"We Need Your Help": Implementing an Assurance Model for Tobacco Cessation Delivery to Increase Program Reach and Diversity

Issues: This presentation illustrates how a large local health department (LHD) redesigned its tobacco cessation delivery model as funding decreased. LHD consistently achieves completion rates over 50% for cessation delivery. However, the program struggled with logistical problems, staff shortages, and ineffective reach into populations with higher smoking rates; residents from zip codes with persistently poor health outcomes were no longer attending. Once the LHD could no longer offer free nicotine replacement therapy (NRT), participation also decreased.  

Description: In response to these challenges tobacco program staff created a cost-effective delivery model that relies on assurance and support for community partners rather than only direct provision of services. This model was originally developed to improve outreach for disparate populations, but proved so successful it was adopted for the entire cessation program of this large LHD. By the end of 2014 the agency will have supported cessation programs targeting LGBT, individuals with chronic mental illness, substance users, African Americans, and patients of medical missions.  All of these interventions are being delivered in areas that do not typically receive health services.

Lessons Learned: This LHD’s cessation program continues to prosper even with fewer resources; the new approach is malleable and dynamic, and changes with each session to best meet the needs of the community. The eventual goal is to make this tobacco program self-supporting as it expands to include on-site, employer-provided cessation. The presentation includes data on money saved, cessation outcomes and follow-up data of participants, quality assurance, and recommendations for future directions.