Implementing an Evidence-based Tobacco Control Program at Five 2-1-1 Call Centers: An Evaluation Using the...

Area of Science:

• Public Health
• Health Services Research
• Tobacco Control

Background:

• Smoke-free home policies are crucial for reducing secondhand smoke exposure.
• Evidence-based interventions are needed to promote smoke-free homes, especially in low-income populations.
• Social service agencies, like 2-1-1 call centers, offer a scalable platform for health interventions.

Purpose of the Study:

• To analyze facilitators and barriers to scaling up the Smoke-Free Homes (SFH) Program within 2-1-1 call centers.
• To evaluate the implementation of an evidence-based intervention promoting smoke-free homes among low-income populations.
• To identify factors influencing the successful adoption and sustainability of public health programs in community service settings.

Main Methods:

• A mixed-methods approach using the Consolidated Framework for Implementation Research.
• Online surveys administered to 2-1-1 staff before training, after training, and post-implementation (N=120, 101, 79).
• Semi-structured telephone interviews with 25 staff to explore attitudes, contextual factors, and implementation outcomes.

Main Results:

• Post-implementation, a majority of staff found SFH consistent with their mission (79%) and believed it increased smoke-free homes (70%).
• Perceived appropriateness and staff positivity toward SFH were lower post-implementation compared to pre-implementation.
• Staff reported concerns regarding intervention sustainability, required time and resources, and workflow integration.

Conclusions:

• The SFH intervention was found to be acceptable and feasible across multiple 2-1-1 sites.
• Implementation success was influenced by intervention delivery demands, perceived effectiveness, and organizational mission alignment.
• Addressing barriers such as funding, dedicated staff time, and workflow fit is essential for future scale-up of tobacco control programs.