Clinician compliance with primary prevention of tobacco use: the impact of social contingencies.

Abstract Background. This study evaluated clinicians' compliance with delivering written advice and information against tobacco use (prevention prescriptions) to adolescent patients. Methods. Clinicians in 77 orthodontic offices were trained (and asked) to provide anti-tobacco counseling and prescriptions to 10- to 18-year-olds for 2 years. Each of eight prescriptions was provided for distribution to adolescent patients. Information concerning prescription-tracking methods and operant learning theory variables such as modeling and feedback was obtained using a cross-sectional interview of clinical staff. The proportion of prescriptions written was regressed on possible “determinants.” Analyses were replicated for two time periods. Results. Mean anti-tobacco prescription compliance was 66 and 73% for two separate time periods. Multiple regression analyses were computed for the first ( R = 0.45, F (7,63) = 2.29, P R = 0.48, F (7,63) = 2.76, P Conclusions. Results suggest that compliance with primary prevention procedures may be influenced by feedback from patients, staff modeling, and formal office tracking information.