title: Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses.
abstract: BACKGROUND
  Tobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness. This study evaluated the implementation, technical assistance, and perceived impact of a model curriculum ("Learning About Healthy Living") to promote wellness and motivation to quit tobacco use in psychosocial rehabilitation clubhouses.
  
  
  METHODS
  We used semi-structured interviews (n = 9) with clubhouse staff (n = 12) and a survey of participating clubhouse members (n = 271) in nine clubhouses.
  
  
  RESULTS
  Fifty-eight percent of clubhouse participants completed surveys. Results showed tobacco users open to tobacco-free policies (62%) and perceiving more discussions about quitting tobacco with healthcare providers (69%). Analyses of staff interviews and member surveys revealed four key themes: (1) the curriculum was successfully implemented and appreciated; (2) technical assistance kept implementation on track; (3) adding wellness content and interactive components should enhance the curriculum; and, (4) the curriculum advanced other healthful policies and practices.
  
  
  CONCLUSIONS
  Mental health settings are important locations for implementing programs to address tobacco use. In this real-world implementation of a model curriculum in psychosocial rehabilitation clubhouses, the curriculum tested well, was feasible and well-received, and suggests potential impact on tobacco use outcomes. Revision, dissemination, and a randomized controlled trial evaluation of the model curriculum should now occur.
authors.affiliation: Tobacco Prevention and Evaluation Program, Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, CB 7595, 590 Manning Drive, Chapel Hill, North Carolina 27599, USA. jose.lee@unc.edu
authors.forename: Joseph G L
authors.initials: JG
authors.lastname: Lee
authors.forename: Leah M
authors.initials: LM
authors.lastname: Ranney
authors.forename: Adam O
authors.initials: AO
authors.lastname: Goldstein
authors.forename: Anna
authors.initials: A
authors.lastname: McCullough
authors.forename: Sterling M
authors.initials: SM
authors.lastname: Fulton-Smith
authors.forename: Nicole O
authors.initials: NO
authors.lastname: Collins
mesh_terms: D000328:Adult; D000368:Aged; D003479:Curriculum; D003625:Data Collection; D005260:Female; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D009657:North Carolina; D019982:Organizational Case Studies; D016730:Program Development; D012047:Rehabilitation Centers; D016540:Smoking Cessation; D055815:Young Adult