Web-Based Training to Expand the Reach of Brief Tobacco Interventions

Background: Tobacco cessation brief interventions (BIs) are low cost and effective for increasing quit attempts and quit rates. However, training to conduct BIs has been offered almost exclusively to health care professionals, limiting their potential reach into communities. Methods: This novel randomized, controlled trial compares the effectiveness of two training modalities (Web-based (WBT) and in-person classroom (IP)) for teaching brief intervention skills to “health influencers” (HIs), community members expressing an interest in helping tobacco users quit. This study also examines the cost effectiveness of each training modality. Results: Findings support the assertion that when comparable instructional methods are used, a WBT curriculum can be as effective as an IP condition. Approximately 70% of participants, across conditions, reported conducting brief interventions in the past 90 days, and the mean number of interventions delivered during that period was high (8 in the IPT group and 12 in the WBT group). However, attrition of participants may diminish the apparent effectiveness of WBT, even when the comparability of instructional outcomes is demonstrated. Cost comparisons between the two modalities indicate that at scale (i.e. training 5,000 or more participants), Web-based training is less costly per person trained, and per person “activated” (i.e. those who report intervening), and per brief intervention conducted. Conclusions: Training Health Influencers to deliver BIs can be accomplished through in-person or web-based training. The cost of offering web-based training offers a clear advantage at scale; however, training preference and the needs of diverse populations suggests an ongoing role for in-person training.