Competency-based training to advance clinical proficiencies and reduce disparities in the treatment of tobacco dependence

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Despite remarkable decreases in tobacco use, the benefits of tobacco control efforts are not equitably distributed. Tobacco-related disparities include a higher prevalence of daily smoking, lower rates of quitting, poorer responses to standard evidence-based treatments, less access to evidence-based treatments, variation in health care providers' delivery of tobacco treatment, and an increased burden of tobacco-related cancers and other tobacco-related diseases. Many tobacco users belong to more than one disparate group. Addressing these disparities is a high priority for cancer and tobacco control efforts. Critical barriers to reducing tobacco- related disparities include a tobacco treatment workforce unprepared to understand, assess, and treat tobacco users from disparate groups; knowledge deficits regarding the nature and impact of tobacco-related disparities; known research-to-practice gaps in the clinical proficiencies needed to treat tobacco use among disparate groups more effectively; and a unidimensional or essentialist conceptualization of the determinants that contribute to these inequities. These barriers prevent the development of personalized, relevant comprehensive tobacco treatment plans for these individuals. A unified, multidisciplinary competency-based curriculum developed by tobacco treatment disparities research, practice, and training experts and disseminated nationally would represent significant progress toward addressing these barriers. The goal of this project is to develop an innovative, competency-based Tobacco Use Treatment among Disparate Populations (TUT-DP) Training Module that will advance the proficiencies of the clinical and research workforce to meet the biomedical, behavioral, and clinical needs of groups that experience tobacco-related disparities. Experts in the field from multiple disciplines perceive a need for this resource. Among the innovative aspects of this project is the use of Intersectionality to integrate models of disparities and develop guiding principles for understanding biopsychosocial influences that produce tobacco-related disparities across disparate populations. The specific aims are: Aim One: Using a multidisciplinary team of tobacco research, practice, and training experts and an iterative process, develop a competency-based, highly disseminable TUT-DP Training Module that includes train-the-trainer resources, slides, and problem-based and experiential learning activities supported by high- quality recorded demonstration and trigger videos, a training manual, and learner evaluation instruments. Aim Two: Pilot test and refine the TUT-DP Training Module with trainers and learners from diverse professional backgrounds. Aim Three: Disseminate the TUT-DP Training Module broadly among tobacco treatment training programs and relevant professional organizations. This project is expected to have a sustained and powerful impact on the field by disseminating an innovative and engaging multidisciplinary training experience that advances clinical proficiencies and serves as an essential tool for clinical training in tobacco disparities. We will seek additional funding through the appropriate mechanism to examine the effectiveness of the TUT-DP Training Module in the next phase of this cancer education work.