The 13th World Conference on Tobacco OR Health

Objective: Although evidence-based treatments for tobacco use and dependence exist, they are not widely disseminated. Little is known about effective dissemination strategies and efforts are hampered by a dearth of dissemination research (Kerner et al., 2005). The Push-Pull-Infrastructure (PPI) model, developed by Robert Wood Johnson (Orleans et al., 2003; 1999) was used to guide state-wide dissemination of: 1) Multi-component cognitive-behavioral therapy (MCBT), and 2) brief interventions (5A's), focusing on developing demand and capacity in healthcare settings and workplaces in Arkansas. Several state-wide programs were involved including treatment programs (face-to-face, telephone, computer-based), a centralized referral program, and hands-on, multifaceted provider education and smoke-free workplace assistance programs.

Methods: Program objectives were mapped to PPI model objectives: 1) Proving/improving evidence-based interventions for wide population use, 2) Creating demand for effective interventions, and 3) Building capacity of systems to use evidence-based treatments. Strategies were developed to meet program objectives. An integrated data collection system was utilized to seamlessly track and follow-up on all referrals and treatment enrollments.

Results: Outcomes from July 1, 2005 to June 30, 2006 will be presented:

1) MCBT was adapted for wide population use with face-to-face, telephone, and computer-based delivery. Three and six-month outcomes will be presented. Progress with computer-base delivery will be demonstrated.

2) Creation of demand will be demonstrated by number of referrals and enrollments of various groups in response to worksite and healthcare policy changes, provider education strategies.

3) Building capacity will be demonstrated by assessing systems-level changes and the resulting referrals and enrollments in response to these changes.