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Member Research & Reports

Member Research & Reports

UAB: Using Continuous Quality Improvement Tools to Promote Tobacco Cessation Among Primary Caregivers in a Home Visiting Program in Alabama

Alabama’s Maternal, Infant, and Early Childhood Home Visiting (MIECHV)–funded program was one of 10 state teams accepted to participate in the first wave of the Federal Home Visiting Program State and Territory Continuous Quality Improvement Practicum. This article reports methods and results of Alabama’s continuous quality improvement (CQI) project and lessons learned in developing CQI capabilities among state and local public health practitioners.

Dr. Matthew Fifolt, Dr. Julie Preskitt, Ms. Heather Johnson, and Ms. Elizabeth Johns collaborated on this article, Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health.

The MIECHV program requires all awardees to lead continuous quality improvement (CQI) initiatives to identify areas for improvement and monitor progress toward program goals. The aim of the CQI Practicum was that 60 percent of primary caregivers who used tobacco products would make a quit attempt. On the basis of CQI interventions, Alabama reached its goal; 12 of 20 primary caregivers in these two HV programs made quit attempts.

The team recognized a need to develop a better understanding of the research literature in order to create tools that would enable home visitors to broach the sensitive topic of tobacco cessation with clients. Program revisions reflected new knowledge of behavior change, nicotine replacement therapies, and other tools and strategies for tobacco cessation. Alabama utilized multiple CQI tools to reach an ambitious, behavior-based aim; these same concepts could be broadly applied to quality improvement initiatives in any federal or state public health program to guide process- and outcomes-based improvement efforts.

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