October 2003

Grant Results

SUMMARY

In 2000, the U.S. Public Health Service and the Centers for Disease Control and Prevention (CDC) released revised guidelines for clinical and community tobacco cessation interventions that have the potential to reduce smoking rates nationally. In 2001–02, researchers at the University of Wisconsin Center for Tobacco Research and Intervention oversaw development of a national blueprint for disseminating these guidelines.

Key Results

  • The consortium produced A National Blueprint for Disseminating and Implementing Evidence-Based Clinical and Community Strategies to Promote Tobacco-Use Cessation.
  • With input from the consortium, the Center for Tobacco Research and Interventiondeveloped a plan for transitioning to a permanent secretariat that will oversee implementation of the blueprint.

Funding
The Robert Wood Johnson Foundation (RWJF) provided two grants totaling $107,641 to the Center for Tobacco Research and Intervention for this work. The federal Agency for Healthcare Research and Quality and the National Cancer Institute also provided funding.

 See Grant Detail & Contact Information
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THE PROBLEM

The CDC released the Strategies for Reducing Exposure to Environmental Tobacco Smoke, Increasing Tobacco-Use Cessation and Reducing Initiation in Communities and Health Care Systems in 2000, the same year that the Public Health Service issued Treating Tobacco Use and Dependence Clinical Practice Guideline, an update of a 1996 publication.

An RWJF grant to the Center for Tobacco Research and Intervention provided partial funding for the update. (See the Grant Results on ID# 034068.) Numerous public and private funders, including RWJF (see Grant Results on ID#s 029389, 030329, 030520, 030375, 030254 and 030525), have supported dissemination of these evidence-based tobacco cessation guidelines, but early efforts lacked the coordination necessary for maximum impact and efficiency.

Recently, major funders have begun joining together to co-fund national dissemination blueprints to integrate their efforts and leverage their investments.

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RWJF STRATEGY

In addition to awarding grants to disseminate the original Public Health Service guidelines (see above), RWJF also funded:

  • Dissemination of the guide to organized labor (see Grant Results on ID# 029471).
  • Development of a primary care practitioners' pocket guide (see Grant Results on ID# 029466).
  • A conference and proceedings about the guidelines (see Grant Results on ID# 030465).
  • An evaluation of the implementation of the guide by Allina Medical Clinic which helped inform RWJF's national program, Addressing Tobacco in Managed Care (see Grant Results on ID# 030499).
  • In conjunction with other organizations, the development of a blueprint for adolescents (see Grant Results on ID#s 037525 and 041053 to the Youth Tobacco Cessation Collaborative).
  • In conjunction with other organizations, the development of a blueprint for pregnant smokers through RWJF's national program, Smoke Free Families: Innovations to Stop Smoking During and Beyond Pregnancy, working with the National Partnership to Help Pregnant Smokers Quit (see Grant Results).

RWJF saw the project described here as an opportunity to develop a new blueprint for adults, which would build on and coordinate with these other blueprints, and integrate them all into a national blueprint.

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THE PROJECT

The Center for Tobacco Research and Intervention served as the coordinating body, or secretariat, for the national blueprint development process. Under the first grant (ID# 043405), it assembled a consortium of 10 major public and private funders of tobacco cessation research (see the Appendix) to write the blueprint.

Under the second grant (ID# 045383), the consortium completed the blueprint and oversaw the transition to a permanent secretariat. Center activities included convening two meetings to review the blueprint draft, gathering additional feedback from external reviewers and facilitating conference calls with groups developing the blueprints for adolescents and pregnant smokers (see RWJF Strategy).

Two consultants, Allan Best, Ph.D., and Elaine Arkin, M.S., provided scientific input and facilitated collaboration among consortium members.

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RESULTS

The project accomplished the following:

  • The consortium produced A National Blueprint for Disseminating and Implementing Evidence-Based Clinical and Community Strategies to Promote Tobacco-Use Cessation. Completed in October 2002, the Blueprint combines into one document the tobacco cessation strategies outlined in the community and clinical guidelines. The Blueprint gives clinicians, health systems, consumers and communities objectives and strategies for implementing key recommendations from the two guidelines. The Blueprint recommends increasing the use of the best evidence-based tobacco cessation tools currently available, such as the Five A's (Ask, Advise, Assess, Assist and Arrange), while also stressing the need for continued research into more effective interventions, particularly for youth and underserved populations. The Blueprint emphasizes the importance of maintaining a tobacco cessation collaboration among groups with expertise in evidence-based cessation interventions and a willingness to commit significant resources to their dissemination.
  • With input from the consortium, the Center for Tobacco Research and Interventiondeveloped a plan for transitioning to a permanent secretariat that will oversee implementation of the blueprint. The Center for Tobacco Research and Intervention developed an outline of the skills needed by the permanent secretariat and its role in providing technical assistance. It also drafted a communication plan for making the blueprint widely available to national, state, regional and local audiences and recommended guidelines and criteria for selecting new members of the tobacco cessation collaboration.

Communications

In October 2002, the Agency for Healthcare Research and Quality submitted the Blueprint to the Secretary of the U.S. Department of Health and Human Services for approval before publication. As of September 2003, the Secretary was still reviewing the document. Project staff and representatives of the consortium gave panel presentations about the blueprint at both the 2001 and 2002 National Conferences on Tobacco or Health. See the Bibliography for details.

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LESSONS LEARNED

  1. To achieve consensus within large collaborations, face-to-face meetings are essential. The Center for Tobacco Research and Intervention had originally planned a series of teleconferences but realized that bringing the consortium members together at the beginning and end of the blueprint development process was critical. Breaking into small workgroups that reported to the larger consortium was also an important consensus-building strategy. (Project Director)

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AFTER THE GRANT

In October 2002, the Washington-based Center for Tobacco Cessation became the new blueprint secretariat. Created early in 2002 with joint funding from RWJF (Grant ID# 040101) and the American Cancer Society, the Center for Tobacco Cessation is a clearinghouse for efforts to translate tobacco research into practice. Six members of the blueprint consortium (the American Cancer Society, CDC, National Cancer Institute, Agency for Healthcare Quality and Research, American Legacy Foundation and National Institute of Drug Abuse) have agreed to support blueprint dissemination activities through 2005.

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GRANT DETAILS & CONTACT INFORMATION

Project

Blueprint for Disseminating Tobacco Dependence Guidelines

Grantee

University of Wisconsin Medical School (Madison,  WI)

  • Development of a Blueprint for Disseminating Tobacco Dependence Guidelines
    Amount: $ 53,909
    Dates: September 2001 to May 2002
    ID#:  043405

  • Completing and Implementing a National Blueprint to Promote Tobacco Cessation
    Amount: $ 53,732
    Dates: May 2002 to November 2002
    ID#:  045383

Contact

Michael C. Fiore, M.D., M.P.H.
(608) 262-8673
mcf@ctri.medicine.wisc.edu

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APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Organizations Participating in the Consortium that Developed the Blueprint

  • Agency for Health Care Research and Quality
  • Centers for Disease Control and Prevention
  • National Cancer Institute
  • American Cancer Society
  • American Legacy Foundation
  • Center for Medicare and Medicaid Services
  • Health Resources and Services Administration
  • National Heart, Lung, and Blood Institute
  • Substance Abuse and Mental Health Services Administration
  • The Robert Wood Johnson Foundation
  • Indian Health Services

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

A National Blueprint for Disseminating and Implementing Evidence-Based Clinical and Community Strategies to Promote Tobacco-Use Cessation. Madison, Wis.: University of Wisconsin, Center for Tobacco Research and Intervention, October 2002.

Presentations and Testimony

Linda Bailey, Cathy Backinger, Cathy Melvin and Victoria Wagman. "Getting There from Here: Using the Blueprints to Achieve Healthy People 2010," at the 2002 National Conference on Tobacco or Health, November 21, 2002, San Francisco. An abstract and PowerPoint presentation are available online.

Corinne G. Husten, Michael Fiore, Scott J. Leischow and Jon F. Kerner. "A National Blueprint for Disseminating and Implementing Evidence-Based Clinical and Community Strategies to Promote Tobacco-Use Cessation," at the 2002 National Conference on Tobacco or Health, November 21, 2002, San Francisco. An abstract and PowerPoint presentation are available online.

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Report prepared by: Jayme Hannay
Reviewed by: Robert Narus
Reviewed by: Molly McKaughan
Program Officer: C. Tracy Orleans

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