Building capacity for cessation services in primary care settings; A health systems approach

Beginning in January, 2007, the Hawaii Primary Care Association (HPCA) entered into a 3 year collaborative agreement with the Cancer Research Center of Hawaii and the National Cancer Institute's Cancer Information Service, Pacific Region, to establish a Primary Care Tobacco Cessation Network among all of Hawaii's 13 Federally Qualified Health Centers (FQHCs). The intent of the network is to promote the use and evaluation of evidence-based approaches to tobacco cessation in FQHCs statewide. This three year project is funded by the Hawaii Tobacco Trust Fund, with year one devoted to conducting a statewide needs assessment of the capacity of each FQHC to provide tobacco cessation programs and services. The needs assessment utilized a health systems approach, and investigated various aspects of cessation services at FQHCs including: workforce training, marketing and service utilization, use of pharmacological therapy, reimbursement issues, counseling and referral services, collaboration, and evaluation. Furthermore, a Primary Care Tobacco Cessation Advisory Group (PCTCAG) was formed under HPCA leadership at the beginning of the project, comprised of representatives from each FQHC. The goal of this group was to determine from the results of the needs assessment the action plan for Years 2 and 3. Outcomes for this project to date have included the creation of a tobacco cessation resource directory on the HPCA website through which each FQHC can access a variety of resources and tools. An expected long term outcome is the formulation of policy recommendations which HPCA can use for future advocacy on behalf of the FQHCs.