Online Program

Systematic design of patient and staff smoking cessation processes at state operated substance abuse facilities in North Carolina

Wednesday, November 6, 2013 : 12:30 p.m. - 12:50 p.m.

Rohit Ramaswamy, PhD, MPH, Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Cheryll Lesneski, DrPH, Public Health Leadership Program, UNC Gillings School of Global Public Health, Chapel Hill, NC
Susan Saik, MD, Division of State Operated Healthcare Facilities, NC Dept. of Health and Human Services, Raleigh, NC
Tamara Atkinson, R.J.Blackley Alcohol and Drug Treatment Center, Butner, NC
Cecilee Steinmetz, BSBA, University of North Carolina, Chapel Hill, Chapel Hill, NC
The paper describes the approach and results from an innovative implementation science project to help residents and staff at three inpatient Alcohol and Drug Treatment Centers(ADATC) in North Carolina accomplish and sustain a smoke-free lifestyle. 81% of individuals served by these facilities reported tobacco use. North Carolina is establishing regulations for state mental health facilities to become smoke free campuses in 2013. Integration of smoking cessation programs into addiction treatment faces three barriers: (a) substance abuse treatment professionals do not consider smoking cessation important;(b) no time to integrate smoking cessation activities into addiction treatment programs and(c)not enough staff with smoking cessation counseling skills. The first barrier is no longer an option due to the impending regulations. Our approach addresses the remaining two barriers and consists of three steps. First, we train health care providers in ALL three ADATCs on smoking cessation interventions. Next, we train selected staff in ONE facility in process design and continuous quality improvement. Finally, we work with a team of clinicians and administrators in the target facility to develop and test processes to integrate smoking cessation into existing addiction treatment protocols without reducing the quality. The effectiveness of this approach is assessed by comparing this facility's achievement of Joint Commission smoking cessation metrics with one of the other facilities acting as a control site. The output of this project is an Ā“implementation guideĀ” that will be used to systematically implement smoking cessation program in other alcohol and drug treatment facilities in North Carolina and beyond.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Design a smoking cessation program that is integrated into the alcohol and drug addiction treatment programs already offered by state operated facilities. Demonstrate how a design and continuous quality improvement approach can be used to systematically implement evidence-based smoking cessation interventions within existing treatment contexts. Evaluate the effectiveness of these methods in achieving smoking cessation outcomes for a vulnerable population in North Carolina.

Keyword(s): Smoking Cessation, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator for this project and the lead author for the grant proposal funding this work. I have a background in implementation research and continuous quality improvement which are the key approaches used and tested for this project. Training service providers is also an important component and I run UNC SPH's Center for Global Learning which will provide the distance learning expertise for designing a customized training program for health professionals.
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.