CDC's Best Practices for Comprehensive Tobacco Control Programs—2014 is an evidence-based guide to help states plan and establish effective tobacco control programs to prevent and reduce tobacco use. This document updates. Patient and clinician videos related to the cardiovascular effects of smoking and assistance with quitting smoking. Smoking and Your Heart; How to Quit Smoking; Smoking Cessation with Your Patients.
Choosing and Adapting Community Interventions . Promoting the Adoption and Use of Best Practices .
A survey of families in the area had shown that most elementary school children spent much of their time watching TV or playing video games. Engrossed in these activities, the kids weren’t getting the exercise they needed.
Research had shown that introducing children to “lifetime” sports – tennis, swimming, hiking, skiing – was one of the best ways to instill in them a long- term commitment to regular physical activity. Members of the Coalition recognized this as a “best practice,” a proven solution to their problem. They realized, however, that they needed the cooperation of the schools, as well as local officials, to teach and promote these sports, as well as provide facilities for them.
The research team is testing whether providing program content via mobile phones increases long-term tobacco abstinence among participants in a best-practices Web-based smoking cessation intervention. This project is currently.
How could they go about convincing these indispensable partners to invest the necessary time, money, and energy? Was there a best practice for persuading a community to adopt good solutions? Best or promising practices can help you solve community problems, and save you the trouble of reinventing the wheel.
If someone else has already found an effective way to resolve your issue or advance your cause, it makes sense to use it. The first section of this chapter discussed how to recognize and choose promising practices for health and community development. Sometimes, however, those are only the preliminary steps. Once they’re completed, there may remain the task of getting those practices actually adopted and used in the community. In this section, we explore how to do just that, as well as looking at what a “best practice” is, and how to go about finding one appropriate for your needs. What is a best practice? A best practice may be a particular method, or it may be a whole program or intervention.
In general, a method or program gains such status by being: Measurable. That means that its goals are clear and that progress toward them can be measured. A smoking cessation program, for instance, can find out exactly what percentage of the smokers it served quit, and remained smoke- free after a year. It can also compare that percentage to similar percentages for other smoking cessation programs and for the general population. Notably successful. The method or program not only gains good results, but makes more progress toward achieving its goals than most others with similar aims. Replicable. The method or program is structured and documented clearly enough so that it can be reproduced (“replicated” is the formal term that social scientists, health professionals, government agencies, and funders often use) elsewhere.
Replication is always an issue. Even when every detail of a program is recorded, and its philosophical base is carefully explained, it’s seldom possible to reproduce it exactly. Communities and populations are different in size, character, culture, and other ways, and all of that affects the operation of a program or the application of a technique. In addition, some programs work as well as they do because of the individual skills or character of those who run them, a factor that it’s often impossible to reproduce. The real test of replication, as far as you’re concerned, should be whether you can reproduce it – exactly, or adapted to your needs – in your own situation.
If you can, it’s replicable; if you can’t, it’s not, regardless of what the research says. In a sense, the more adaptable a program or practice is, the more replicable it is, and that may be the key to whether it will be adopted by others. Best practices, in short, are those methods or programs that have been found to be successful in accomplishing their goals, and that can be used, or adapted for use, in your circumstances. The standards for choosing a best practice vary tremendously, depending upon who’s doing the choosing. In some cases, almost any program that can show some success is labeled a best practice. In others, the criteria are so strict that only a few are selected (more likely with professional associations that are trying to set or uphold research standards.)Where the standards are relatively loose, programs designated as best practices may be only adequate, rather than truly the best the field has to offer.
Where the standards are too strict, many superb programs may be passed over because they don’t collect enough data on themselves, or for other technical reasons. When looking at best practices with an eye toward using one for a local intervention, it’s important to keep in mind whose best practices they are, and how they were chosen. Keep in mind that “promising practices” – those that may not have been tested or in existence for very long, but seem to work – are also worth investigating. You may find something that seems to have serious potential, and that fits perfectly with the folks you work with, the goals you want to accomplish, and your philosophy. Some other things to keep in mind when considering best practices: Fit with your community and population.
Does the method or program make sense given the realities of your community? Can it be adapted to match those realities?
A community health education program may ignore the possibility that a large part of the population may speak very little or no English, for instance, or may be illiterate in any language. The program may be adaptable, but it also may make more sense to find a program that takes such circumstances into account. Appropriateness to your goals. Does the best practice in question actually address your specific goals? The fact that it’s a best practice for the issue you’re concerned with doesn’t necessarily mean that it has the same aims you do. If it treats the symptoms of a problem, that may not be enough if you’re attempting to deal with the underlying causes, for instance. Fit with the structure and philosophy of the organization or initiative that will use it.
Coverage For Tobacco Use Cessation Treatments (updated May 2014) This updated 2014 document provides an overview of the evidence base for tobacco cessation insurance coverage, best practices for designing cessation coverage. With the proliferation of smartphones such as the iPhone, mobile phones are being used in novel ways to promote smoking cessation. Each app was independently coded by two reviewers for their (1) approach to smoking cessation. This article reviews the evidence for effective smoking cessation interventions in hospitalized cardiac and pulmonary patients. Research evidence from 1992 through June 2002 was located through searches of CINAHL (169. Best Practices for Cessation: When selecting and developing tobacco treatment skills and programs, MDQuit encourages healthcare providers to stay up-to-date on clinical techni.
A program all of whose authority is in the hands of organization staff would not be a good fit with an organization whose main thrust is to help participants take control of their lives, for example. Availability of resources.
A sure way to make an effort fail is to approach it with inadequate resources, whether money, personnel, or skills. Make certain you understand exactly what a particular best practice will require in the way of resources – and that you can somehow provide them – before you commit to using it. Cost- effectiveness. If a program works well, but costs huge amounts of money or time to reproduce, it may be all but useless to most organizations or communities that want to use it. A program that works slightly less well, but costs a third as much might, in fact, be a much better candidate for the “best practice” label. We have previously set out some general criteria for identifying best and promising practices and programs, based largely on the work of Lisbeth Schorr.
According to those criteria, best practices have all or many of these characteristics: They are comprehensive, aiming at all aspects of an issue. They are flexible and responsive, reacting to the needs of the population and changes in circumstances and conditions. They persevere, keeping at it as long as is necessary – indefinitely, if that’s what it takes. They look at issues and people in their context – family, history, community, etc. They target the underlying causes in addition to the symptoms of an issue or problem. They have – and stick to – a clear mission.
They evolve over time, as need dictates. They are managed by competent people with appropriate skills. Their staff members are trained and supported to provide high- quality, responsive service. They foster strong staff/participant relationships based on mutual respect. They collaborate, both internally and externally. Both the organization and individual staff members have a set of core values that strengthen their dedication, morale, and resolve, and that give them a shared sense of purpose for the work.
Why promote the adoption and use of best practices? One answer to this question is obvious: employing a method or program that’s been tested and found successful increases the chances that you’ll accomplish your goals, and that life will therefore be better for the folks who participate. There are, however, further reasons why the use of a best practice can be advantageous. Using a recognized best practice makes it easier to justify the work.
If an organization or initiative is starting from scratch, the community – and especially potential participants – may be justifiably skeptical about what it’s doing. Demonstrating that it’s using a practice that has been shown to be effective can relieve at least some of that skepticism and gain support. Using recognized best practices can bolster the credibility of an organization. It shows not only that the organization is using a tested process, but that it has been thinking ahead and conducting research to make sure it’s doing the best job possible. Using best practices can make it easier to get funding. Funders look more favorably on proposals that can demonstrate proven success. There is a downside to this advantage as well.
Sometimes funders insist on the use of best practices, or of a single best practice. They see this as minimizing the possibility of interventions not working, but it also minimizes the possibility of innovation and the development of new best practices. Moreover, it ignores the fact that best practices don’t always work in every situation, and that some organizations may get outstanding results using practices that don’t show up in the research. Using a best practice removes a lot of the guesswork from planning. Employing a program or method whose structure and process are carefully documented makes it easier to set up and implement, and increases the chances that it will go smoothly.
The originators of the practice are known, and might be available to consult on how to best implement it.