This study will assess the process and the degree of implementation of a smoking cessation program in the 1.5 years following its dissemination to 18 agencies responsible for performing case management home visits to women enrolled in the Family Case Management and Healthy Start programs. The program, initially developed for use in public health clinics, was adapted for use in case management home visits and a one- day training was provided to 73 case managers. Follow-up information on the program utilization will be obtained from: (1) in-depth interviews with key informants at the 18 agencies; (2) perusal of relevant documents; and (3) structured interviews with the 73 individuals who attended the training and about 40 other case managers they, in turn, trained to deliver the program. Specifically, the study will assess: a. How the smoking cessation program was incorporated into case management home visit protocols, what degree of monitoring and accountability were attached to its implementation, and what organizational support and resources were allocated to its maintenance. b. The case managers knowledge, attitudes, and normative perceptions about the program and their experiences with program implementation that may predispose, enable and reinforce consistent program implementation. c. The degree of program delivery and program coverage as part of home visits. d. The factors associated with program delivery and program coverage, including how they are affected by the above items a. and b. and by characteristics of the agency to which the case managers are attached. Results from the study will be used to develop better program dissemination strategies to enhance the likelihood that train-the- trainer events will result in effective program implementation.
