Grant Number:	1P01CA298972-01A1 Interpret this number
Primary Investigator:	Mccarthy, Danielle
Organization:	University Of Wisconsin-Madison
Project Title:	Identifying Effective and Efficient Strategies to Enhance the Use of Evidence-Based Tobacco Helpline Treatment Among Adult Community Health Center Patients
Fiscal Year:	2026

ABSTRACT Tobacco use remains a significant driver of disease and mortality in the US and is highly prevalent among patients served by Community Health Centers (CHCs) that provide care to millions of US adults. Efforts to increase access to evidence-based tobacco cessation treatment through resources like state tobacco helplines have helped many people quit tobacco but have not reached all people affected by tobacco use. The goal of the proposed Program Project is to enhance tobacco cessation and address gaps in tobacco treatment in partnership with 16 Community Health Centers (CHCs). CHCs are particularly well positioned for this effort, as they treat patients whose smoking prevalence is roughly twice that of the general population. While CHCs consistently screen for tobacco use and advise patients to quit, they currently connect few of their patients to tobacco treatment, and they often lack the resources to deliver recommended treatment at the point of care while addressing patients' other pressing needs. The proposed P01 Program Project, comprising 3 highly integrated research Projects supported by 3 Shared Resource Cores, will leverage CHC strengths to evaluate promising intervention and implementation strategies that can help close gaps in tobacco treatment. Project 1 will use an efficient sequential multiple assignment randomized trial to evaluate centralized strategies that leverage electronic health record (EHR) data to generate multi-modal patient outreach to increase use of remote tobacco helpline treatments until patients achieve their goals (e.g., quitting combusted tobacco). This project will generate knowledge about how to optimize tobacco outreach and smoking treatment in CHC settings to stoke CHC patient desire to change and increase use and re-use of evidence-based helpline treatment, as needed, to reduce or quit smoking. Project 2 will use an efficient and pragmatic cluster- randomized crossover trial design to evaluate the population-level reach, effectiveness, and costs of adding centralized tobacco treatment to services provided at the point-of-care at CHCs (vs. an enhanced point-of-care comparator). Project 3 will refine and evaluate promising implementation resources and strategies designed to overcome challenges to tobacco treatment outreach and delivery in varied CHC settings by leveraging EHR reporting tools to create sustainable means to facilitate, monitor, and improve and sustain CHC tobacco treatment delivery. The Administrative, CHC Engagement, and Methods Shared Resource Cores will work with all 3 Projects to advance the science of tobacco treatment delivery in CHCs, while also generating implementation tools such as patient-facing tobacco treatment outreach materials; tobacco helpline treatment manuals; implementation guides and EHR resources for tobacco treatment in CHCs; and case studies of sustained CHC tobacco care programs. The Projects and Cores in this P01 are highly integrated to foster multilevel evaluation of health system practices that can effectively and efficiently increase the population-level impact of existing tobacco treatments and reduce tobacco-driven morbidity and mortality in CHCs.





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