TY - JOUR
T1 - Multimethod Formative Research to Improve the Training and Delivery of Tobacco-cessation Interventions in Behavioral Health Settings
AU - Allen, Alicia Marie
AU - Muramoto, Myra L.
AU - Campbell, Jean
AU - Connolly, Timothy E.
AU - McGuffin, Beverly A.
AU - Bernstein, Andrew D.
N1 - Publisher Copyright:
© 2019 American Society of Addiction Medicine. Unauthorized reproduction of this article is prohibited.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Introduction:Despite progress in reducing tobacco use within the general population, high prevalence of tobacco use continues in individuals with mental health and substance use disorders ("clients"). Tobacco use persists as the leading cause of premature mortality in this population. While behavioral health providers have frequent contacts with this population, they lack training in tobacco cessation counseling. Methods: We conducted multimethod formative data collection consisting of key informant interviews with providers, field observations at clinical sites, and structured group interviews with behavioral health providers, and, separately, clients. Activities were conducted at 4 behavioral health agencies with 9 behavioral health clinic sites in southern Arizona. Recurring phrases and level of repetition were quantified to identify themes. These themes were then used to adapt the method of training delivery and revise the curriculum content for providers at the participating sites. Results: Results indicated that providers had "training fatigue" and low satisfaction with multiple, online trainings. Further, providers noted issues including time constraints, competing clinical priorities, and low access to tobacco-cessation materials. Clients demonstrated high self-awareness around the importance of quitting smoking and professed frustration at being unable to quit, despite multiple attempts. Finally, both providers and clients agreed that a personal, supportive approach to cessation counseling was preferred. Conclusions: Using results from this formative research to revise delivery and content of existing smoking-cessation training for behavioral health providers may address barriers to assisting clients with smoking cessation. Additional research to determine the efficacy of the adapted training is needed.
AB - Introduction:Despite progress in reducing tobacco use within the general population, high prevalence of tobacco use continues in individuals with mental health and substance use disorders ("clients"). Tobacco use persists as the leading cause of premature mortality in this population. While behavioral health providers have frequent contacts with this population, they lack training in tobacco cessation counseling. Methods: We conducted multimethod formative data collection consisting of key informant interviews with providers, field observations at clinical sites, and structured group interviews with behavioral health providers, and, separately, clients. Activities were conducted at 4 behavioral health agencies with 9 behavioral health clinic sites in southern Arizona. Recurring phrases and level of repetition were quantified to identify themes. These themes were then used to adapt the method of training delivery and revise the curriculum content for providers at the participating sites. Results: Results indicated that providers had "training fatigue" and low satisfaction with multiple, online trainings. Further, providers noted issues including time constraints, competing clinical priorities, and low access to tobacco-cessation materials. Clients demonstrated high self-awareness around the importance of quitting smoking and professed frustration at being unable to quit, despite multiple attempts. Finally, both providers and clients agreed that a personal, supportive approach to cessation counseling was preferred. Conclusions: Using results from this formative research to revise delivery and content of existing smoking-cessation training for behavioral health providers may address barriers to assisting clients with smoking cessation. Additional research to determine the efficacy of the adapted training is needed.
KW - behavioral health
KW - formative research
KW - providers
KW - qualitative data
KW - smoking cessation
KW - substance use
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U2 - 10.1097/ADM.0000000000000522
DO - 10.1097/ADM.0000000000000522
M3 - Article
C2 - 30908345
AN - SCOPUS:85074552551
SN - 1932-0620
VL - 13
SP - 470
EP - 475
JO - Journal of addiction medicine
JF - Journal of addiction medicine
IS - 6
ER -