Tobacco cessation skills certification in Arizona: application of a state wide, community based model for diffusion of evidence based practice guidelines

Objective-To describe the development and preliminary results from a commun ity based certification model for training in tobacco cessation skills in A rizona. Design-A programme evaluation using both quantitative pre-post measures and qualitative methods. Setting-Arizona's comprehensive tobacco control programme of state funded, community based local projects and their community partners providing tobac co treatment services for geographically, socioeconomically, and ethnically diverse communities. Intervention-A three tiered model of skills based training emphasising Agen cy for Health Care Policy and Research guidelines, and utilising a training of trainers approach to build community capacity. Certification roles addr essed basic tobacco cessation skills, tobacco cessation specialist, and tob acco treatment services manager. Participants-Initial target audience was community based local project pers onnel and their community partners, with later adoption by community organi sations unaffiliated with local projects, and the general public. Main evaluation measures-Process measures: participant satisfaction, knowle dge, skills, and self-efficacy. Outcome: participant demographics, communit y organisations represented, post-training, cessation related activities. Results-During the model's implementation year, 1075 participants attended certification training, 947 participants received basic skills certificates and 82 received specialist certificates. Pre, post, and three month measur es of self efficacy showed significant and durable increases. Analysis of p articipant characteristics demonstrated broad community representation. At post-training follow up, 80.9% of basic skills trainees had performed at le ast one brief intervention and 74.8% had made a referral to intensive servi ces. Among cessation specialists, 48.8% were delivering intensive services and 69.5% were teaching basic skills classes. Conclusions-Initial experience with Arizona's state wide, community based m odel for certification of tobacco cessation skills training suggests this m odel may be a promising method for broad, population based diffusion of evi dence based tobacco cessation guidelines.