197079 Instituting Change in a Large HMO: Tobacco Cessation

Monday, November 9, 2009

Denise G. Schaefer, MPH, RD, CHES , Regional Health Education, Kaiser Permanente, Pasadena, CA
Cynthia A. Beaulieu, MPH, CHES , Regional Health Education, Kaiser Permanente, Pasadena, CA
Purpose: Discuss the experience of a large HMO in integrating a comprehensive approach that facilitates lifestyle behavior change using tobacco cessation as a model.

Background: Tobacco remains the leading cause of death in the United States (American Lung Association, 2005). Kaiser Permanente Southern California sought to increase the number of members who quit smoking. Utilizing the knowledge of Adult Learning Theory, Stages of Change, and Social Learning Theory, a multifaceted approach was created to facilitate behavior change through physician intervention, integration of a variety of health education resources, partnership with the health care team, and integration into electronic systems. The model addresses barriers to implementation common to large organizations.

Method: The model includes ten elements to facilitate organizational commitment and integration of tobacco cessation: (1) evidence-based interventions, (2) organizational readiness and support, (3) passionate champions, (4) quality education resources, (5) employees/physicians to model desired behavior, (6) integration into systems, (7) integration into operations, (8) communication strategies, (9) performance metrics, and (10) evaluation/lessons learned.

Results: Although knowledge and resources are essential to behavior change, it is critical to embed awareness and access to services through the patients' experience. The presentation will discuss the elements of the model, the cyclical nature of the model, and the model's influence in improving impact and outcomes.

Learning Objectives:
1. Identify ten elements of a comprehensive model to increase organizational commitment to integrate lifestyle change to their clients. 2. Discuss learnings and expansion of the use of the model to create an easy path for promoting other lifestyle behaviors, such as exercise, in a comprehensive and integrated way.

Keywords: Health Care Managed Care, Change

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Regional Director, Health Education for Kaiser Permanente, Southern California, I lead and direct this health promotion initiative for the organizaition.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.