Collaborative Learning: A Qualitative Study Exploring Factors Contributing to a Successful Tobacco Cessation Train-the-Trainer Program as a Community of Practice

Abstract

Individuals with behavioral health conditions account for 50% of annual smoking-related deaths, yet rarely receive tobacco dependence treatment within local mental health authorities (LMHAs). As lack of training and knowledge are key barriers to providing tobacco dependence treatment, Taking Texas Tobacco-Free (TTTF) developed an iterative, 4–6-months train-the-trainer program to embed expertise and delivery of sustained education on tobacco-free workplace policies and practices in participating centers. We explore the employee “champions’” train-the-trainer program experiences using a community of practice (CoP) model to identify key contributors to successful program implementation. Across 3 different LMHAs, we conducted semi-structured individual and group interviews online at 2 time points. We interviewed each champion twice (except for 1 champion who dropped out between measurements); pre-implementation (3 group interviews; N = 4 + 4 + 3 = 11 champions); post-implementation (7 individual interviews and 1 group interview; 7 + 3 = 10 champions). Therefore, 11 champions participated in pre- and post-implementation interviews from July 2020–May 2021. Guided by an iterative, thematic analysis and constant comparison process, we inductively coded and summarized data into themes. Five factors contributed to successful program implementation: value of peer support/feedback; building knowledge, champion confidence, and program ownership; informative curriculum, adaptable to targeted populations; staying abreast of current tobacco/nicotine research and products; and TTTF team responsiveness and practical coaching/assistance. Champions reported the TTTF train-the-trainer program was successful and identified attitudes and CoP processes that effectively built organizational capacity and expertise to sustainably address tobacco dependence. Study findings can guide other agencies in implementing sustainable tobacco-free training programs.

Providers’ Non-Cigarette Tobacco Use Intervention Practices in Relation to Beliefs about Patients, Prioritization of and Skills for Intervention, and Referral Knowledge in Texas Healthcare Centers Providing Care to Persons with Behavioral Health Needs

“…Additionally, centers can promote attendance to freely available online education that often have the benefit of providing continuing education credits (e.g., those offered by the American Lung Association or the Smoking Cessation Leadership Center). Additionally, a “train-the-trainer” program can be considered to build and sustain capacity for the treatment of other tobacco use through building a community of practice within the center [ 27 , 28 ]. Importantly, at least one prior study has suggested that training opportunities may be welcomed by providers; a study on vaping and e-cigarettes revealed that providers perceived a need for increased clinical skills training especially on treatment options for other tobacco use [ 29 ].…”

Organization-Level Factors Associated with Changes in the Delivery of the Five A’s for Smoking Cessation following the Implementation of a Comprehensive Tobacco-Free Workplace Program within Substance Use Treatment Centers

“…However, little is known about how broader-level influences (e.g., center-level provider factors) can impact the success of these tobacco-free workplace programs by influencing providers' behaviors within the center overall (e.g., increasing the provision of tobacco cessation interventions). Several prominent implementation science frameworks and multilevel models of health behavior, including, but not limited to, the Socioecological Model [56], suggest the importance of broader-level factors (e.g., organization-level factors such as normative beliefs, values, culture, and policies and/or communities of practice among providers [57]) in influencing the overall patient care provision. Understanding more about the impact of center-level factors in the context of a comprehensive tobacco-free workplace program can help identify important predictors of desirable provider behavior changes within substance use treatment centers.…”

A Serious Game for Patients With Eating Disorders (Maze Out): Pilot User Experience and Acceptance Study

“…Creating tutorials aimed at new patients and new staff might be another option to help implement Maze Out. A “Train-The-Trainer” model can be very cost-effective and successful in creating capacity while rolling out Maze Out in clinical practice [ 48 - 50 ].…”