A statewide initiative to train behavioral health providers in smoking cessation.

Abstract

Individuals with mental health and substance use disorders smoke at rates two to four times higher than the general population and account for over half of smoking-related deaths. Building capacity of behavioral health providers to provide smoking cessation treatment may decrease smoking prevalence in these groups. The present study evaluated a statewide rollout of a capacity building training program to teach behavioral health providers to deliver a manualized smoking cessation group intervention for patients with mental health and substance use disorders. Behavioral health treatment providers (N = 333) participated in a day-long training. Pretraining and posttraining evaluations were conducted on the day of training to assess changes in confidence, attitudes, and knowledge regarding smoking cessation and possible barriers to implementing the smoking cessation curriculum in treatment programs. These constructs were reassessed in follow-up surveys conducted online 2 and 6 months posttraining. A subset of providers participated in follow-up telephone calls to discuss implementation of smoking cessation programming. Posttraining evaluations indicated that trainees' confidence, attitudes, and knowledge of smoking interventions improved. Follow-up surveys indicated that these gains decreased but were maintained above baseline. Over one-half of survey respondents reported taking at least one implementation step. Interviewees reported that agency and staff-level barriers such as difficulty coordinating a group, staff turnover, and inadequate time with clients precluded more widespread implementation. Training for behavioral health providers is effective in improving confidence, attitudes, and knowledge regarding smoking cessation interventions. Consistent implementation requires ongoing support and agency problem solving to address common barriers.