Abstract
Smoking prevalence among individuals with mental and behavioral health needs is considerably higher compared to the general population, but evidence-based smoking cessation therapies are underutilized in mental and behavioral healthcare settings, despite the fact that these treatments are both safe and effective. The goal of this paper is to present the background, design and pilot of Project TEACH (Tobacco Education and Cessation in the Health System) developed to improve clinical practice by offering specialized training in the provision of smoking cessation interventions to care providers in community mental health centers in Texas. This is achieved through engaging the expertise of clinicians at the MD Anderson Cancer Center’s Tobacco Treatment Program and disseminating this expertise to care providers by means of a novel tele-mentoring approach called Project ECHO (Extension for Community Healthcare Outcomes). Evaluation of our pilot ECHO training project demonstrated that the training was very well received and resulted in self-reported enhancement of the providers’ professional practice. This is the first project to extend the collaborative ECHO model to train healthcare providers in smoking cessation. This approach has potential to reduce smoking rates among smokers with mental and behavioral health needs, and consequently contribute to the prevention of cancer and other chronic diseases in this vulnerable population.
Highlights
The goal of this paper is to present the background, design and pilot of a project developed to improve clinical practice related to smoking cessation in community mental and behavioral healthcare settings
Smoking rates increase with severity of mental illness and may be as high as 64–79% among individuals with serious mental illness (SMI), defined as a mental, behavioral or emotional disorder that meets diagnostic criteria specified in the Diagnostic and Statistical Manual and results in serious functional impairment (Annamalai, Singh, & O’Malley, 2015; Evins & Cather, 2015; McClave, McKnight-Eily, Davis, & Dube, 2010; Roberts, Evins, McNeill, & Robson, 2016)
The importance of Project TEACH lies in the dissemination and implementation of evidence-based clinical practice for smoking cessation which had already been researched elsewhere and proven to be effective
Summary
The goal of this paper is to present the background, design and pilot of a project developed to improve clinical practice related to smoking cessation in community mental and behavioral healthcare settings. Considering the complex association between tobacco dependence and psychiatric disorders, many clinical providers who work in mental and behavioral healthcare settings lack the necessary training and experience in smoking assessment and cessation interventions for their target population (AAMC, 2007; Hall & Prochaska, 2009; Himelhoch et al, 2014) These providers report low levels of confidence in their ability to counsel and help smokers to quit (Himelhoch et al, 2014).
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