Examining health systems grantee partnerships with behavioral health treatment facilities to support tobacco-related policy and practice changes using implementation science

Abstract

Integrating policies and practices that require tobacco use screening and treatment within behavioral health treatment facilities promotes tobacco use dependence treatment among individuals who experience mental health conditions. The New York (NY) Tobacco Control Program funds regional grantee organizations to provide technical assistance to facilities to support the adoption of tobacco cessation policies. This study describes how state-funded grantees supported Behavioral Health Treatment Facilities and highlights factors that facilitated or hindered NY facilities' adoption and implementation of systems changes. We used a qualitative design to interview nine regional grantee staff members and 15 staff members from four facilities to understand the policy adoption and implementation processes and how grantee partnerships supported these processes. We used the Consolidated Framework for Implementation Research to identify facilitators and barriers to adoption and implementation processes. Grantees supported the adoption and implementation processes by providing ongoing technical assistance, materials to improve electronic health record systems, financial incentives, and free nicotine replacement therapy. Facility and grantee staff members reported facilitators that included champions encouraging implementation of tobacco-related policies and practices, facility leadership committed to systems changes, and other state regulatory offices requiring similar policies and practices. Barriers included staffing shortages, staff turnover, and prioritizing treatment for conditions considered more urgent than tobacco use. These findings demonstrate how implementation science can be used to assess how state-funded grantees support the adoption of tobacco-related policies and practices within behavioral health treatment facilities. This study can inform future strategies to support systems change and overcome barriers to adoption, implementation, and maintenance.