Summary of Qualitative Interviews with Clinic Administrators (n = 5), Health Educators (n = 5), and Patients (n = 31) Regarding Enhanced Standard Program (ESP) and Connection to Health for Smokers Program (CTHS)
| Clinic Administrators | Both Programs Aligned Well with Clinical Priorities. Both programs were feasible to implement with existing clinic resources. Health educators became more skilled in delivering smoking cessation services by participating in this research. CTHS required a steeper learning curve but provided more support for ongoing patient engagement, which was viewed as positive. Greater integration with the electronic health record both for referrals into these programs and for follow-up would be required to optimize sustainability. |
| Health Educators | Both programs were well-accepted by health educators. Health educators appreciated the training on principles of smoking cessation required for implementation of both programs, and on the benefits of smoking plans informed by social and behavioral determinants of health that was required for implementation of CTHS. CTHS was a more satisfying for most staff because it was perceived as more holistic and tailored to individual patient needs. ESP was perceived as easier to implement but not necessarily appropriate for all patients. Opportunities to improve efficiency and combine elements of each into a single improved program were identified. |
| Patient Participants | Patients in both programs reported high levels of satisfaction, especially with the degree of caring and sensitivity to challenges they faced in quitting smoking, and the level of follow up they received. They did not generally recall discussing a connection between smoking and other social and behavioral determinants of health with the health educator. Some indicated a desire for a program that would have more sustained engagement over a longer period of time to encourage them to reach their goals. Most patients in both arms indicated that this was the first time they had participated in an organized smoking cessation program. ESP patients focused program feedback on factual information that they learned from the program. Some appreciated the information, but others reported it was not new. CTHS patients focused program feedback on the detailed action plans they developed. Most appreciated the action planning process but not all were able to achieve their chosen goals. |