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Tobacco Control Integration Project (TCIP)

 

In Oregon, people with lower incomes and lower education levels smoke at more than three times the rate of those with greater resources. The Tobacco Control Integration Project (TCIP) is taking a comprehensive and collaborative approach to reducing this tobacco-use disparity by advancing policies and systems changes at the service-delivery level. TCIP brings what the state’s Tobacco Prevention and Education Program (TPEP) knows about tobacco control to the Oregonians who need it most.

In partnership with TPEP, Oregon Health Authority (OHA) and Oregon’s Department of Human Services (DHS), TCIP integrates comprehensive tobacco control initiatives into the health and human services provided by DHS/OHA. TCIP reaches approximately half of all tobacco users in the state through policy changes to reduce exposure to second-hand smoke; procedural changes to ensure that all DHS clients have direct access to smoking cessation resources; and messaging specifically addressing DHS/OHA clients. TCIP objectives also include a counter-advertising campaign and support of a policy proposal to raise tobacco prices in Oregon.

On this page:

Addictions and Mental Health Division (AMH)

Children, Adults, and Families Division (CAF)

Division of Medical Assistance Programs (DMAP)

Public Health Division (PHD)

Seniors and People with Disabilities Division(SPD)

Evaluation

Media

TPEP-TCIP

Tobacco-free DHS

TCIP Presentations to Date

 

 Addictions and Mental Health Division (AMH)   

  • The Clinician-assisted Tobacco Cessation training held in Medford, Oregon, in early December 2011, brought together 44 clinicians.  Participants included psychiatrists, nurse practitioners, physician assistants, nurses, addiction counselors and clinical psychologist.  Dr. Jodi Prochaska from the Department of Psychiatry, University of California, San Francisco, provided a training on evidence-based treatment of tobacco dependence with focus on smokers with co-occurring psychiatric and addictive disorders.
  • A report of the survey of all AMH residential treatment facilities in Oregon is complete and available on the Tobacco Freedom website.  This report was submitted to Centers for Chronic Disease Control and Prevention (CDC), Preventing Chronic Disease Journal which was accepted and published November 2011.  The title of the brief is Promoting Smoke- free Environments and Tobacco Cessation in Residential Treatment Facilities for Mental Health and Substance Addictions.  To view the Brief go to www.cdc.gov/pcd/issues/2012/11_0080.htm
  • The AMH tobacco-free campus policy was adopted 10/1/11. The policy covers all funded and licensed addictions and mental health residential treatment facilities and will go into effect in two phases.  On 1/1/12 tobacco cessation is included in all residential treatment plans and 7/1/12 facility campuses become tobacco-free.
  • The Tobacco Freedom 2011 Spring and Fall training were successful. A total of 194 participants attended. The participants included facility administrators, program mangers, nurses and peer counselors. Dr. Chad Morris from the University of Colorado, School of Medicine and his team delivered the training. 
  • Tobacco Freedom launched its website in December 2010 - www.oregon.gov/oha/amh/pages/tobacco-freedom/main.aspx. Recent postings include a report on tobacco cessation services offered to Oregon’s Medicaid population by health plan and a listing of online training for behavioral health clinical providers on nicotine replacement therapy and psychotropic medication.

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Children, Adults, and Families Division (CAF)  

  • Client exit survey to assess messages and efficacy of reach of QL cards completed in Eugene July 2011.
  • “Cost of Tobacco” QuitLine information cards and posters are being distributed through CAF Central Office to all CAF District and Field Offices around the state beginning June 2011.
  • Amendments proposed to CAF administrative rules (OAR’s) to establish compliance with the Oregon Indoor Clean Air Act (ICAA) in certified foster homes, academic boarding schools, and residential care agencies.

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Division of Medical Assistance Programs (DMAP)   

  • Dr. Jeffrey Fellows from Kaiser Health Research Center presented on tobacco cessation and return of investment to health plans’ Medical Directors June 2011.
  • All 15 managed care organization completed the tobacco cessation services survey. Preliminary findings were presented to health plans on March 14, 2011. The full report was submitted to health plans on May 9, 2011.
  • Presentations to plans and their medical directors occurred during March and April 2011.
  • Tobacco cessation minimum standards of service (TCMSS) have been drafted and vetted within DMAP.
  • TCMSS are also drafted into Oregon Administrative Rules for managed care organizations with intent to make them final on January 2012.

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Public Health Division (PHD)  

  • Tobacco-free campus language integrated into the scoring component (equal to 2% of total points possible) of all Public Health Division renewal contracts and new Requests for Proposal (RFP’s).
  • Working with web governance committee to place QuitLine referral button/links on redesigned PHD web pages.
  • Work group currently surveying Family Health programs and inventorying publications and outreach materials for possible integration of tobacco cessation messaging.
  • TCIP-OFH work group also looking at possible inclusion of cessation messages in WIC text message system.

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 Seniors and People with Disabilities Division (SPD)  

  • Two surveys were conducted during the period between October and December 2011.  One was an online survey to collect information from a sample of Community-Based Programs serving people with disabilities and the other was a telephone survey of 144 Nursing Facilities in the State. The purpose of these two surveys is to assess readiness for smoke-free policy and cessation training of staff.
  • In collaboration with Managers and Directors for Developmental Disabilities (DD) statewide programs, an advisory group was formed September 2011.  This group meets monthly with TCIP staff to provide input on best approaches to incorporating tobacco cessation messaging in programs serving the DD population.
  • Workgroups and pilot projects forming around the state, including Douglas County. Klamath and Lake Counties are considering a pilot.
  • Added QuitLine button/links to the following homecare agency web pages:
  • Homecare Worker workgroup is active and meeting monthly. The group has:
    • Developed a list of recommended interventions;
    • Vetted language for insertion into newsletters and on websites;
    • Conducted a survey for workers who smoke to test cessation messages and interventions. These results were used to inform the workgroup on preferred messages for homecare workers, which aided in the drafting of a cessation policy.
    • Passed the Homecare Worker Tobacco Cessation Policy, identifying effective communication channels to systematically promote tobacco cessation benefits to homecare workers.

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Evaluation   

  • Contracted with and developed scope of work for Program Design and Evaluation Services (PDES) for evaluation support to TCIP.
  • Created evaluation plans for TCIP efforts in each division and tracking progress towards grant objectives.
  • Assessed residential AMH facilities; submitting report for publication.

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Media   

  • Launched TV ads targeting tobacco disparities in September 2011.
  • Conducted focus groups among low-SES individuals who smoke to learn more about how they receive information, what messages might resonate and push them toward quitting and to better understand their smoking behavior.
  • Researched existing advertising and messages in other states targeted toward people experiencing fewer financial resources.
  • Started work on a comprehensive media plan that will coordinate media relations and paid advertising, and will culminate in a targeted advertising campaign in the spring of 2011.
  • Launched advertising campaign featuring “Debi” and “Daddy’s Tape” and including Free NRT end card.

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TPEP-TCIP 

  • Working with rules coordinators and policy analysts in each Division to update Oregon Administrative Rules (OAR’s) and bring them into compliance with the Oregon Smoke-free Workplace law. Developed a process and designed a tool for rule analysis.
  • Working with Liaisons and county coordinators to accurately assess the level of compliance with Tobacco-Free DHS.
  • Creating a plan of action to bring facilities into compliance with Tobacco-Free DHS.

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Tobacco-free DHS 

  • In collaboration with the Department of Administrative Services (DAS) and the Portland State Office Buildin(PSOB) Tenant Advisory Group (TAG), the campus of the PSOB became 100% tobacco-free in October 2011.
  • In collaboration with TPEP Coordinators, completed assessments of 137 DHS/OHA facilities in 27 of 36 Oregon counties.
  • Facilities being evaluated for tobacco-free status in relation to the Tobacco-free DHS policy, which mandates that properties wholly owned and/or operated by DHS must maintain completely tobacco-free campuses.
  • Facilities that DHS/OHA does not own or that are shared with other tenants will be considered for possible, future lease negotiations to bring all facilities at the location up to the Tobacco-free DHS policy standard.

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TCIP Presentations to Date 

  • Clinician-assisted Tobacco Cessation Training – December 2011, Medford, OR
  • Bringing Tobacco Control to Those Who Need it Most: Oregon’s Tobacco Control Integration Project – October 2011, Washington D.C.
  • Oregon Public Health Association Annual Conference and Meeting – October 2011, Corvallis, OR
  • Spring and Fall Tobacco Freedom Training – April and September 2011, Salem, Roseburg and Coos Bay, OR
  • Managed Care Medical Directors – March 2011, Salem, OR
  • Managed Care Organizations Quality Performance and Improvement Workgroup – March 2011, Salem, OR
  • Managed Care Organizations Rules and Contracts Language Workgroup – February 2011, Salem, OR
  • Medicaid Advisory Committee – February 2011, Salem, OR
  • Senior Services Commission – February 2011, Salem, OR
  • ASTHO Conference call with tobacco issues sub-committee – January, 2011, national call
  • Place Matters ancillary session – November 2010, Portland, OR
  • Mental Health Consumer/Survivor Advisory Councils – October 2010, Salem, OR
  • Prevention Conference – September 2010, Eugene, OR
  • Home Care Commission – August 2010, Salem, OR
  • SPD Program Mangers Meeting – July 2010, Salem, OR
  • Senior Services Commission – June 2010, Salem, OR
  • Healthy-Active Douglas County – June 2010, Roseburg, OR
  • AMH Spring Conference – May 2010, Salem, OR
  • Home Care Commission – April 2010, Salem, OR
  • Promising Practices Conference – April 2010, New Orleans, LA

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