300797
Utilizing systems-change to address commercial tobacco dependence within Tribal and Indian Health Service (IHS) clinics: A feasibility study
Objectives: American Indian Systems for Tobacco Addiction Treatment (STAT), funded by ClearWay Minnesota℠, is a feasibility study aimed to partner with three Tribal and IHS clinics in Minnesota to systematically integrate commercial tobacco intervention into every healthcare visit based on the Five A’s of the United States Public Health Service Clinical Practice Guideline (2008). The intervention focuses on two main strategies: 1) healthcare provider training, and 2) the provision of customized clinical system tools to encourage and support clinic staff involvement in the assessment of smoking status and treatment of commercial tobacco dependence. Clinic tools include tobacco screening prompts, reminders, patient education materials, provider feedback loops and improved referral systems.
Methods: A situational analysis was conducted using baseline assessments, interviews, and discussions with key clinic staff to identify current clinical cessation practice, available resources, and needs for tailoring the intervention at each clinic. Further data collection includes process documentation, provider training evaluations, and provider self-reported knowledge and behavior change.
Results: This intervention has prepared clinic systems to better address commercial tobacco addiction by forming internal working groups and tailoring system-changes by recognizing the capacity and unique challenges of each clinic. More support is needed for on-site, intensive cessation counseling. Final project results available in spring 2015.
Learning Areas:
Other professions or practice related to public healthProvision of health care to the public
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Identify elements of the Five A Model for tobacco dependence treatment according to the United States Public Health Service Clinical Practice Guideline (2008).
Describe the components of a systems-level approach to commercial tobacco dependence treatment, specifically tailored for American Indian clinics.
Keyword(s): Tobacco Control, Native Americans
Qualified on the content I am responsible for because: I am Bitterroot Salish from the Confederated Salish and Kootenai Tribes, University of Minnesota School of Public Health graduate student and Coordinator of this feasibility study for the American Indian Cancer Foundation. I have extensive knowledge on tobacco dependence treatment according to USPHS Clinical Practice Guidelines and can share lessons learned on implementation of systems-change strategies with clinics. My research interests include American Indian health disparities and community-based interventions to reduce cancer incidence and mortality.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.