Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses

Joseph GL Lee,Anna McCullough,Sterling M Fulton-Smith,Leah M Ranney,Adam O Goldstein,Nicole O Collins

doi:10.1186/1471-2458-11-702

Abstract

BackgroundTobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness. This study evaluated the implementation, technical assistance, and perceived impact of a model curriculum ("Learning About Healthy Living") to promote wellness and motivation to quit tobacco use in psychosocial rehabilitation clubhouses.MethodsWe used semi-structured interviews (n = 9) with clubhouse staff (n = 12) and a survey of participating clubhouse members (n = 271) in nine clubhouses.ResultsFifty-eight percent of clubhouse participants completed surveys. Results showed tobacco users open to tobacco-free policies (62%) and perceiving more discussions about quitting tobacco with healthcare providers (69%). Analyses of staff interviews and member surveys revealed four key themes: (1) the curriculum was successfully implemented and appreciated; (2) technical assistance kept implementation on track; (3) adding wellness content and interactive components should enhance the curriculum; and, (4) the curriculum advanced other healthful policies and practices.ConclusionsMental health settings are important locations for implementing programs to address tobacco use. In this real-world implementation of a model curriculum in psychosocial rehabilitation clubhouses, the curriculum tested well, was feasible and well-received, and suggests potential impact on tobacco use outcomes. Revision, dissemination, and a randomized controlled trial evaluation of the model curriculum should now occur.

Highlights

Tobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness
While adults living with severe and persistent mental illness (SPMI) can and do quit when using evidence-based cessation treatment [5,6,7], albeit with higher relapse rates [8], smoking prevalence among individuals living with SPMI remains between 36% and 49% [9]
A structured group approach to promoting healthful living and tobacco cessation can be an important tool in addressing the high tobacco use prevalence among people living with SPMI

Summary

Introduction

Tobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness. While adults living with SPMI can and do quit when using evidence-based cessation treatment [5,6,7], albeit with higher relapse rates [8], smoking prevalence among individuals living with SPMI remains between 36% and 49% [9]. These large disparities in tobacco use persist because of slow progress in changing tobacco-related norms among mental health providers and clients as well as a historical reluctance by mental health providers to address tobacco addiction [10,11,12]

Methods

Results

Discussion

Conclusion