A Multi-State Asian-Language Quitline for Smokers

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DESCRIPTION (provided by applicant): This study addresses a significant gap in the implementation of effective tobacco cessation services as recommended by the Community Guide to Preventive Services. The Guide recommends telephone counseling, or "quitlines," as a key population-based tobacco control strategy. Currently, all 50 U.S. states have established quitlines. However, only one quitline offers direct counseling in Asian languages. Justifications for the absence of Asian-language services range from the lack of proven protocols for this population to the practical difficulty of staffing a program in multiple Asian languages. The project will translate an experimentally validated, Asian-language, smoking cessation telephone counseling protocol into a multi-state quitline operation. State health departments in California, Hawaii and Colorado will work with the researchers who developed and tested the protocol to create a practical dissemination model. The project aims to demonstrate that collaboration between researchers and policy makers will help to translate research results quickly into real world public health practice. The project involves both dissemination and implementation and has two overlapping phases. In the first phase, researchers will work with three states that are ready to adopt an Asian quitline. Together they will: (1) evaluate the dissemination success of a multi-state model for an Asian quitline in which each state promotes the quitline individually, but a centralized operation provides the counseling service; (2) examine the natural variation in implementation of promotional strategies by comparing smokers' responses to advertising messages in the context of state-specific cessation policies; and (3) test implementation fidelity by comparing the number and length of counseling sessions with those in California's original Asian trial, and with those of participating states' English and Spanish quitlines. In the second phase, researchers will work with the health departments in other states to encourage further dissemination. Specifically, they will: (1) examine the organizational readiness of other state health departments to adopt either the multi-state Asian quitline or to start their own Asian quitlines, and to assess their change in readiness from year 1 to year 3; (2) conduct in-depth interviews with representatives from selected state health departments, state quitline operators, and community organizations to determine their perceptions of barriers to adoption of Asian-language quitlines; and (3) set in motion a process for further dissemination by recruiting at least one additional state to join the multi-state Asian quitline by year 3 of the project. The proposed multi-state quitline project, if implemented successfully, can serve as a model for other states in providing behavioral cessation services to Asian-language smokers, helping to reduce disparities in access to effective treatment for these populations.