Promoting Statewide Quality Improvement in Tobacco Use Prevention Through Longitudinal Health Promotion Training for Tennessee County Health Departments

Abstract

Professional development in health promotion is fundamental to conduct effective multiyear community-based health promotion programs to address tobacco use. Provided with $15 million over 3 years in new resources from the United States’ Master Tobacco Settlement Agreement, the Tennessee Department of Health organized a longitudinal staff development effort for 95 county health departments using an experiential pedagogy. Through statewide WORKshops, standardized plans, electronic reporting, use of logic modeling, social and behavior theory, and public health terminology were introduced and emphasized. A summative county evaluation document, entitled the Community Health Improvement Plan Against Tobacco Use (CHIPATU), was part of the experiential approach. The report was completed by health department officials from these 95 counites. This report documented tobacco use problem statements, county investments of Tobacco Settlement funds, strategy and project descriptions, and local changes in statewide outcome measures in three focused areas: reducing pregnancy smoking, reducing secondhand smoke exposure for young children, and reducing youth tobacco use initiation. The CHIPATU became a capstone evaluation document that reinforced county-based responsibility for assessment, goal setting, intervention planning, implementation, application of continuous improvement tools, and results. A statewide summary of 3 years’ efforts and outcomes from the 95 county CHIPATUs was included in the state Health Commissioner’s annual budget presentation for the Governor and General Assembly. The results documented the efficacy of the Department’s primary prevention programs, supported by staff development in use of health promotion approaches, to address long-standing public health issues.