The index of tobacco treatment quality: development of a tool to assess evidence-based treatment in a national sample of drug treatment facilities

Cupertino, A. Paula; Hunt, Jamie J.; Gajewski, Byron; Yu, Jun; Marquis, Janet; Friedmann, Peter D.; Engelman, Kimberly K.; Richter, Kimber P.

doi:10.1186/1747-597x-8-13

Cited by 12 publications

(23 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The average number of smokers among the facilities was 75% and almost a quarter (23%) stated that there was a state mandate for tobacco treatment. The final sample was comparable to all 3,800 U.S. outpatient, adult drug treatment facilities on 14 clinic characteristics; more details on survey development, methods, representativeness, and main findings are available elsewhere (Cupertino et al, 2013). …”

Section: Resultsmentioning

confidence: 99%

Staff commitment to providing tobacco dependence in drug treatment: Reliability, validity, and results of a national survey.

Hunt

Cupertino

Gajewski

et al. 2014

Psychology of Addictive Behaviors

Self Cite

View full text Add to dashboard Cite

Although most people in treatment for illicit drug use smoke cigarettes, few facilities offer any form of treatment for tobacco dependence. One reason for this may be that drug treatment staff have varying levels of commitment to treat tobacco. We developed and validated a 14-item Tobacco Treatment Commitment Scale (TTCS), using 405 participants in leadership positions in drug treatment facilities. We first conducted a confirmatory factor analysis to evaluate four a priori domains suggested by our original set of 38 items—this did not produce a good fit (CFI=0.782, RMSEA=0.067). We then conducted a series of exploratory factor analyses to produce a more precise and reliable scale. The final confirmatory factor analysis indicated a three-factor solution, produced a good fit (CFI=0.950, RMSEA=0.058), and had substantial unified reliability of 0.975. The final TTCS contained 14 items in 3 domains: Tobacco is less harmful than other drugs; It’s not our job to treat tobacco; and Tobacco treatment will harm clients. These constructs account for most of the variance in the survey items and emerged as major sentiments driving staff commitment to providing tobacco services. The TTCS can be used to understand the role of staff attitudes in the adoption of tobacco services in this important treatment setting.

show abstract

Section: Resultsmentioning

confidence: 99%

Staff commitment to providing tobacco dependence in drug treatment: Reliability, validity, and results of a national survey.

Hunt

Cupertino

Gajewski

et al. 2014

Psychology of Addictive Behaviors

Self Cite

View full text Add to dashboard Cite

show abstract

“…Rates of cigarette smoking among individuals in the US with substance-related diagnoses typically exceed 70%, according to epidemiological data (1–3) and reports from treatment organizations (4, 5). Much of the excess mortality experienced by individuals with substance-related disorders is attributable to tobacco use (6, 7).…”

mentioning

confidence: 99%

Medicaid, Private Insurance, and the Availability of Smoking Cessation Interventions in Substance Use Disorder Treatment

Knudsen

Roman

2015

View full text Add to dashboard Cite

Objective Integration of smoking cessation services within substance use disorder treatment would benefit many patients. Although prior studies have identified organizational characteristics associated with delivery of these services, less is known regarding associations between financial factors and the availability of smoking cessation services. This study examines whether reliance on Medicaid and private insurance revenues is associated with the availability of counseling-based smoking cessation programs and medications within US specialty treatment organizations. Methods Administrators of a national sample of 372 treatment organizations participated in face-to-face structured interviews from October 2011 to December 2013. Participants provided data regarding smoking cessation services, sources of revenues, and other organizational characteristics. Multiple imputation was used to address missing data, and models were estimated using logistic regression with adjustment for clustering of organizations within US states. Results Greater reliance on Medicaid revenues was positively associated with the odds of offering counseling-based smoking cessation programs, sustained-release bupropion, varenicline, and nicotine replacement. Reliance on private insurance revenues was positively correlated with the three medications. Conclusions These findings point to future potential increases in the availability of smoking cessation services in the context of expanding insurance coverage under health care reform. Longitudinal research will be needed to examine whether this impact is realized.

show abstract

“…17 Nearly half (48%) of participating facilities were privately owned and not for profit. Most (66%) of the facilities had fewer than 100 clients per year.…”

Section: Resultsmentioning

confidence: 99%

Commitment and Capacity for Providing Evidence-Based Tobacco Treatment in Us Drug Treatment Facilities

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background Although people with mental illness, including substance use disorders, consume 44% of cigarettes in the U.S., few facilities provide tobacco treatment. This study assesses staff- and facility-level drivers of tobacco treatment in substance use treatment. Methods We administered surveys to 405 clinic directors selected from a comprehensive inventory of 3,800 U.S. outpatient facilities. The main outcome was the validated 7-item Index of Tobacco Treatment Quality. Other measures included the validated Tobacco Treatment Commitment Scale and indicators of facility resources for providing tobacco treatment. Results We used stepwise model selection to determine the relationship between capacity/resources and treatment quality. The final model retained 7 items and had good fit (adj. R2=0.43). Four capacities significantly predicted treatment quality. We used SEM to test the impact of staff commitment on treatment quality; the model had good fit and the relationship was significant (CFI=0.951, RMSEA=0.054). Adding the 7 capacity/resources maintained similar model fit (CFI=0.922, RMSEA=0.053). Staff commitment was slightly strengthened in this model, with a rise in parameter estimate from 0.449 to 0.560. All resource/capacity items were also significant predictors of treatment quality; the strongest was receiving training in how to provide tobacco treatment (0.360), followed by dedicated staff time (.279) and having a policy that requires staff to offer treatment (.272). Conclusions Staff commitment to providing tobacco treatment was the strongest predictor of tobacco treatment quality, followed by resources for providing treatment. Interventions to change staff attitudes and improve resources for tobacco treatment have the strongest potential for improving quality of care.

show abstract

The index of tobacco treatment quality: development of a tool to assess evidence-based treatment in a national sample of drug treatment facilities

Cited by 12 publications

References 37 publications

Staff commitment to providing tobacco dependence in drug treatment: Reliability, validity, and results of a national survey.

Staff commitment to providing tobacco dependence in drug treatment: Reliability, validity, and results of a national survey.

Medicaid, Private Insurance, and the Availability of Smoking Cessation Interventions in Substance Use Disorder Treatment

Commitment and Capacity for Providing Evidence-Based Tobacco Treatment in Us Drug Treatment Facilities

Contact Info

Product

Resources

About