GB smoking cessation training for health care providers in LA: midterm confidence in competencies and estimation of population impact

Background Between 2011 and 2016, Global Bridges (GB) in Latin America successfully trained health care providers (HCP) in declarative and procedural knowledge and confidence in competencies (Moore `s level 3A, B and 4). However, a study that explored patients´ reported HCP performance failed to show effect. Methods Cross-sectional study among all trainees between 2011 and 2016. The survey was electronically conducted (Survey Monkey) with 26 questions that explored demography, confidence in skills and practices in smoking cessation. A sample size of 400 individuals was required. Inclusion criteria were: attended at least one day session and a valid email. A mathematical model of impact estimation was developed (subrogate of level 5 of Moore). Abstinence rates for brief advice and intensive intervention of were appraised from Cochrane Review. Results Of 1915 trainees with valid e-mail, 402 surveys were obtained in 2 recruitment rounds. The response rate was different for the two periods 2011-2014 (17%) and 2014-2016 (56%). Countries (Argentina 28%, Uruguay 20% and Mexico 17%) and occupation (physicians 61% and psychologists 18%) were unevenly represented. Among the responses, female gender prevailed (64.7%). 79.4% stated GB training was extremely/very useful and more than 80% expressed to be very confident/ confident to provide SC support. Respondents declared to assist 2.1 smokers per day (CI 1.6-2.6), and to offer brief advice and intensive advice, with or without drugs, in 80% and 69% of cases respectively. The model estimated that 1,564 trainees would have achieved 12,012 quitters with brief advice and 38,788 quitters due to intensive intervention in the following year after training, in the worst case scenario (lower CI). Conclusions GB´s SC program in Latin America exhibited to maintain trainees´ confidence in competences in the medium term and to return at least 50,800 quitters in the following year of the educational intervention.