<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03040349</url>
  </required_header>
  <id_info>
    <org_study_id>ELKE4599</org_study_id>
    <nct_id>NCT03040349</nct_id>
  </id_info>
  <brief_title>Tobacco Treatment TrAining Network in Greece &amp; Cyprus</brief_title>
  <acronym>TiTAN</acronym>
  <official_title>Evaluation of the Primary Care Tobacco Treatment TrAining Network in Greece &amp; Cyprus</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Crete</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Ottawa Heart Institute Research Corporation</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Aristotle University Of Thessaloniki</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Global Bridges Healthcare Alliance for Tobacco Dependence Treatment (Mayo Clinic)</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>University of Ioannina</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>University of Nicosia</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Pfizer Grants for Learning and Change</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>University of Crete</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The overall aim of the TiTAN Greece &amp; Cyprus project is to expand the Global Bridges Tobacco&#xD;
      Treatment Training Network in the WHO Europe region through a focus on primary health care&#xD;
      providers in Greece and Cyprus. A robust evaluation will be conducted alongside the TiTAN&#xD;
      program. A pre-post evaluation will be used to examine the impact on the TiTAN program on:&#xD;
&#xD;
        1. Provider engagement (number of providers attending training), number of local champions;&#xD;
&#xD;
        2. Provider knowledge, beliefs, perceived behavioral control, and intentions related to the&#xD;
           delivery of tobacco treatment;&#xD;
&#xD;
        3. Rates of evidence-based tobacco treatments (5As) are delivered to patients who smoke;&#xD;
&#xD;
        4. Provider satisfaction with training program, resources, and network outreach activity&#xD;
           and areas for improvement; and&#xD;
&#xD;
        5. Estimates on the impact on patient-level outcomes including number of patient quit&#xD;
           smoking at 1 and 3-month follow-up.&#xD;
&#xD;
      All PHC providers will be surveyed before and after the intervention program is delivered. We&#xD;
      will randomly select a sub-sample of providers and will survey patients from their practice&#xD;
      before and after the intervention program in order to validate changes in 5As delivery.&#xD;
      Qualitative interviews will be completed with a sub-sample of providers at the end of year 1.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Design The evaluation design schema is presented in Appendix B. A pre-post evaluation design&#xD;
      will be used. All PHC providers will be surveyed before, immediately following the training&#xD;
      session and 3-months after the intervention program is delivered. Additionally, a random&#xD;
      sample of providers will be identified from which a cross-sectional sample of eligible&#xD;
      smokers from their practice will be surveyed pre- and post-intervention to assess provider&#xD;
      performance in the delivery of 5As tobacco treatment intervention. Qualitative interviews&#xD;
      will be completed with a sub-sample of providers at the end of year 1.&#xD;
&#xD;
      Procedures&#xD;
&#xD;
      Provider Recruitment An invitation letter will be sent to all GPs and other PHC providers in&#xD;
      the target region. We will include both GPs working in private and public practices in the&#xD;
      target region. A follow-up phone call will be placed to all providers by a member of the&#xD;
      investigative team, one week after the invitation was sent to confirm interest in&#xD;
      participation. We will aim to reach all providers with a minimum of three attempts being made&#xD;
      to reach all providers before classifying them as &quot;unable to contact&quot;. Participating&#xD;
      providers will sign an information sheet and consent form.&#xD;
&#xD;
      Provider Pre- and Post-Assessment Survey All participating providers will a complete a survey&#xD;
      prior to the foundational training (Time 1) which will assess demographic variables and&#xD;
      outcomes of interest. Immediately following the training (Time 2) and 3-months following the&#xD;
      training (Time 3), providers will complete follow-up surveys which will re-assess outcomes of&#xD;
      interest and satisfaction with the intervention program.&#xD;
&#xD;
      Semi-structured interviews will be conducted with 10 PHC providers at the end of year 1 in&#xD;
      order to inform year 2 activities. Providers will be asked to self-identify and will be drawn&#xD;
      from all sub-regions. These interviews will be conducted by a trained team member and will be&#xD;
      recorded. Key themes will be identified and extracted.&#xD;
&#xD;
      Additionally in order to gain an overall picture of the number of initial and consultations&#xD;
      for smoking cessation made by participating providers, we will collect information on basic&#xD;
      activities for a 1-year period following the introduction of the training program. A contact&#xD;
      log has been created which can be used prospectively by providers and or used retrospectively&#xD;
      (ie. chart audit).&#xD;
&#xD;
      Patient-Level Sampling In order to gather information about rates of 5As delivery, a&#xD;
      sub-sample of 20 GPs will be randomly selected for patient level data collection. From the&#xD;
      sub-sample of randomly selected providers, 16 eligible patients will be recruited before&#xD;
      (time 1) and after (time 2) intervention delivery.&#xD;
&#xD;
      Patient-level data collection will be limited to GPs as other health care professionals are&#xD;
      likely working alongside the GPs as opposed to a separate practice. Provider eligibility for&#xD;
      the patient-level evaluation will include:&#xD;
&#xD;
        1. is a GP working in a public or private primary care practice setting;&#xD;
&#xD;
        2. participation in TiTAN training program;&#xD;
&#xD;
        3. GP has not participated in other smoking cessation training in the previous 2-3 years;&#xD;
&#xD;
        4. sees a minimum of 15 patients per day seen in the practice in order to ensure efficient&#xD;
           use of data collection resources; and,&#xD;
&#xD;
        5. located within a reasonable distance from where the training will take place in order to&#xD;
           minimize costs associated with travel.&#xD;
&#xD;
      Randomization and Informed Consent Randomization will be stratified by region involved in the&#xD;
      present study (Crete, Athens, Ioannina, Thessaloniki, Cyprus) and type of practice&#xD;
      (private/public) and years of experience. An independent third party researcher will randomly&#xD;
      select GPs from the recruitment list provided for inclusion in the present study. GPs&#xD;
      selected for participation in the patient-level sampling will be informed via telephone and&#xD;
      asked to sign an informed consent for this component of the study.&#xD;
&#xD;
      Patient Pre-Post Data Collection The pre-intervention assessment will be conducted prior to&#xD;
      implementing the intervention program to establish baseline activities of the practice.&#xD;
      During the screening period, a research assistant will be located in the clinic waiting room.&#xD;
      The research assistant will screen consecutive patients scheduled for an annual exam or&#xD;
      non-urgent appointment for eligibility using the study screening form.&#xD;
&#xD;
      Recruitment statistics will be recorded using the recruitment tracking sheet]in order to&#xD;
      calculate prevalence of tobacco use (total number of tobacco users/total number of patients),&#xD;
      reasons for ineligibility and reasons for non-participation.&#xD;
&#xD;
      Eligible patients who agree to participate in the study will review and sign the study&#xD;
      information sheet and consent form and contact sheet with the Research Assistant.&#xD;
      Participants will be tracked using the study master list and will be assigned a study ID.&#xD;
      Only the study ID will be included on the study survey. Consenting patients will then be&#xD;
      given the exit survey to complete at the end of the their visit with their primary care&#xD;
      provider. The survey will collect information about whether their physician or another&#xD;
      clinician asked about their smoking status (ask); advised them to quit smoking (advise); and&#xD;
      provided cessation assistance (assist). The exit survey will also gather socio-demographic&#xD;
      and smoking history, beliefs, and intentions.&#xD;
&#xD;
      The post-intervention assessment will involve the collection of data from a second&#xD;
      cross-sectional sample of 16 patients approximately 3-months following the implementation of&#xD;
      the intervention within the practice. The methods described in the pre-intervention&#xD;
      assessment will be repeated at the post-assessment.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date type="Anticipated">February 2017</start_date>
  <completion_date type="Anticipated">December 2019</completion_date>
  <primary_completion_date type="Anticipated">September 2019</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>N/A</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Provider Performance in the Delivery of Cessation Treatments assessed via patient exit survey</measure>
    <time_frame>Change between pre-intervention and post intervention (3-months)</time_frame>
    <description>Performance in the delivery of each of the 5As will be assessed via exit interview with eligible patients. The survey will ask participants to respond either &quot;yes&quot; or &quot;no&quot; or &quot;don't know&quot; regarding whether their PHC provider asked them about their smoking status (ask); advised them to quit smoking (advise); assessed their readiness to quit (assess); provided assistance with quitting (assist); prescribed pharmacotherapy, provided self-help materials, and arranged follow-up support</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Provider Self-efficacy assessed by questionnaire</measure>
    <time_frame>Change between pre-intervention and post-training (1-month)</time_frame>
    <description>Provider self-efficacy will be assessed before and after the intervention</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Provider knowledge assessed by questionnaire</measure>
    <time_frame>Change between pre-intervention and post intervention (3-months)</time_frame>
    <description>Provider knowledge of evidence-based tobacco treatment guidelines will be assessed using a brief 15-item knowledge assessment to examine key concepts addressed as part of training. The knowledge assessment has been tested as part of the TiTAN Crte project.</description>
  </secondary_outcome>
  <number_of_arms>1</number_of_arms>
  <enrollment type="Anticipated">300</enrollment>
  <condition>Tobacco Use</condition>
  <arm_group>
    <arm_group_label>TiTAN Intervention</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>The TiTAN Crete program has adapted the existing curricula and resources originally developed at the University of Ottawa Heart Institute and which are specific to primary practice settings. To facilitate maximum uptake the intervention program was adapted to reflect: language; cultural appropriateness; local patient beliefs and attitudes regarding tobacco-use and cessation; local social and clinical norms; provider perceptions surrounding 5As delivery; and, practice characteristics. The TiTAN multi-component training includes: 1) a 1-day foundational tobacco treatment training program for general practitioners, 2) the dissemination of provider and patient tools, and 3) E-blasts and webinars to supplement skills development and continuing medical education through e-learning.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Training</intervention_name>
    <description>The training program consists of a one-day core session addressing tobacco use with patients in the context of a busy primary care practice setting.The curriculum design was designed to be 2/3 theory and 1/3 practical. The program employs teaching techniques including role-play and case-study approaches known to enhance practice change.</description>
    <arm_group_label>TiTAN Intervention</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Provider and Patient Tools</intervention_name>
    <description>Provider and patient tools were translated and adapted for use in primary care settings in Greece. A tool kit of resources will be distributed to providers which includes: patient tobacco use survey; provider consult form; provider medication reference sheet; patient quit plan booklet; and, waiting room posters. The provider consult form uses a checklist style set-up and provides real-time reminders for conducting an initial smoking cessation visit and follow-up appointments. The TiTAN Crete tools are available online at www.titan.uoc.gr</description>
    <arm_group_label>TiTAN Intervention</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>E-blast and Webinars</intervention_name>
    <description>In order to develop the network and continue to provide training opportunities for skills development we will develop a communication platform via an email list-serv to proactively communicate with providers who participate in the TiTAN program. A quarterly e-blast will be sent to all health care professionals involved in the TiTAN program. The e-blast will address the latest evidence-base practice, and skill development. Links to videos will also be provided. A webinar series will be scheduled to cover topics identified as interest by the primary health care providers. The webinar series will also be linked the Global Bridges EPACTT project.</description>
    <arm_group_label>TiTAN Intervention</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  • are a current smoker (&gt;5 cigarette per day on most days of the week);&#xD;
&#xD;
               -  are 18 years of age or older;&#xD;
&#xD;
               -  are scheduled for an annual exam or non-urgent medical appointment at the primary&#xD;
                  care clinic;&#xD;
&#xD;
               -  are able to read and/or understand Greek; and,&#xD;
&#xD;
               -  have the mental capacity to provide informed consent and complete study&#xD;
                  protocols.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  n/a&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Christos Lionis, MD, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of Crete</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Christos Lionis</last_name>
    <phone>302810394621</phone>
    <email>lionis@uoc.gr</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Sophia Papadakis</last_name>
    <phone>306982551782</phone>
    <email>sophiapapadakis@gmail.com</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>University of Crete</name>
      <address>
        <city>Heraklion</city>
        <state>Crete</state>
        <zip>71500</zip>
        <country>Greece</country>
      </address>
    </facility>
    <contact>
      <last_name>Christos Lionis, MD, PhD</last_name>
      <email>lionis@uoc.gr</email>
    </contact>
    <contact_backup>
      <last_name>Sophia Papadakis, PhD</last_name>
      <phone>306982551782</phone>
      <email>sophia.papadakis@gmail.com</email>
    </contact_backup>
    <investigator>
      <last_name>Christos Lionis, MD, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Sophia Papadakis, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Constantine Vardavas, MD, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>George Samoutis, MD, PhD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Andrew Pipe, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Athina Tatsioni, MD, PhD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Emmanuel Smyrnakis, MD, PhD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Greece</country>
  </location_countries>
  <verification_date>January 2017</verification_date>
  <study_first_submitted>January 30, 2017</study_first_submitted>
  <study_first_submitted_qc>January 31, 2017</study_first_submitted_qc>
  <study_first_posted type="Estimate">February 2, 2017</study_first_posted>
  <last_update_submitted>January 31, 2017</last_update_submitted>
  <last_update_submitted_qc>January 31, 2017</last_update_submitted_qc>
  <last_update_posted type="Estimate">February 2, 2017</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University of Crete</investigator_affiliation>
    <investigator_full_name>Christor Lionis</investigator_full_name>
    <investigator_title>Professor, Clinic of Social and Family Medicine, Dept Medicine</investigator_title>
  </responsible_party>
  <keyword>primary care</keyword>
  <keyword>greece</keyword>
  <keyword>cyprus</keyword>
  <keyword>tobacco use treatment</keyword>
  <keyword>evidence-based guidelines</keyword>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03040349
org study id: ELKE4599
nct id: NCT03040349
lead sponsor: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The overall aim of the TiTAN Greece & Cyprus project is to expand the Global Bridges Tobacco
      Treatment Training Network in the WHO Europe region through a focus on primary health care
      providers in Greece and Cyprus. A robust evaluation will be conducted alongside the TiTAN
      program. A pre-post evaluation will be used to examine the impact on the TiTAN program on:

        1. Provider engagement (number of providers attending training), number of local champions;

        2. Provider knowledge, beliefs, perceived behavioral control, and intentions related to the
           delivery of tobacco treatment;

        3. Rates of evidence-based tobacco treatments (5As) are delivered to patients who smoke;

        4. Provider satisfaction with training program, resources, and network outreach activity
           and areas for improvement; and

        5. Estimates on the impact on patient-level outcomes including number of patient quit
           smoking at 1 and 3-month follow-up.

      All PHC providers will be surveyed before and after the intervention program is delivered. We
      will randomly select a sub-sample of providers and will survey patients from their practice
      before and after the intervention program in order to validate changes in 5As delivery.
      Qualitative interviews will be completed with a sub-sample of providers at the end of year 1.
Design The evaluation design schema is presented in Appendix B. A pre-post evaluation design
      will be used. All PHC providers will be surveyed before, immediately following the training
      session and 3-months after the intervention program is delivered. Additionally, a random
      sample of providers will be identified from which a cross-sectional sample of eligible
      smokers from their practice will be surveyed pre- and post-intervention to assess provider
      performance in the delivery of 5As tobacco treatment intervention. Qualitative interviews
      will be completed with a sub-sample of providers at the end of year 1.

      Procedures

      Provider Recruitment An invitation letter will be sent to all GPs and other PHC providers in
      the target region. We will include both GPs working in private and public practices in the
      target region. A follow-up phone call will be placed to all providers by a member of the
      investigative team, one week after the invitation was sent to confirm interest in
      participation. We will aim to reach all providers with a minimum of three attempts being made
      to reach all providers before classifying them as "unable to contact". Participating
      providers will sign an information sheet and consent form.

      Provider Pre- and Post-Assessment Survey All participating providers will a complete a survey
      prior to the foundational training (Time 1) which will assess demographic variables and
      outcomes of interest. Immediately following the training (Time 2) and 3-months following the
      training (Time 3), providers will complete follow-up surveys which will re-assess outcomes of
      interest and satisfaction with the intervention program.

      Semi-structured interviews will be conducted with 10 PHC providers at the end of year 1 in
      order to inform year 2 activities. Providers will be asked to self-identify and will be drawn
      from all sub-regions. These interviews will be conducted by a trained team member and will be
      recorded. Key themes will be identified and extracted.

      Additionally in order to gain an overall picture of the number of initial and consultations
      for smoking cessation made by participating providers, we will collect information on basic
      activities for a 1-year period following the introduction of the training program. A contact
      log has been created which can be used prospectively by providers and or used retrospectively
      (ie. chart audit).

      Patient-Level Sampling In order to gather information about rates of 5As delivery, a
      sub-sample of 20 GPs will be randomly selected for patient level data collection. From the
      sub-sample of randomly selected providers, 16 eligible patients will be recruited before
      (time 1) and after (time 2) intervention delivery.

      Patient-level data collection will be limited to GPs as other health care professionals are
      likely working alongside the GPs as opposed to a separate practice. Provider eligibility for
      the patient-level evaluation will include:

        1. is a GP working in a public or private primary care practice setting;

        2. participation in TiTAN training program;

        3. GP has not participated in other smoking cessation training in the previous 2-3 years;

        4. sees a minimum of 15 patients per day seen in the practice in order to ensure efficient
           use of data collection resources; and,

        5. located within a reasonable distance from where the training will take place in order to
           minimize costs associated with travel.

      Randomization and Informed Consent Randomization will be stratified by region involved in the
      present study (Crete, Athens, Ioannina, Thessaloniki, Cyprus) and type of practice
      (private/public) and years of experience. An independent third party researcher will randomly
      select GPs from the recruitment list provided for inclusion in the present study. GPs
      selected for participation in the patient-level sampling will be informed via telephone and
      asked to sign an informed consent for this component of the study.

      Patient Pre-Post Data Collection The pre-intervention assessment will be conducted prior to
      implementing the intervention program to establish baseline activities of the practice.
      During the screening period, a research assistant will be located in the clinic waiting room.
      The research assistant will screen consecutive patients scheduled for an annual exam or
      non-urgent appointment for eligibility using the study screening form.

      Recruitment statistics will be recorded using the recruitment tracking sheet]in order to
      calculate prevalence of tobacco use (total number of tobacco users/total number of patients),
      reasons for ineligibility and reasons for non-participation.

      Eligible patients who agree to participate in the study will review and sign the study
      information sheet and consent form and contact sheet with the Research Assistant.
      Participants will be tracked using the study master list and will be assigned a study ID.
      Only the study ID will be included on the study survey. Consenting patients will then be
      given the exit survey to complete at the end of the their visit with their primary care
      provider. The survey will collect information about whether their physician or another
      clinician asked about their smoking status (ask); advised them to quit smoking (advise); and
      provided cessation assistance (assist). The exit survey will also gather socio-demographic
      and smoking history, beliefs, and intentions.

      The post-intervention assessment will involve the collection of data from a second
      cross-sectional sample of 16 patients approximately 3-months following the implementation of
      the intervention within the practice. The methods described in the pre-intervention
      assessment will be repeated at the post-assessment.
allocation: N/A
intervention model: Single Group Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Provider Performance in the Delivery of Cessation Treatments assessed via patient exit survey
time frame: Change between pre-intervention and post intervention (3-months)
description: Performance in the delivery of each of the 5As will be assessed via exit interview with eligible patients. The survey will ask participants to respond either "yes" or "no" or "don't know" regarding whether their PHC provider asked them about their smoking status (ask); advised them to quit smoking (advise); assessed their readiness to quit (assess); provided assistance with quitting (assist); prescribed pharmacotherapy, provided self-help materials, and arranged follow-up support
measure: Provider Self-efficacy assessed by questionnaire
time frame: Change between pre-intervention and post-training (1-month)
description: Provider self-efficacy will be assessed before and after the intervention
measure: Provider knowledge assessed by questionnaire
time frame: Change between pre-intervention and post intervention (3-months)
description: Provider knowledge of evidence-based tobacco treatment guidelines will be assessed using a brief 15-item knowledge assessment to examine key concepts addressed as part of training. The knowledge assessment has been tested as part of the TiTAN Crte project.
arm group label: TiTAN Intervention
arm group type: Experimental
description: The TiTAN Crete program has adapted the existing curricula and resources originally developed at the University of Ottawa Heart Institute and which are specific to primary practice settings. To facilitate maximum uptake the intervention program was adapted to reflect: language; cultural appropriateness; local patient beliefs and attitudes regarding tobacco-use and cessation; local social and clinical norms; provider perceptions surrounding 5As delivery; and, practice characteristics. The TiTAN multi-component training includes: 1) a 1-day foundational tobacco treatment training program for general practitioners, 2) the dissemination of provider and patient tools, and 3) E-blasts and webinars to supplement skills development and continuing medical education through e-learning.
intervention type: Behavioral
intervention name: Training
description: The training program consists of a one-day core session addressing tobacco use with patients in the context of a busy primary care practice setting.The curriculum design was designed to be 2/3 theory and 1/3 practical. The program employs teaching techniques including role-play and case-study approaches known to enhance practice change.
arm group label: TiTAN Intervention
intervention type: Behavioral
intervention name: Provider and Patient Tools
description: Provider and patient tools were translated and adapted for use in primary care settings in Greece. A tool kit of resources will be distributed to providers which includes: patient tobacco use survey; provider consult form; provider medication reference sheet; patient quit plan booklet; and, waiting room posters. The provider consult form uses a checklist style set-up and provides real-time reminders for conducting an initial smoking cessation visit and follow-up appointments. The TiTAN Crete tools are available online at www.titan.uoc.gr
arm group label: TiTAN Intervention
intervention type: Behavioral
intervention name: E-blast and Webinars
description: In order to develop the network and continue to provide training opportunities for skills development we will develop a communication platform via an email list-serv to proactively communicate with providers who participate in the TiTAN program. A quarterly e-blast will be sent to all health care professionals involved in the TiTAN program. The e-blast will address the latest evidence-base practice, and skill development. Links to videos will also be provided. A webinar series will be scheduled to cover topics identified as interest by the primary health care providers. The webinar series will also be linked the Global Bridges EPACTT project.
arm group label: TiTAN Intervention
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Christos Lionis, MD, PhD
role: Principal Investigator
affiliation: University of Crete
last name: Christos Lionis
phone: 302810394621
email: lionis@uoc.gr
last name: Sophia Papadakis
phone: 306982551782
email: sophiapapadakis@gmail.com
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country: Greece
responsible party type: Principal Investigator
investigator affiliation: University of Crete
investigator full name: Christor Lionis
investigator title: Professor, Clinic of Social and Family Medicine, Dept Medicine
sharing ipd: No