuala Lumpur health districts, Malaysia, who were planned to be involved in a larger project, known as the SCIDOTS Project. A pretest-posttest survey of a single group was conducted. Changes in scores before and after the training program in knowledge and attitude were measured.

Results

Ten DOTS providers participated in the program and completed both the pretest and posttest survey questionnaire. The trainees’ median scores in knowledge of health risks of tobacco and tobacco-related diseases, the association between TB and tobacco, and overall knowledge significantly increased compared to the baseline (p?<?0.05). Upon completion of the program, the majority of the trainees (70–100%) believed that they were competent and confident in performing most SCI activities.

Conclusion

This preliminary study suggests that a customized in-service training program on SCI designed for and delivered to TB DOTS providers could significantly improve their knowledge, attitude, and practice related to SCI. It has also highlighted the gap related to SCI in nursing education and calls for urgent curricula reforms.