An ongoing tobacco use cessation effort, funded by the Robert Wood Johnson Foundation, is using a new collaborative method to engage healthcare providers in performing more frequent interventions in the course of their clinical practice when encountering patients who smoke. This seems to be working, and success of the program seems to depend, not only on the efficacy of the clinical interventions, which have been available for many years, but also on the nature of the partnerships that are being forged and the unique characteristics of the collaborative methods used to build the partnerships to accelerate the adoption of effective clinical interventions. Our overall Phase I goal is to demonstrate the feasibility of training others in applying these proven collaborative methods for making health professionals more effective as interventionists in changing unhealthy behavior. These collaborative methods were developed over the past 13 years and have been applied by their developer in many coalition-building projects at the community, corporate, and statewide level. The smoking cessation project is the first time that these methods were applied to a healthcare problem and also the first time that the developer has applied them nationwide. Our Phase I SBIR seeks to determine whether these methods are scalable and extensible, as developing a robust commercial product based upon them would require. By scalable, we mean that trainees can learn the methods with fidelity, apply them effectively, and ideally even teach them to others. By extensible, we mean that these methods can be adapted to change any in a broad class of unhealthy behaviors, of which tobacco use is only one typical example. Other kinds of unhealthy behavior that might be targeted effectively include many addictions, the causes or contributing factors in certain illnesses and, in general, any health condition that admits to a proven intervention and during which the patient will encounter a clinician who can apply the intervention. This encounter need not result from initiative by the patient, who might not want to change the target behavior or might not even be consciously aware of it. The research is innovative in the following ways: it seeks to achieve change through a new technique that is uniquely different from other collaborative methods; it applies this technique to smoking cessation, marking the first such application in a healthcare setting and the first at a nationwide scale; and it focuses on clinicians and healthcare professionals, empowering them as catalysts for change, rather than focusing directly on patients, as is usually done. Tobacco is the leading preventable cause of death, and yet 46 million Americans still smoke. A commercial product that empowers interventions capable of changing unhealthy behavior practiced by millions of people nationwide would have the potential to save many lives and prevent much illness and disability. ? ? ?
