|
Smoking prevalence among adults living in poverty remains too high. Community health centers (CHCs) can play a pivotal role in addressing smoking in this population. Yet, lack of clinic protocols, trained staff, and robust electronic support systems can make the delivery of smoking cessation services challenging. Smoking cessation activities in CHCs also often fail to address social barriers to successful quit attempts (e.g. housing instability, social isolation, stress, mental illness, co-occurring substance use) or behaviors (e.g. poor diet, physical inactivity) that can magnify cardiovascular disease and cancer risks from smoking. With NIH funding, we developed “Connection to Health” (CTH), a comprehensive program for diabetes patients in CHCs, designed to assess social and behavioral determinants of health and to facilitate self-management support with automated motivational text messages, community referrals, and follow-up. Our CHC partners and stakeholders have requested to use CTH as the foundation for a new type of smoking cessation program. We will pursue two aims in this study: 1) to adapt CTH to incorporate smoking cessation services in English and Spanish with input from providers and patients; and 2) to test CTH with 90 smokers in three CHCs within our practice-based research network, comparing outcomes to a standard smoking cessation program for 90 additional smokers. This pilot will inform a future grant proposal focused on smoking in CHCs, where thousands of California’s medically vulnerable tobacco users receive care. |
