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a University of
Arizona College of Medicine, Department of Family and Community
Medicine, and University of Arizona College of Public Health, Arizona
Program for Nicotine and Tobacco Research, Tucson, Arizona, USA, b University of Arizona
College of Public Health, Arizona Program for Nicotine and Tobacco
Research, c Arizona Department of Health
Services, Tobacco Education and Prevention Program, d University
of Arizona College of Public Health, Arizona Program for Nicotine and
Tobacco Research, and National Cancer Institute
Correspondence to: Myra L Muramoto, University of Arizona College of Public Health, Arizona Program for Nicotine and Tobacco Research, PO Box 210462, Tucson, AZ 85721, USA; myram{at}u.arizona.edu
Received 22 February
2000; Revision received 28 June 2000;
Accepted 29 June 2000
OBJECTIVE
To describe
the development and preliminary results from a community based
certification model for training in tobacco cessation skills in Arizona.
DESIGNA programme
evaluation using both quantitative pre-post measures and qualitative methods.
SETTINGArizona's
comprehensive tobacco control programme of state funded, community
based local projects and their community partners providing tobacco
treatment services for geographically, socioeconomically, and
ethnically diverse communities.
INTERVENTIONA three
tiered model of skills based training emphasising Agency for Health
Care Policy and Research guidelines, and utilising a training of
trainers approach to build community capacity. Certification roles
addressed basic tobacco cessation skills, tobacco cessation specialist,
and tobacco treatment services manager.
PARTICIPANTSInitial
target audience was community based local project personnel and their
community partners, with later adoption by community organisations
unaffiliated with local projects, and the general public.
MAIN EVALUATION
MEASURESProcess measures: participant
satisfaction, knowledge, skills, and self-efficacy. Outcome:
participant demographics, community organisations represented,
post-training, cessation related activities.
RESULTSDuring the
model's implementation year, 1075 participants attended certification
training, 947 participants received basic skills certificates and 82 received specialist certificates. Pre, post, and three month measures
of self efficacy showed significant and durable increases. Analysis of
participant characteristics demonstrated broad community
representation. At post-training follow up, 80.9% of basic skills
trainees had performed at least one brief intervention and 74.8% had
made a referral to intensive services. Among cessation specialists,
48.8% were delivering intensive services and 69.5% were teaching
basic skills classes.
CONCLUSIONSInitial
experience with Arizona's state wide, community based model for
certification of tobacco cessation skills training suggests this model
may be a promising method for broad, population based diffusion of
evidence based tobacco cessation guidelines.
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