Vijayaraghavan M, Bonniot C, Satterfield J, Clark B, Xia F, Cheng C, Safier J, Pamatmat M, Schroeder S A
UCSF Smoking Cessation Leadership Center, University of California, San Francisco, United States.
Division of General Internal Medicine, University of California, San Francisco, United States.
Prev Med Rep. 2024 Oct 5;47:102896. doi: 10.1016/j.pmedr.2024.102896. eCollection 2024 Nov.
Smoking is concentrated in behavioral health populations in the United States, calling for efforts to increase access to cessation services.
Between 2010 and 2023, the Smoking Cessation Leadership Center (SCLC) implemented state Leadership Academies-a facilitated summit of public health leaders and community champions charged with developing an action plan to address smoking in their state. Using a multi-methods approach, we evaluated state Leadership Academies using the RE-AIM framework. States completed progress surveys and set targets for reductions in smoking prevalence within 5 years of participating in the summit. We measured the average yearly decline in smoking prevalence for adults with frequent poor mental health and heavy drinking from the Behavioral Risk Factors Surveillance System.
SCLC reached 24 state Leadership Academies. The mean annual smoking prevalence decline for frequent poor mental health was 1.2 % (95 % CI 0.9 %-1.4 %) and heavy drinking was 1.1 % (95 % CI 0.8 %-1.3 %) during their time in the Leadership Academy. Since 2010, SCLC trained 57,312 individuals, conducted 127 webinars, and facilitated collaborations among 2773 organizations. State action plans focused on large-scale education initiatives to train behavioral health providers. Action plans also focused on improving policy and systems-level initiatives that increased implementation of tobacco-free grounds policy in behavioral health facilities and eliminated barriers to access to cessation pharmacotherapy.
Leadership Academies are a multi-layered engagement and action framework to initiate and sustain incremental change in the provision of smoking cessation services in behavioral health facilities, with the potential to reduce smoking prevalence among impacted behavioral health populations.
吸烟现象在美国行为健康人群中较为集中，因此需要努力增加戒烟服务的可及性。
2010年至2023年期间，戒烟领导中心（SCLC）实施了州领导学院项目——这是一个由公共卫生领导人及社区倡导者参加的促进峰会，负责制定本州解决吸烟问题的行动计划。我们采用多方法途径，使用RE-AIM框架对州领导学院项目进行评估。各州完成了进展情况调查，并设定了在参加峰会后5年内降低吸烟率的目标。我们从行为危险因素监测系统中测量了心理健康状况经常较差且酗酒的成年人吸烟率的年均下降情况。
SCLC覆盖了24个州领导学院。在参与领导学院项目期间，心理健康状况经常较差的人群吸烟率年均下降1.2%（95%置信区间0.9%-1.4%），酗酒人群吸烟率年均下降1.1%（95%置信区间0.8%-1.3%）。自2010年以来，SCLC培训了57312人，举办了127场网络研讨会，并促进了2773个组织之间的合作。州行动计划侧重于大规模教育举措，以培训行为健康服务提供者。行动计划还侧重于改善政策和系统层面的举措，这些举措增加了行为健康设施中无烟场所政策的实施，并消除了获得戒烟药物治疗的障碍。
领导学院是一个多层次的参与和行动框架，可启动并维持行为健康设施戒烟服务的渐进式变革，有可能降低受影响行为健康人群的吸烟率。
