Need. Tobacco use is causally linked to 17 different cancers, as well as heart disease, stroke, and chronic obstructive lung diseases. Thus, addressing tobacco use is critical to cancer prevention in Texas. Population-level tobacco control initiatives have been successful at reducing smoking rates overall; however, equivalent reductions are not being experienced among individuals with behavioral health (e.g., mental and substance use) needs. Consequently, cancer incidence is also elevated in this group. Evidence-based practices (EBPs) known to be effective in reducing tobacco use include enforced tobacco-free work environments, education initiatives for all employees, specialized training on...
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Need. Tobacco use is causally linked to 17 different cancers, as well as heart disease, stroke, and chronic obstructive lung diseases. Thus, addressing tobacco use is critical to cancer prevention in Texas. Population-level tobacco control initiatives have been successful at reducing smoking rates overall; however, equivalent reductions are not being experienced among individuals with behavioral health (e.g., mental and substance use) needs. Consequently, cancer incidence is also elevated in this group. Evidence-based practices (EBPs) known to be effective in reducing tobacco use include enforced tobacco-free work environments, education initiatives for all employees, specialized training on tobacco cessation interventions, and community-level outreach. Unfortunately, there is a known research-to-practice gap in the adoption of EBPs for tobacco cessation in behavioral health treatment settings, creating a need for the implementation and sustainment of comprehensive tobacco-free workplace programming that includes attention to aforementioned EBPs. Taking Texas Tobacco Free (TTTF) is a successful, evidence-based comprehensive tobacco-free workplace program for cancer prevention that has been implemented in behavioral health settings across more than half of Texas through PP130032, PP160081, and PP170070. A cornerstone of TTTF implementation has been the provision of education on each core program component to all staff and clinicians at participating agencies, which has been associated with significant knowledge gains: the mechanism underlying the changes in staff and clinician behaviors addressing tobacco use among the clients in their care. In PP200051, we propose to disseminate and implement a TTTF evidence-based tobacco control training curriculum that will facilitate long-term, competent, center-led delivery of staff and clinician education about EBPs for tobacco control in these settings through new employee, annual, and in-service training events, which will ensure that embedded expertise on EBPs for tobacco control is not jeopardized over time through staff turnover. Responsiveness to CPRIT priorities include: 1) it is an interdisciplinary project; 2) it is a collaborative project between nonprofit entities; 3) it is a project to eliminate tobacco use to reduce new cases and deaths from tobacco-related cancers; and 4) it will strengthen the health care system infrastructure by supporting the delivery of the most appropriate evidence-based cancer prevention interventions with 5) reach to rural and medically underserved populations. Overall Project Strategy. The overall goal is to increase the reach and effectiveness of TTTF through development of a curriculum and training program for behavioral health treatment setting program champions that, through its dissemination and implementation, will facilitate and increase the delivery of ongoing center-led education about EBPs for tobacco control into the foreseeable future. Active and passive dissemination strategies will include a step-by-step implementation/replication guide and toolkit with training and teaching resources, social media program promotion and wide availability on our website, and hands-on technical assistance. Implementation will occur in phases that include exploration through formative evaluation, organizational preparation, active program implementation, and sustainment. Iterative stakeholder feedback will guide implementation. Specific Goals. PP200051 has 3 primary goals: 1) adapt the TTTF education/training materials on EBPs for tobacco control into a scaled-out full curriculum to increase capacity to facilitate sustainable, competent, center-led education in behavioral health settings to address the problem of tobacco use and dependence among individuals with behavioral health needs; 2) execute and evaluate an active implementation within >/=2 behavioral health agencies (comprising multiple centers and including multiple employees) to fully inform the dissemination products (e.g., step-by-step implementation/replication guide with teaching tips; coaching and rating materials) to reflect setting-specific considerations, barriers, and solutions; and 3) passively and actively disseminate the adapted TTTF educational/training curriculum to interested stakeholders across the state, including non-participating behavioral health agencies (i.e., those not actively participating in Goal 2), the public at large, and academic audiences. Significance and Impact. PP200051 will increase the sustainment of EBPs for tobacco control in participating behavioral health treatment settings and will facilitate center-led uptake of the program among non-participants in PP200051. Ultimately, the sustained implementation of EPBs in behavioral health treatment centers will lead to cumulative decreases in tobacco smoke exposure and increased tobacco quit rates, which will reduce the incidence of tobacco-related cancers among Texans.
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