Influencing Taft-Hartley Funds to provide tobacco cessation benefits.
BACKGROUND
Taft-Hartley Health and Welfare Funds ("funds") administer health insurance plans that cover approximately nine million U.S. adults. Unionized workers covered by funds work primarily in blue- and pink-collar occupations and smoke at a rate almost twice that of workers in other occupations. Most funds do not provide comprehensive coverage for tobacco cessation treatment for fund participants (workers, family members, and retirees).


OBJECTIVE
This study tested a pilot intervention to increase the provision and promotion of cessation benefits among Minnesota-based funds by educating the funds' advisors.


METHODS
Tailored educational outreach was conducted to advisors (administrators, consultants, attorneys) of 10 Minnesota-based funds (2009-2011). Pre- and post-intervention advisor interviews measured perceptions/knowledge/attitudes about tobacco use, cessation, coverage, and promotion of benefits. Pre- and post-intervention data on benefit provision were collected from Summary Plan Descriptions (SPDs) and Summary Material Modifications (SMMs) of 10 Minnesota-based funds and 19 comparison funds in Massachusetts and Washington, and compared in 2011. SPDs/SMMs were scored on benefit adequacy, comparing services covered and the extent to which they met DHHS recommendations.


RESULTS
Minnesota-based funds provided significantly higher coverage (except for copays and pre-conditions) pre-intervention. However, there were no significant differences between Minnesota and comparison funds in rate of improvement in benefits over time. At follow-up, advisors reported a significant increase in confidence in their knowledge to address smoking issues in funds. Advisors also reported sharing intervention information with fund trustees.


CONCLUSIONS
Educational strategies to influence advisors who provide guidance to fund trustees may help to increase advisors' confidence to address cessation benefit improvement.
WorkSHIFTS, Public Health Law Center, William Mitchell College of Law, St. Paul, Minnesota 55105, USA. susan.weisman@wmitchell.edu
Susan R
SR
Weisman
Deborah
D
Hennrikus
Kelvin
K
Choi
Brooke
B
Nunn
Jean L
JL
Forster
Mary Kay
MK
Hunt
Rodney
R
Skoog
Wade
W
Luneburg
Bernie
B
Hesse
D000328:Adult; D005500:Follow-Up Studies; D006264:Health Benefit Plans, Employee / Q000191:economics*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007342:Insurance Benefits / Q000191:economics; D019458:Insurance Coverage / Q000191:economics; D008910:Minnesota; D010865:Pilot Projects; D012907:Smoking / Q000191:economics / Q000453:epidemiology; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*; D000074606:Smoking Prevention; D013997:Time Factors