Columbia and Aetna will partner together on a project funded by a $500,000 grant from the Robert Wood Johnson Foundation's (RWJF) Addressing Tobacco in Managed Care program. Columbia and Aetna, with assistance from the Deschutes Research Institute, will create CD-ROM-based interactive tools for dentists to assist patients in quitting the use of tobacco products. Dental staffs may receive continuing education credits for completion of certain aspects of the CD-ROM.
Aetna's networks of participating dental providers are the largest managed by a single company, including approximately 7,000 available Dental Maintenance Organization (DMO) general dentist practice locations. With the program focusing on Aetna's DMO locations, there is a potential to reach its nearly 4 million DMO members, as well as the dentists' other tobacco-using patients.
The National Institutes of Health reported that more than 80 percent of adult tobacco smokers want to stop and that oral health personnel can successfully help smoking patients stop.
"The dental office is often the source of preventive health information for the patient," said David A. Albert, the principal investigator of the Columbia and Aetna project. "Patients in general are encouraged to visit the dentist for annual check-ups and cleanings. Educating the entire dental staff on tobacco cessation initiatives may lead to additional quit attempts or successful cessation in patients who use any tobacco products."
"Aetna is excited about our continued collaboration with Columbia," said Tom Gotowka, Aetna's chief dental officer. "With Aetna's dentist population and membership size, we can provide a unique opportunity to measure results and to increase dental providers' awareness of tobacco cessation initiatives."
The three-year project will evaluate the CD-ROM's effectiveness as the primary source of continuing education on this topic for the dental staff, which includes the dentist, dental hygienist and dental assistants. The dentists will use the CD-ROM, along with updates via electronic mail, to stimulate tobacco cessation behaviors among their patients.
Previous studies have indicated that advice from a health care provider can be the single most effective stimulus for an individual seeking preventive care, yet tobacco cessation counseling is not routinely offered in the dental practice.
In previous work, Columbia and Aetna have examined dental provider opinions and practices surrounding the placement of dental sealants. A previous grant from the Robert Wood Johnson Foundation examined the introduction of tobacco cessation through dental offices participating in Aetna's DMO in New York, New Jersey, Connecticut and Pennsylvania. This was the first grant RWJF made to a dental project.
The Columbia and Aetna approach will be used to facilitate change within both the dental managed care system and dental offices. The aim of the effort is to develop and disseminate a comprehensive interactive CD-ROM and related materials on tobacco cessation to dentists who participate in the Aetna DMO and to evaluate its effectiveness in altering dental provider behaviors toward their role in tobacco cessation. This program has the potential to expand communication of tobacco cessation techniques to thousands of practicing dentists in the United States.
The project employs multiple components, including: the use of continuing education via CD-ROMs to provide education on tobacco control; identification of records of dentist's patients who smoke; setting patient quit dates; provision of tobacco cessation materials for dissemination to identified patients, and developing health plan performance measures for cessation-related efforts.
"Having spent the past 15 years using the dental visit as a clinical opportunity to provide brief counseling, the Deschutes Research Institute is excited about the opportunity to extend our training modules to use interactive computer-based technology," said Herb Severson, director of the Deschutes Research Institute. "In addition, working with Aetna and Columbia is a tremendous opportunity to train dental staffs, helping reduce tobacco use. Dentists have proven to be a powerful resource for professional advice on quitting smoking and have proven effective when trained to deliver a brief office based intervention."
Columbia's School of Dental and Oral Surgery (SDOS), founded in 1917, is located at the Columbia Presbyterian Medical Center campus in northern Manhattan. In addition to providing education programs for pre- and post-doctoral candidates, SDOS conducts research in state-of-the-art facilities and oversees an extensive community-based service program for residents in the surrounding community, which is a federally designated medical and dental manpower shortage area. Outreach into the community includes dental programs in seven area public schools, a dental van, and three off-site community-based dental clinics, providing a rich learning environment for students at SDOS.
Aetna is one of the nation's leading providers of health care and related group benefits, serving 17.5 million health care members, 13.7 million dental members and 11.7 million group insurance customers as of Sept. 30, 2001.