Smoking cessation: a community-based approach to continuing medical education
Continuing medical education can help close the gaps between current and desired tobacco cessation practices. This paper reports a case of an innovative community-based continuing education approach implemented by a multi-organizational initiative aimed at increasing smoking cessation rates among adults in the USA. The approach involved collaborative partnerships with healthcare professionals and other stakeholders in 14 communities where smoking cessation was an established priority. The centralized evidence-based educational curriculum was delivered locally to more than 15,600 clinicians. Evaluation provided evidence of positive impact on clinicians, healthcare systems, and communities. A collaborative, community-based approach to continuing medical education has potential to increase tobacco cessation rates by leveraging efforts of multiple stakeholders operating at the community level into more effective and sustainable tobacco cessation projects. Future research is needed to study effectiveness of and appropriate evaluation frameworks for this approach.
KEYWORDSTobacco cessation Continuing medical education Community-based approach
The CS2day partner organizations include California Academy of Family Physicians, CME Enterprise, Healthcare Performance Consulting, Interstate Postgraduate Medical Association, Physicians’ Institute for Excellence in Medicine, Purdue University School of Pharmacy, Telligen, University of Virginia School of Medicine, and University of Wisconsin School of Medicine and Public Health. We want to thank Dr. Karen Hudmon, Dr. Mary E. Gilles, Mrs. Jing Su, Mrs. Louise J. Strayer, and the University of Arizona HealthCare Partnership for their contributions to this paper.
The CS2day initiative was supported by an educational grant from Pfizer. The funder played no role in the design or implementation of the initiative nor in the interpretation and reporting of the evaluation findings. All authors had full access to all of the planning documents and evaluation data and can take responsibility for the integrity of the data and the accuracy of the data analysis.
Conflict of Interest
The authors have no conflict of interest to disclose.
Adherence to Ethical Principles
No animal or human research studies were carried out by the authors for this article; therefore, the project plan was not submitted for an Institutional Review Board review. The evaluation procedures were consistent with the research subjects protection practices in that data from participants were kept confidential, and neither participants nor their clinical settings were identified in the manuscript.
- 1.World Health Organization. WHO report on the global tobacco epidemic 2013. Available at http://www.who.int/tobacco/global_report/2013/en/index.html. Accessibility verified May 6, 2014.
- 5.Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service; 2008.Google Scholar
- 6.Jamal A, Dube SR, Malarcher AM, Shaw L, Engstrom MS, Centers for Disease Control and Prevention. Tobacco use screening and counseling during physician office visits among adults: National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005–2009. MMWR Morbidity and Mortality Weekly Report. 2012;61(Suppl):38-45.PubMedGoogle Scholar
- 9.Davis DA, Barnes BE, Fox RD, eds. The continuing professional development of physicians: from research to practice. The United States of America: American Medical Association Press; 2003.Google Scholar
- 11.Kühne-Eversmann L, Fischer MR. Improving knowledge and changing behavior towards guideline based decisions in diabetes care: a controlled intervention study of a team-based learning approach for continuous professional development of physicians. BMC Res Notes. 2013;6:14.PubMedCentralPubMedCrossRefGoogle Scholar
- 15.Matthews, A.K., Li, C.C., Kuhns, L.M., Tasker, T.B., & Cesario, J.A. (2013). Results from a community-based smoking cessation treatment program for LGBT smokers. Journal of Environmental on Public Health 984508Google Scholar
- 21.Miller, W.R., & Rollnick, S. (2009). Ten things that motivational interviewing is not. Behavioural and Cognitive Psychotherapy 37 129-140Google Scholar
- 26.Venner, K.L., Feldstein, S.W., & Tafoya, N. (2006). Native American motivational interviewing: weaving Native American and Western practices. A manual for counselors in Native American communities. Available at http://www.motivationalinterview.org/Documents/Native%20American%20MI%20Manual.pdf. Accessibility verified May 6, 2014
- 27.Bellg AJ, Borrelli B, Resnick B, Treatment Fidelity Workgroup of the NIH Behavior Change Consortium, et al. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychology. 2004;23(5):443-451.PubMedCrossRefGoogle Scholar
- 28.Breitenstein SM, Gross D, Garvey CA, Hill C, Fogg L, Resnick B. Implementation fidelity in community-based interventions. Research in Nursing & Health. 2010;33:164-173.Google Scholar
- 29.Harn B, Parisi D, Stoolmiller M. Balancing fidelity with flexibility and fit: what do we really know about fidelity of implementation in schools? Exceptional Children. 2013;79(2):181-193.Google Scholar
- 32.Marinopoulos SS, Dorman T, Ratanawongsa N, et al. Effectiveness of continuing medical education. Evidence Report/Technology Assessment No. 149 (Prepared by the Johns Hopkins Evidence-based Practice Center, under Contract No. 290-02-0018.) AHRQ Publication No. 07-E006. Rockville, MD: Agency for Healthcare Research and Quality; 2007.Google Scholar