CLINICIAN COMPLIANCE WITH PRIMARY PREVENTION OF TOBACCO USE - THE IMPACT OF SOCIAL CONTINGENCIES

Background. This study evaluated clinicians' compliance with deliverin g written advice and information against tobacco use (prevention presc riptions) to adolescent patients. Methods. Clinicians in 77 orthodonti c offices were trained (and asked) to provide anti-tobacco counseling and prescriptions to 10- to 18-year-olds for 2 years. Each of eight pr escriptions was provided for distribution to adolescent patients. Info rmation concerning prescription-tracking methods and operant learning theory variables such as modeling and feedback was obtained using a cr oss-sectional interview of clinical staff. The proportion of prescript ions written was regressed on possible ''determinants.'' Analyses were replicated for two time periods. Results. Mean anti-tobacco prescript ion compliance was 66 and 73% for two separate time periods. Multiple regression analyses were computed for the first (R = 0.45, F-(7,F-63) = 2.29, P < 0.001) and second (R = 0.48, F-(7,F-63) = 2.16, P < 0.001) time periods. Prescription tracking and praise from patients were sig nificant correlates for the first time period; praise and modeling wer e significant for the second time period. Twenty and twenty-three perc ent, respectively, of the variance in office prescription rate was exp lained. Conclusions. Results suggest that compliance with primary prev ention procedures may be influenced by feedback from patients, staff m odeling, and formal office tracking information. (C) 1997 Academic Pre ss.