247258 Lessons learned from implementing the PHS Tobacco Guideline: Defining a practical Implementation Process Model with micro-level strategies for individual clinics

Monday, October 31, 2011

Susan Sanders, MSA , U.S. Department of Health and Human Services, Office on Women's Health, Washington, DC
The U.S. Department of Health and Human Services, Office on Women's Health (OWH), convened Federal partners to implement the Public Health Service's Treating Tobacco Use and Dependence: 2008 Update (the Guideline) for women of childbearing age in underserved clinics. Initial project results identified practical steps and micro-level strategies to help improve success in Guideline implementation in individual clinics. OWH summarized the steps and strategies into an Implementation Process Model, which offers multiple practical details and examples that any clinic can use. The Guideline recommends interventions for tobacco cessation and discusses systems change strategies. Phase 1 of the OWH project implemented the Guideline in twenty Clinical Collaboratives from the Indian Health Service and Health Resources and Services Administration. Focus groups with provider and administrative clinical personnel identified lessons learned, including the need to establish a culture of tobacco awareness and cessation in individual clinics. To develop such a culture and ensure success in Guideline implementation, project participants had to address barriers and identify micro-level systems change strategies for their individual clinics. Derived from the lessons learned, the Model includes practical “how-to” information about: • Assessing current status; • Identifying champion/leader(s); • Planning data collection and evaluation; • Determining funding/reimbursement; • Formulating policies and internal links; • Establishing external linkages; • Providing training; • Delivering interventions; and • Assessing and evaluating the program.

Although the OWH project focused on underserved women, the Model can apply to an entire clinic, including all patients.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs

Learning Objectives:
1. Describe the PHS Tobacco Clinical Practice Guideline interventions and systems change strategies. 2. Explain the components of the micro-level Implementation Process Model for employing the PHS Guideline in an individual clinic. 3. List at least three micro-level strategies for implementing each component of the Model in an individual clinic.

Keywords: Tobacco, Public Health Careers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Public Health Advisor and Coordinator of a Federal InterAgency Committee on Tobacco and Young, Low-SES Women. Program Manager of two clinical demonstration projects implemented in selected Federally-funded Indian Health Services and HRSA clinics across the country. Focus of the demonstration projects included: Tobacco cessation intervention by clinical staff and administrators using the PHS Guideline as the method of tobacco cessation intervention, to establish a culture of tobacco awareness and cessation in the participating clinics, and to use lessons learned from the demonstration project to establish a Process Model that can be implemented in all public health clinics.
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.