The 13th World Conference on Tobacco OR Health

Objective: To describe an innovative approach to adopting the Public Health Service (PHS) tobacco use treatment guidelines that applies principles of community-based participatory research (CBPR) in clinical settings serving disadvantaged populations. To present a new chart stamp that operationalizes the PHS 5A's framework.

Methods: A collaborative approach to quality improvement was developed through establishment of a partnership between an academic research center and a hospital-affiliated network of community health centers (CHC's) in Northern Manhattan. The partnership emphasized processes of co-learning and capacity building by harnessing the specific skills and knowledge of clinic and quality assurance staff and researchers in designing a systems change based on an adaptation of the 5 A's.

Results: In-depth site assessments were conducted at 9 CHC's to gather data on sites' policies, practices and barriers around cessation service provision and to assess future needs for customized assistance and training. Based on this feedback, researchers and network members developed a new chart stamp and tobacco treatment referral system. Customized procedures for system implementation were created for each CHC. We will present the chart stamp and other system changes in the context of a CBPR approach. To date, the chart stamp system has been implemented at 4 sites and adopted by the New York State Department of Health Tobacco Control Program for cessation centers statewide.

Conclusion: A CBPR strategy based on adaptation of the 5 A's framework resulted in adoption of the clinical guideline for tobacco use as well as a new approach to guideline implementation in clinics serving disadvantaged populations.