Author ORCID Identifier

https://orcid.org/0000-0002-6403-6227

Year of Publication

2021

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Social Work

Department/School/Program

Social Work

First Advisor

Dr. Melanie Otis

Abstract

Tobacco users with mental illnesses (MI) have continued to experience disparate rates of tobacco use, related illnesses and mortality. Despite higher rates of tobacco use among clients with MI, few providers in mental health settings deliver evidence based tobacco treatment. If tobacco use is not addressed, clients with MI will continue to experience disproportionate rates of tobacco use and related burden. Utilizing the theory of planned behavior (TPB), this study examined factors associated with provider intentions to deliver tobacco treatment, and their tobacco treatment delivery practices. Based on the main constructs of the TPB, providers’ attitudes about tobacco treatment delivery, beliefs about how influential others and/or their peers view tobacco treatment delivery in their practice settings, and perceived facilitators and barriers to deliver tobacco treatment influence their intentions to deliver tobacco treatment, and subsequently their delivery of tobacco treatment.

Data were derived from a cross-sectional survey of 219 mental health providers (MHPs) in an inpatient state psychiatric facility in Kentucky. The study found that attitudes, subjective norms and perceived behavioral control significantly influenced MHPs’ intentions to deliver tobacco treatment, supporting the TPB model. Additionally, intentions partially mediated the association between attitudes and brief interventions, as well as between subjective norms and MHPs’ delivery of brief interventions for tobacco treatment, and fully mediated the association between perceived behavioral control and MHPs’ delivery of brief interventions for tobacco treatment. Subjective norms was the strongest predictor of both intentions and the delivery of brief interventions for tobacco treatment highlighting the importance of putting more emphasis on subjective norms when designing interventions to enhance MHPs’ delivery of tobacco treatment in this sample of MHPs. Marital status and disciplinary group were also found to significantly predict MHPs’ intentions to deliver tobacco treatment.

Findings from this study provide useful information to guide the development of better strategies to enhance MHPs’ delivery of tobacco treatment in mental health settings. The study results also expand knowledge on current implementation of evidence-based tobacco treatment interventions in mental health settings, the nature of those interventions, and factors that facilitate or hinder MHPs’ delivery of tobacco treatment to clients with MI. This knowledge may be useful in guiding tobacco treatment interventions in mental health settings to reduce the disparity in tobacco use and related burden in this vulnerable population, and to facilitate further research in this area.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2021.112

Included in

Social Work Commons

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