Date of Award

Spring 5-3-2019

Document Type


Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Greene, Debbie Ph.D, RN, CNE

Second Advisor

Winn, Sheryl DNP, APRN, ANP-BC

Third Advisor

Russell, RN, Ph.D



Significant progress has been made in the reduction of tobacco use in the United States, but the smoking prevalence among the socially and economically disadvantaged populations (i.e. individuals who are homeless, uninsured, LGBT, and living with HIV) is significantly higher than the general population (CDC, 2018b). As a result, these vulnerable populations carry a disproportionate burden of tobacco-related mortality and morbidity (CDC, 2018b). There is a cost-effective and evidence-based treatment for tobacco use dependence (Fiore et al, 2008), but the delivery by primary care providers to this population is inconsistent (Tyman, Bonevski, Paul, & Bryant, 2014). This study focused on determining whether the delivery of a multi-component intervention (i.e. educational session, quick reference materials, and prompts in the electronic health records) to the health care providers (n=13) at a federally qualified health care clinic would result in an improvement in the percentage of behavioral health referrals and pharmacotherapy for smoking cessation treatment. A retrospective electronic medical record review of the 8 weeks prior to the intervention, and 8 weeks after the intervention, was conducted to examine changes in provider compliance with smoking cessation treatment guidelines. The data collected suggested that there was a statistically significant increase in compliance with the delivery of the qualifying treatment (Z=-2.09, p=.037) following the intervention. The study also examined the relationship between demographic characteristics of providers and improvement in provider compliance with no significant positive correlations. Additional research is needed to examine whether this improvement in compliance can be sustained at six months.

Included in

Nursing Commons