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Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed

Author

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  • Matthew Taing

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
    HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Bryce Kyburz

    (Integral Care, Austin, TX, USA)

  • Isabel Martinez Leal

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
    HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Kathy Le

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
    HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
    Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA)

  • Tzu-An Chen

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
    HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Virmarie Correa-Fernandez

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
    HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Teresa Williams

    (Integral Care, Austin, TX, USA)

  • Daniel P. O’Connor

    (HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
    Department of Health & Human Performance, The University of Houston, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX 77204, USA)

  • Ezemenari M. Obasi

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
    HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

  • Kathleen Casey

    (Integral Care, Austin, TX, USA)

  • Litty Koshy

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA)

  • Lorraine R. Reitzel

    (Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204-5029, USA
    HEALTH Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA)

Abstract

Tobacco use is exceedingly high among those who are homeless or at risk of homelessness but not commonly addressed by clinicians. Taking Texas Tobacco Free (TTTF) is a tobacco control program that addresses known clinician barriers to intervention (e.g., low training receipt, limited resources). Here, we examine the process and outcomes of TTTF’s adaptation within four agencies that provide housing or other services to individuals who are homeless or vulnerably housed. Pre- and post-implementation data were collected from clinicians ( N = 68) to assess changes in training receipt, knowledge, and intervention behaviors, relative to program goals. Results indicated significant gains in clinicians’ receipt of training in 9 (of 9) target areas ( p ’s ≤ 0.0042) and a 53% knowledge gain ( p < 0.0001). From pre- to post-implementation, there were mean increases in the use of the 5As (ask, advise, assess, assist, and arrange) and other evidence-based interventions for tobacco cessation, with significant gains seen in assisting residents/clients to quit, arranging follow-ups, and providing or referring for non-nicotine medications ( p ’s ≤ 0.0491). All program goals, except gains related to advising smokers to quit and the use of specific interventions (behavioral counseling), were met. Overall, TTTF improved clinicians’ capacity to address tobacco use among homeless and vulnerably housed individuals and can serve as a model for tobacco control efforts in similar agencies.

Suggested Citation

  • Matthew Taing & Bryce Kyburz & Isabel Martinez Leal & Kathy Le & Tzu-An Chen & Virmarie Correa-Fernandez & Teresa Williams & Daniel P. O’Connor & Ezemenari M. Obasi & Kathleen Casey & Litty Koshy & Lo, 2020. "Clinician Training in the Adaptation of a Comprehensive Tobacco-Free Workplace Program in Agencies Serving the Homeless and Vulnerably Housed," IJERPH, MDPI, vol. 17(17), pages 1-15, August.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:17:p:6154-:d:403493
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    References listed on IDEAS

    as
    1. Businelle, M.S. & Cuate, E.L. & Kesh, A. & Poonawalla, I.B. & Kendzor, D.E., 2013. "Comparing homeless smokers to economically disadvantaged domiciled smokers," American Journal of Public Health, American Public Health Association, vol. 103(S2), pages 218-221.
    2. Braciszewski, Jordan M. & Colby, Suzanne M., 2015. "Tobacco use among foster youth: Evidence of health disparities," Children and Youth Services Review, Elsevier, vol. 58(C), pages 142-145.
    3. Kendzor, D.E. & Businelle, M.S. & Poonawalla, I.B. & Cuate, E.L. & Kesh, A. & Rios, D.M. & Ma, P. & Balis, D.S., 2015. "Financial incentives for abstinence among socioeconomically disadvantaged individuals in smoking cessation treatment," American Journal of Public Health, American Public Health Association, vol. 105(6), pages 1198-1205.
    4. Bauer, J.E. & Hyland, A. & Li, Q. & Steger, C. & Cummings, K.M., 2005. "A longitudinal assessment of the impact of smoke-free worksite policies on tobacco use," American Journal of Public Health, American Public Health Association, vol. 95(6), pages 1024-1029.
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    Cited by:

    1. Brian J. Carter & Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Educating Substance Use Treatment Center Providers on Tobacco Use Treatments Is Associated with Increased Provision of Counseling and Medication to Patients Who Use Tobacco," IJERPH, MDPI, vol. 20(5), pages 1-17, February.
    2. Ammar D. Siddiqi & Tzuan A. Chen & Maggie Britton & Isabel Martinez Leal & Brian J. Carter & Virmarie Correa-Fernández & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Kathleen Casey & Lorraine R, 2023. "Changes in Substance Use Treatment Providers’ Delivery of the 5A’s for Non-Cigarette Tobacco Use in the Context of a Comprehensive Tobacco-Free Workplace Program Implementation," IJERPH, MDPI, vol. 20(3), pages 1-16, February.
    3. Maggie Britton & Isabel Martinez Leal & Midhat Z. Jafry & Tzuan A. Chen & Anastasia Rogova & Bryce Kyburz & Teresa Williams & Lorraine R. Reitzel, 2023. "Influence of Provider and Leader Perspectives about Concurrent Tobacco-Use Care during Substance-Use Treatment on Their Tobacco Intervention Provision with Clients: A Mixed-Methods Study," IJERPH, MDPI, vol. 20(7), pages 1-21, March.
    4. Vijay Nitturi & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Kelli Drenner & Bryce Kyburz & Teresa Williams & Ezemenari M. Obasi & Maggie Britton & Molly Howard & Rogelio Rangel , 2021. "Implementation and Outcomes of a Train-the-Trainer Program at Behavioral Health Treatment Centers as a Mechanism to Maintain Organizational Capacity to Address Tobacco Use Disorder," IJERPH, MDPI, vol. 18(21), pages 1-15, November.
    5. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Matthew Taing & Daniel P. O’Connor & Lorraine R. Re, 2021. "Organizational Factors Moderating Changes in Tobacco Use Dependence Care Delivery Following a Comprehensive Tobacco-Free Workplace Intervention in Non-Profit Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(19), pages 1-16, October.
    6. Pooja Agrawal & Matthew Taing & Tzu-An Chen & Sean M. Reuven & Michael S. Businelle & Darla E. Kendzor & Eric H. Bernicker & Lorraine R. Reitzel, 2020. "Understanding the Associations between Smoking-Related Risk Perception, Interest in Quitting Smoking, and Interest in Lung Cancer Screening among Homeless Adult Smokers," IJERPH, MDPI, vol. 17(23), pages 1-11, November.
    7. Isabel Martinez Leal & Matthew Taing & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Kathy Le & Litty Koshy & Tzuan A. Chen & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & , 2021. "Addressing Smoking Cessation among Women in Substance Use Treatment: A Qualitative Approach to Guiding Tailored Interventions," IJERPH, MDPI, vol. 18(11), pages 1-25, May.
    8. Jayda Martinez & Midhat Z. Jafry & Tzuan A. Chen & Michael S. Businelle & Darla E. Kendzor & Maggie Britton & Maya Vijayaraghavan & Lorraine R. Reitzel, 2022. "Guest Support for Outdoor Smoke-Free Policies within a Homeless Shelter," IJERPH, MDPI, vol. 19(4), pages 1-15, February.
    9. Cassidy R. LoParco & Tzuan A. Chen & Isabel Martinez Leal & Maggie Britton & Brian J. Carter & Virmarie Correa-Fernández & Bryce Kyburz & Teresa Williams & Kathleen Casey & Anastasia Rogova & Hsien-Ch, 2022. "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," IJERPH, MDPI, vol. 19(19), pages 1-13, September.
    10. Kathy Le & Tzuan A. Chen & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Bryce Kyburz & Teresa Williams & Kathleen Casey & Haleem A. Brown & Daniel P. O’Connor & Lorraine R. , 2021. "Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers," IJERPH, MDPI, vol. 18(14), pages 1-14, July.
    11. Matthew Taing & Vijay Nitturi & Tzuan A. Chen & Bryce Kyburz & Isabel Martinez Leal & Virmarie Correa-Fernández & Ezemenari M. Obasi & Teresa Williams & Kathleen Casey & Daniel P. O’Connor & Litty Kos, 2021. "Implementation and Outcomes of a Comprehensive Tobacco Free Workplace Program in Opioid Treatment Centers," IJERPH, MDPI, vol. 19(1), pages 1-17, December.

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