Thinking Outside of the Box:

Transcription

1 Thinking Outside of the Box: Creative Approaches to Tobacco Cessation Wednesday, August 23 rd, 2017, 2:00pm EDT Presented by: Carole Specktor, MPA Catherine Gangi, MPH, CHES Erica Sitton, MA, OTR/L Sally Sales, MA

2 Welcome! Lea Simms Project Coordinator, National Behavioral Health Network for Tobacco & Cancer Control National Council for Behavioral Health 2

3 Jointly funded by CDC s Office on Smoking & Health & Division of Cancer Prevention & Control Provides resources and tools to help organizations reduce tobacco use and cancer among people with mental illness and addictions 1 of 8 CDC National Networks to eliminate cancer and tobacco disparities in priority populations Visit and Join Today! Free Access to Toolkits, training opportunities, virtual communities and other resources Webinars & Presentations State Strategy Sessions Community ofpractice #BHtheChange

4 Tobacco Cessation

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6 Housekeeping How to join the webinar? GoToWebinar INSTRUCTIONS: Join the webinar: Call in using your telephone: +1 (631) Access Code: Audio PIN: Shown after joining the meeting To ask a question: type it into the Q&A pod. Technical difficulties? Call Citrix Tech Support at

7 Today s Agenda Welcome & Housekeeping Minnesota landscape Creating effective change for tobacco cessation Educating staff and getting buy-in Making an impact Moderated Q&A 7

8 Guest Speaker #1 Carole Specktor, M.P.A. Senior Cessation Manager, ClearWay Minnesota 8

9 Community Engagement Grant Overview National Council for Behavioral Health Webinar August 23,

10 About ClearWay Minnesota Tobacco Use in Minnesota Today s Presentation Community Engagement Grants: The Why The What The How Available Resource 10

11 About ClearWay Minnesota

12 Mission: Reduce the harm tobacco causes the people of Minnesota Grant-making, QUITPLAN stop-smoking services and statewide outreach activities 12

13 3 Tobacco Use in Minnesota

14 Adult Smoking Prevalence in U.S. & Minnesota US MN Sources: Minnesota Adult Tobacco Survey 2014 Update; National Health Interview Survey (NHIS) 14

15 Percent current smokers Some Groups Smoke at Higher Rates Percent of adults who are current cigarette smokers, 2014 (BRFSS) Amer Indian [1%] Asian [4%] Black [5%] Hispanic [5%] 15.9 White [82%] HS grad or less [35%] Income <35K [21%] 34.1 Out of Work [4%] 27.8 Binge drinking [20%] 43.4 Psych distress [2%] Horizontal line is statewide average percent of 16.3% (BRFSS, 2014). [%] is the percent that group makes up of the total adult population. 15

16 Percent Current Smokers Disparities in Tobacco Use Related to Mental Health Status among Adults in Minnesota Percent of adults who are current smokers, by mental health status, Minnesota, Ever Depression? 43.4 Now have serious psychological distress? Now receiving treatment? Current smoking rate was: 1.9 times as high for adults who had ever been diagnosed with a depressive disorder 2.5 times as high for adults who now have serious psychological distress 1.6 times as high for adults who are currently taking medication or receiving treatment for mental or emotional health problems Yes No Source: Minnesota Behavior Risk Factor Surveillance System,

17 Community Engagement Grants The What, Why and How

18 Community Engagement Grants Goals Primary: To link low-ses smokers to existing cessation services Secondary: To create organizational capacity to continue the work beyond the grant period. Grants to community-based organizations Funding Amount: Up to $50,000 Grant Period: 12 Months 18 18

19 Why Low Socioeconomic Status (SES)? SES remains one of greatest predictors of tobacco usage Prevalence Industry targeting Normative Competing priorities Less access to cessation services Disproportionate impact 19 19

20 Low SES Smoking in Minnesota Figure 1: Minnesota Adult Smoking Prevalence by Income Figure 2: Minnesota Adult Smoking Prevalence by Education Level 30% 35% 25% 20% 15% 10% 24.4% 15.9% 14.7% 8.7% $35,000 or less $35,001 to $50,000 $50,001 to $75,000 $75,001 or more 30% 25% 20% 15% 10% 28.6% 20.1% 15.6% Less than High School High school graduate/ged Some college or technical school College graduate or beyond 5% 5% 5.1% 0% 0% Source: Minnesota Adult Tobacco Survey 2014 Update 20 20

21 Environmental Scan Literature States Foundations Key Informants 21

22 Scan Themes: How to Reach Low SES Smokers Top three themes: Partner with community/social service organizations Ensure cultural sensitivity / tailored materials Trusted messenger Reach smokers where they are already gathering or receiving services 22

23 Granting to Community-based Organizations Community-Based Organizations Understand their communities Best situated to devise actions and solutions Trusted source Where tobacco users are already gathering and/or receiving services 23

24 Grants Communities Served Number of Organizations People living with mental illnesses American Indian 3 Low-income 3 Latino 1 Southeast Asian Immigrants 1 (on behalf of a coalition of 4 organizations) African Immigrants

25 Resources Case Study: Connection People with Mental Illnesses to Cessation Services

26 Examples of Approaches Culturally-specific tools Materials Community Health Workers (CHWs) Outreach and Community Engagement Culturally-specific venues and events Sage bundles Spanish posters Media Dakota language radio Native news network African newspapers 26 26

27 Case Study: Connecting People with Mental Illnesses to Cessation Services Strategies and accomplishments for each organization Facilitators, challenges and barriers across the four organizations Lessons learned 27

28 Carole Specktor (952)

29 Guest Speaker #2 Catherine Gangi, MPH, CHES Community Health Educator with NAMI working on smoking cessation for people with a mental illness Instructor for QPR suicide prevention classes Instructor for Youth and Adult Mental Health First Aid 29

30 Our Journey with Smoking Cessation Catherine Gangi, MPH, CHES

31 Objectives 1. Learn how to develop interactive programming 2. Learn strategies for discussing smoking cessation with individuals 3. Gain insight on how to discuss smoking cessation and mental illness with providers

32 Key Activities Workshops: NAMI Minnesota delivered 29 one-hour workshops 19 for community members who live with mental illnesses 10 for mental health professionals. Upcoming: Online training Interactive training for mental health providers on smoking and mental illness

33 Provider Workshops One-hour lunch and learn format Reached 166 providers Interactive and tailored learning Smoking cessation interventions FDA-approved medications Strategies for integrating cessation services into current practice And more!

34 Provider Workshop Takeaways Addressing misconceptions: Interaction of smoking with psychiatric medications Impact of smoking on symptoms of mental illnesses Limited knowledge of smoking cessation medications Addressing tobacco use is not a priority Low confidence in discussing tobacco use Follow-up with clients about smoking is rare

35 Agree/Strongly Agree My knowledge of smoking cessation strategies for individuals with mental illnesses increased. 96% I would feel comfortable discussing assessment tools and planning for interventions with my clients/patients 82% I have a better understanding of relapse prevention strategies. 82% I am more familiar with different cessation treatment options. 91% 75% 80% 85% 90% 95% 100%

36 Individual Workshops One-hour workshop Reached 136 individuals Discussion-based format Topics: coping skills, asking for support, preventing relapse, FDA approved medications, etc. Individual one-on-one sessions Carbon monoxide monitor readings Quit Kits Resources, stress ball, water bottle, etc. 112 quit kits distributed

37 Partnerships were formed with: Partnerships

38 Individual Workshop Takeaways Reducing stigma through support and guidance Meeting the individual where they are at Coping strategies Mini quits Feedback from individuals who successfully quit Resources & handouts: developing a quit plan, stress, healthy recipes, etc. Having a conversation in a community space

39 Before Workshop I am comfortable discussing smoking cessation with my doctor or health provider. 84% I know where to get resources and support materials for smoking cessation. 52% After Workshop 0% 20% 40% 60% 80% 100% As a result of this training, I am more comfortable discussing smoking cessation with my doctor or health provider. As a result of this training, I know more about where to get resources and support materials for smoking cessation. 79% 82% 20 follow up calls by a Walgreens pharmacist 77% 78% 79% 80% 81% 82% 83%

40 Comments From Evaluations Presenter was very knowledgeable and the training helped me a lot. I'm ready to start my journey. Good looking out 4 my health Great! Had me really thinking of Quitting Smoking for first time. Introduced ways to Quit that I didn't know. I would like a sponsor to help me on my journey to a better successful quit smoking / a non-smoker It was very help to me. Answer my questions & concerns. Thank you for your time and info. We learning a great deal. They listen to me, and they are well inform about smoking. Very personal, helpful, informative. Not judgmental, easygoing.

41 Next Steps: Online Training Three-hour online training focusing on smoking and mental illness Mental health professionals Throughout Minnesota Developed with a smoking cessation advisory committee of individuals and providers Problem-based learning Insights from workshops were used to focus content

42 Contact Information Catherine Gangi, MPH, CHES Community Health Educator NAMI Minnesota 800 Transfer Road, Suite 31 Saint Paul, MN ext NAMI-HELPS

43 Guest Speaker #3 Erica Sitton, MA, OTR/L Health and Wellness Manager, Mental Health Resources 43

44 CULTIVATING CULTURE CHANGE: Making Tobacco Cessation Part of the Organizational Norm Erica Sitton, MA, OTR/L Mental Health Resources Saint Paul MN Health and Wellness Manager

45 Culture Change

46 Assessment Have you used tobacco products or an e-cig in the last week? Have you or others been concerned about your tobacco/e-cig use?

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49 Ongoing Commercial Tobacco Use (08/2014 to present, n=2047) 60% 50% 46% 52% 49% 49% 46% 46% 40% 39% 47% 46% 47% 30% 20% 20% 10% 0%

50 Newly Abstaining from Commercial Tobacco (01/2016 to 06/2017, n=2047) 30% 25% 20% 19% 23% 26% 26% 28% 16% 15% 10% 5% 0%

51 Carbon Monoxide About $1000 each from CoVita with supplies for 1 year of daily use and maintenance Breath Testing

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54 What Kind of CO Monitor Does MHR Use? Unit: PiCo+ Smokerlyzer from Cost: startup + first year about $1100. About $300/year after that. Training: 2-3 hours free online training materials from CoVita with purchase. Maintenance: Change D-piece monthly. Calibrate with CO canister every 6 months.

55 Guest Speaker #4 Sally Sales, M.A. Community Support Program Director, RESOURCE 55

56 Making an Impact: Creative Approaches to Tobacco Cessation Education RESOURCE Sally Sales, MA Program Director (612)

57 This is not easy. Competing interests Lack of time Myths and fears Find ways to keep the topic fresh, relevant and engaging Create opportunities for conversations

58 Basic Training Developing traditional trainings for all staff Partnered with experts at the American Lung Association for education about tobacco use and cessation Included our own expert practitioners Chemical health staff nicotine is an addiction we need to treat RN info about NRT and how to use it Health Coaches use your MI skills to talk to clients about tobacco use and quitting (we can all be Health Coaches)

59 Following up Tobacco Champions led follow up discussions Health Coach and other Tobacco Champions went out to team meetings not long after the training Opportunity to talk about what you heard Ask questions in a more comfortable setting Hear what your team members are doing Get resources and ideas

60 Give us some positive reasons to quit!

61 I m Worth It Poster contest Call for art Living tobacco-free has many benefits. Tell us about them. Open to all RESOURCE clients We provided info about Financial benefits Health benefits Winners will be made into posters to be displayed at RESOURCE locations + a cash prize

62 Creating a buzz Conversations generated for clients and staff Two pop-ups for staff to vote Celebration to announce the winners Posters distributed to all locations

63 I m Worth It Calendar Another conversation starter Calendar included Client artwork Information about effects of tobacco use Connections to cessation supports and resources Distributed to interested individuals as a way to talk about and support cessation

64 So much to learn The journey continues Deciding what s next How to be inclusive? How to embed this into all we do? KEEP THE CONVERSATIONS GOING!

65 Questions? To ask a question, type it into the Q&A box in your webinar window.

66 Jointly funded by CDC s Office on Smoking & Health & Division of Cancer Prevention & Control Provides resources and tools to help organizations reduce tobacco use and cancer among people with mental illness and addictions 1 of 8 CDC National Networks to eliminate cancer and tobacco disparities in priority populations Visit and Join Today! Free Access to Toolkits, training opportunities, virtual communities and other resources Webinars & Presentations State Strategy Sessions Community ofpractice #BHtheChange

67 Health Financing Webinar Series: Sept. 13: Cracking the (CPT) Code for Tobacco Cessation & Cancer Prevention Oct. 11: Finding New Financing for Tobacco Cessation & Cancer Prevention Efforts Cancer Control Webinar Series: Sept. 12: Promising Practices to Track, Monitor and Address Needs Across the Cancer Continuum in Behavioral Health Populations Oct. 17: Financing Cancer Control Practices for Behavioral Health Populations Other Webinars: Additional Opportunities Aug. 31: Overcoming Implicit Bias in Tobacco Cessation for Behavioral Health Populations Sept. 26: The Intersection of Tobacco, E-Cigarettes, and Marijuana Use

68 Thank you for joining us! As you exit the webinar, please do not forget to complete the evaluation survey. Questions? Please contact Lea Simms at