Helpers Program to Improve Tobacco Cessation in Behavioral Health Treatment Recipients and Agencies
20th Annual Summer Institute
Presenter
Presentation Notes
[Myra]
Presenters
2
Myra Muramoto, MD, MPH
Andy Bernstein, PhD, CPRP
Tim Connolly, RN, MN
Jonathan Brinks, MPH
Presenter
Presentation Notes
[Myra]
Project Partners
3
Funder: Arizona Biomedical Research Centre (Contract: ADHS16-162520)
Presenter
Presentation Notes
[Myra]
Learning Objectives
4
• Importance of tobacco intervention & treatment
• Barriers to implementing tobacco intervention & treatment
• Helpers’ Program for Behavioral Health
• Feasibility study design and progress
• Identifying opportunities and challenges
• Preliminary discussion of lessons learned
Presenter
Presentation Notes
[Myra] Learning Objectives Participants will be able to identify two reasons that tobacco cessation interventions within behavioral health treatment settings are important and how they can reduce long-term health care costs. Participants will be able to describe two historic barriers to implementing tobacco-cessation strategies into behavioral healthcare settings. Participants will be able to describe two elements of the Helpers’ Program which make its training model unique and well-suited to today’s healthcare and social environment. Participants will be able to summarize the process through which the Helpers Program enlisted support of behavioral health agencies to participate in the study and how the Program was designed to change agency culture around tobacco cessation efforts. Participants will be able to write a short proposal as to how they might incorporate the Helpers Program into settings in which they work, and how they might support long-term tobacco cessation efforts among people who use tobacco and their loved ones. Participants will be able to cite at least two findings from the study which support the value of training agency staff in having “helping conversations” with people who use tobacco.
5
Presenter
Presentation Notes
[Jonathan]Poll Title: The national rate of smoking in the general population is 18%. What is the rate for persons with behavioral health disorders?https://www.polleverywhere.com/multiple_choice_polls/EQK6GfKvnnK3FFEzmOVkn
6
Presenter
Presentation Notes
[Jonathan]
7
Presenter
Presentation Notes
[Jonathan]Poll Title: What percentage of deaths for people with mental health disorders is directly attributed to tobacco use?https://www.polleverywhere.com/multiple_choice_polls/5sUtJ1pl5D2MhhmQZzdcy
8
Tobacco Related MortalityPersons with Mental Health Disorders
Callaghan, et al., 2015
Primary Diagnosis % of Deaths From Tobacco
Schizophrenia 53%
Bipolar Disorder 48%
Major Depression 50%
Presenter
Presentation Notes
[Jonathan]
9
Presenter
Presentation Notes
[Jonathan]Poll Title: What percentage of deaths for people with substance use disorders is directly attributed to tobacco use?https://www.polleverywhere.com/multiple_choice_polls/N52IMHyUwuKw9Tq5xlGRJ
Primary Substance % of Deaths From Tobacco
Alcohol 49%
Cocaine 40%
Opioids 39%
Methamphetamine 36%
10
Tobacco Related MortalityPersons with Substance Use Disorders
Callaghan, et al., 2015
Presenter
Presentation Notes
[Jonathan]
11
Presenter
Presentation Notes
[Tim]Poll Title: In your experience, what percentage of clients who use tobacco are interested in quitting?https://www.polleverywhere.com/free_text_polls/UAz8Pm6Mp0OLJHuih9TnR
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Is There An Interest In Quitting?“If you ask them, people with behavioralhealth conditions want to quit at the samerate as the general population…”
Chad Morris, PhD
70% indicate a desire to quit
40% have made a quit attempt
Presenter
Presentation Notes
[Tim]
13
Presenter
Presentation Notes
[Tim]Poll Title: True or False: People with behavioral health disorders experience symptom relief from using tobacco.https://www.polleverywhere.com/multiple_choice_polls/8eMOqeEOuoYBQ4nJccRaD
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• Myth: Provides symptom relief• Reality: Relief is from tobacco withdrawal
• Myth: Other problems are a priority• Reality: Persons who quit benefit
The tobacco industry has long targeted this population.
Taylor, 2014
Mental Health Disorders
&Tobacco
Presenter
Presentation Notes
[Tim]
15
Substance Use Disorder
&Tobacco
• Myth: Doomed by genetics• Reality: Genetics accounts for 40-60%
• Myth: Will distract from treating “primary” addiction
• Reality: Persons who quit benefit in multiple ways
• Myth: Other problems are a priority• Reality: Cause of premature deaths, illness
and relapse
The tobacco industry has long targeted this population.
Presenter
Presentation Notes
[Tim]
Consider Your Experience
16
What has changed or will need to change in the behavioral health SYSTEM to reduce tobacco use among our members?
2-3 volunteers to share their experience
Presenter
Presentation Notes
[Andy]
17
• Responses
Presenter
Presentation Notes
[Andy] [Jonathan to transcribe reported ideas]
18
Helpers Program for Behavioral Health
Presenter
Presentation Notes
[Tim]
19
Clinical System Intervention• Recruit Leadership & Champions
• Staff buy-in
• Environmental assessments
• Helpers BH Training
• Client Materials
• Support & technical assistance
Presenter
Presentation Notes
[Tim]
20
• Be consistent with staff roles and activity flow
• Offer and document Helping Conversations
• Create change talk cues in the milieu
• Address tobacco in groups
Helpers BH Strategies
Presenter
Presentation Notes
[Tim]
21
Helping Conversations
• Structured Conversation
• Client centered, client driven
• Active Listening (purpose & intent)
• Supported by materials and special knowledge
• Establish a helping relationship
Presenter
Presentation Notes
[Tim]
22
Feas
ibilit
ySt
udy
Flow
Presenter
Presentation Notes
[Myra] Q&A
23
• Work in a group with your table mates.
• Use your “Tobacco Action Plan” handout.
• Group discussion of each item.
• Write down your responses.
• Volunteers to report out.
Workshop Activity
Presenter
Presentation Notes
[Jonathan] Distribute workshop materials
Tobacco Action PlanThink About Your Workplace…
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1. What are some ideas you have that can help clients who use tobacco consider quitting?
2. What are some things that your clinical site or agency could start doing that would impact tobacco use among your clients?
3. How will you know if you’re succeeding in your efforts to help?
2-3 volunteers to share their experience
Presenter
Presentation Notes
[Andy]
Take Action!
25
In the next 90 days, what will you commit to doing back in your home agency to foster a milieu that encourages quitting tobacco?
2-3 volunteers to share their commitment
Presenter
Presentation Notes
[Myra]
Learning Objectives
26
• Importance of tobacco intervention & treatment
• Barriers to implementing tobacco intervention & treatment
• Helpers’ Program for Behavioral Health
• Our study design and progress
• Identifying opportunities and challenges
• Preliminary discussion of lessons learned
Presenter
Presentation Notes
[Myra] Learning Objectives Participants will be able to identify two reasons that tobacco cessation interventions within behavioral health treatment settings are important and how they can reduce long-term health care costs. Participants will be able to describe two historic barriers to implementing tobacco-cessation strategies into behavioral healthcare settings. Participants will be able to describe two elements of the Helpers’ Program which make its training model unique and well-suited to today’s healthcare and social environment. Participants will be able to summarize the process through which the Helpers Program enlisted support of behavioral health agencies to participate in the study and how the Program was designed to change agency culture around tobacco cessation efforts. Participants will be able to write a short proposal as to how they might incorporate the Helpers Program into settings in which they work, and how they might support long-term tobacco cessation efforts among people who use tobacco and their loved ones. Participants will be able to cite at least two findings from the study which support the value of training agency staff in having “helping conversations” with people who use tobacco.
