Influencing the influencers: Motivating Taft-Hartley Health and Welfare Funds to provide and promote comprehensive tobacco cessation benefits

Background and Objective: Taft-Hartley Health and Welfare Funds administer health insurance plans that provide coverage for approximately 9 million private sector unionized workers in the U.S., plus dependents and retirees. Participants work primarily in blue-collar occupations and smoke at a rate almost twice that of workers in other occupational categories. Most Taft-Hartley Funds do not provide comprehensive coverage for tobacco cessation treatment. This presentation describes a labor community-academic participatory study that tested an intervention to increase the provision and promotion of benefits among Minnesota-based funds. Methods: Tailored outreach was conducted to fund advisors (administrators, consultants, attorneys) of 10 funds (2009-2011). Pre- and post-intervention interviews with advisors examined changes in perceptions about covering and promoting cessation benefits. Pre- and post-intervention data on benefit provision were collected from Summary Plan Documents (SPDs) of Minnesota funds and 19 corresponding funds in Massachusetts and Washington, and compared (2009-2011). SPDs were scored on benefit adequacy, using a 4-point scale derived from CDC evidence-based recommendations. Results: Scores on the 4-point benefit adequacy scale increased from baseline to follow-up for Minnesota (2.2 to 2.8) and the comparison states (0.3 to 0.8); this change was not significantly different between Minnesota and the comparison states. Pre-post comparison of advisors' attitudes indicated that most had acquired knowledge to address cessation benefits from study events, meetings, and materials, and had discussed what they had learned with colleagues and fund trustees. Conclusions: Increased knowledge and positive attitudes about cessation benefits among fund advisors could lead to improvements in benefit coverage and promotion.