title: Implementing state tobacco treatment services: lessons from the Massachusetts experience.
abstract: This case study was conducted between 2000 and 2003 to examine the implementation of community based tobacco treatment programs funded by the Massachusetts Department of Public Health Tobacco Control Program (MTCP). Four dimensions of implementation, drawn from several models of program evaluation are explored: (a) quantity of services, (b) quality of services, (c) implementation/use of systems, and (d) sustainability. The quantity of services delivered was high, reflecting MTCP's focus on increasing availability of services, particularly in underserved populations. The quality of physician-delivered tobacco intervention did not meet national benchmarks for delivery of all 5As (Ask, Advise, Assess, Assist, Arrange follow-up) and only about half of organizations reported routine systems for auditing tobacco use documentation. Implementation of systems to identify tobacco users and deliver tobacco treatment varied widely by community health settings, with low rates of tobacco use documentation found. Finally, in an era of greater competition for scarce prevention dollars, sustainability of services over time must be planned for from the outset, as indicated by the success of programs that sustained services by proactively and creatively incorporating tobacco treatment into their organizations. This case study can inform states' policies in their design of tobacco treatment services in community health settings.
authors.affiliation: Division of Preventive and Behavioral Medicine at the University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA. lori.pbert@umassmed.edu
authors.forename: Lori
authors.initials: L
authors.lastname: Pbert
authors.forename: Jane
authors.initials: J
authors.lastname: Zapka
authors.forename: Denise G
authors.initials: DG
authors.lastname: Jolicoeur
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: White
authors.forename: Karin
authors.initials: K
authors.lastname: Valentine Goins
authors.forename: George
authors.initials: G
authors.lastname: Reed
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
mesh_terms: D019058:Community Networks / Q000191:economics / Q000458:organization & administration; D003625:Data Collection; D005380:Financing, Government; D006293:Health Promotion / Q000331:legislation & jurisprudence*; D006801:Humans; D007407:Interviews as Topic; D008404:Massachusetts; D019982:Organizational Case Studies; D016730:Program Development; D016540:Smoking Cessation / Q000331:legislation & jurisprudence*