Organizational readiness and engagement of community oncology practices in implementing tobacco use assessment and treatment

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PROJECT SUMMARY/ABSTRACT Smoking remains a leading cause of preventable premature disease, disability, and death in the United States. Tobacco use assessment and treatment is important for individuals with cancer diagnoses, because persistent smoking can increase illness burden and contribute to negative treatment outcomes. Although the National Comprehensive Cancer Network (NCCN) recommends evidence-based tobacco use assessment and treatment, the actual delivery of smoking cessation in the context of cancer care has been inconsistent. Few studies have examined how organizational level factors influence the adoption of NCCN guidelines for smoking cessation in oncology practices. Community based oncology networks serve diverse populations including rural, economically/socially disadvantaged, racial and ethnic minorities, and low-resourced communities. We propose to enhance the clinical trial for the parent grant, “Implementing A Virtual Tobacco Treatment in Community Oncology Practices” (R01CA214427; MPIs Dr. Park and Dr. Ostroff) by: 1) examining organizational contexts that influence adoption of tobacco treatment interventions in cancer care settings; and 2) identifying strategies to facilitate implementation of tobacco use assessment and treatment in NCORP cancer Community Sites and Minority/Underserved Community Sites enrolled in the parent R01 trial. Quantitative research methods will be used to explore the association between organizational readiness to implement tobacco use assessment and treatment and the capacity for cancer care delivery in NCORP community oncology practices. Using a mixed methods approach, we will evaluate sub affiliate level engagement, assess barriers and facilitators to community-engaged research (CEnR), and identify potential implementation strategies to improve adoption of tobacco use assessment and treatment in community oncology settings with a focus on understanding variation among the NCORP sites participating in the SSS 2.0 trial. The significance of this project is its contribution to the limited knowledge about contextual factors influencing the adoption of tobacco use assessment and treatment in community oncology settings. This project will also identify how best to engage community oncology sub affiliates and inform strategies for improving adoption and integration of smoking cessation in community oncology practices. Findings will inform the design of a planned large-scale type III hybrid implementation trial that will test various implementation strategies for developing systems for tobacco use documentation and improving adoption of tobacco use assessment and treatment in community oncology settings.