Implementation mapping for tobacco cessation in a federally qualified health center.
Date
2022-01
Journal Title
Journal ISSN
Volume Title
Repository Usage Stats
views
downloads
Citation Stats
Abstract
Background
Implementation mapping (IM) is a promising five-step method for guiding planning, execution, and maintenance of an innovation. Case examples are valuable for implementation practitioners to understand considerations for applying IM. This pilot study aimed to determine the feasibility of using IM within a federally qualified health center (FQHC) with limited funds and a 1-year timeline.Methods
An urban FQHC partnered with an academic team to employ IM for implementing a computerized strategy of tobacco cessation: the 5A's (Ask, Advise, Assess, Assist, Arrange). Each step of IM was supplemented with theory-driven methods and frameworks. Data collection included surveys and interviews with clinic staff, analyzed via rapid data analysis.Results
Medical assistants and clinicians were identified as primary implementers of the 5A's intervention. Salient determinants of change included the perceived compatibility and relative priority of 5A's. Performance objectives and change objectives were derived to address these determinants, along with a suite of implementation strategies. Despite indicators of adoptability and acceptability of the 5A's, reductions in willingness to adopt the implementation package occurred over time and the intervention was not adopted by the FQHC within the study timeframe. This is likely due to the strain of the COVID-19 pandemic altering health clinic priorities.Conclusions
Administratively, the five IM steps are feasible to conduct with FQHC staff within 1 year. However, this study did not obtain its intended outcomes. Lessons learned include the importance of re-assessing barriers over time and ensuring a longer timeframe to observe implementation outcomes.Type
Department
Description
Provenance
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Domlyn, Ariel M, Carolyn Crowder, Howard Eisenson, Kathryn I Pollak, James M Davis, Patrick S Calhoun and Sarah M Wilson (2022). Implementation mapping for tobacco cessation in a federally qualified health center. Frontiers in public health, 10. p. 908646. 10.3389/fpubh.2022.908646 Retrieved from https://hdl.handle.net/10161/26274.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Scholars@Duke

Kathryn IIonka Pollak
Dr. Pollak is a social psychologist who designs and tests behavioral interventions to promote smoking cessation, reduce health disparities, and improve clinician-patient communication. She also is one of the Multiple Principal Investigators of the Palliative Care Research Cooperative that supports multi-site palliative care trials. Finally, Dr. Pollak serves as a Communication Coach where she teaches clinicians effective communication techniques.
Area of expertise: Health Behavior

James Davis
Dr. James Davis is a practicing physician of Internal Medicine, and serves as the Medical Director for Duke Center for Smoking Cessation, Director of the Duke Smoking Cessation Program and Co-Director of the Duke-UNC Tobacco Treatment Specialist Credentialing Program. His research focuses on development of new pharmaceutical treatments for smoking cessation. He is principal investigator on several trials including a study on “adaptive” smoking cessation and several trials on new medications for smoking cessation. The new medications leverage more novel neurobiological mechanisms - NMDA receptor antagonism, nicotinic receptor antagonism, which impact addiction-based learning and cue response. Additionally, Dr. Davis serves as co-investigator on trials on lung cancer screening, e-cigarettes, minor nicotine alkaloids, imaging trials, lung function trials and others. Dr. Davis leads the Duke Smoke-Free Policy Initiative, is co-author on a national tobacco dependence treatment guideline, and provides training in tobacco dependence treatment for the Duke School of Medicine, Duke Internal Medicine, Family Practice and Psychiatry residency programs.

Patrick Shields Calhoun
I specialize in the assessment and treatment of the psychological and behavioral sequelae of posttraumatic stress disorder (PTSD) including the use of cognitive-behavioral interventions to reduce PTSD symptoms, aggression, and substance misuse.
Research interests
- The psychological, behavioral, and health consequences of traumatic stress
- Health services research related to PTSD and associated behavioral difficulties
- Identification of innovative health behavior change interventions to reduce smoking, alcohol, and drug misuse
- Implementation Science
- Psychometric assessment and methodology

Sarah M Wilson
Sarah M. Wilson is an Assistant Professor in the Department of Psychiatry & Behavioral Sciences at the Duke University School of Medicine, with a secondary appointment in the Department of Population Health Sciences. She is a Research Investigator at the Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT COIN). She also serves as the Associate Director of the Duke Center for AIDS Research Social and Behavioral Sciences Core. Dr. Wilson's research focuses on implementation science and access to healthcare.
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.