Project ECHO: TEACH

The current smoking prevalence rate in Texas is approximately the same as the national average of 16.8% (Learn more here). However, this overall rate masks elevated prevalence in certain segments of the population including those with behavioral health disorders. On average, more than 30% of the behavioral health population smokes and the rates get twice as high depending on the severity and the type of mental disorder. Not only do people with psychiatric disorders have much higher than average prevalence of smoking, but these individuals smoke more cigarettes per day than those without behavioral disorders (Read the complete article here). Tobacco use is the leading cause of preventable death in patients with psychiatric disorders.  Effective behavioral and pharmacologic treatments for tobacco use and dependence exist and are very cost-effective, but are underutilized even in the general population. Behavioral health smokers experience an additional set of barriers to tobacco treatments, which are specific to their psychiatric comorbidities. Therefore, it is critical to reach these patients with smoking cessation practices tailored to their needs.

The LMHAs represent an ideal setting in which to intervene, to reduce tobacco use among individuals with mental and behavioral care needs. However, almost 40% of the LMHAs that assess smoking status did not have a formalized plan to offer smoking cessation treatments. The goal of this project is to increase the access to specialized smoking cessation practices among providers of the Texas LMHAs. This will be accomplished through provider training in intensive smoking cessation interventions tailored to individuals with mental and behavioral care needs using the framework of Project ECHO. The current project will use MD Anderson Tobacco Treatment Program as a model for the intensive tobacco treatment, and will collaborate with and expand on the existing CPRIT-funded project Taking Texas Tobacco Free (Co-PIs: Lam & Reitzel; see Our History).

To address smoking and other tobacco use among psychiatric consumers in Texas, the Cancer Prevention and Research Institute of Texas (CPRIT), awarded a grant entitled "Taking Texas Tobacco Free (TTTF): Expanding the Integral Care Campus and Community Model into a Statewide Cancer Prevention Program" (PP130032; Co- PIs: Lam & Reitzel). The goal of TTTF is to implement a tobacco-free campus program in LMHAs across Texas and to increase the delivery of basic smoking cessation intervention among the LMHA patients.

Project TEACH is an MD Anderson Moonshot and Cancer Control Platform project, which expands upon TTTF and uses the Project ECHO framework to increase access to specialized smoking cessation treatment practices among LMHA providers.

Curriculum Topics

Click on any of the following links to view/download our previous slide presentations

• Motivational Interviewing in Tobacco Cessation: An Overview - Part I
• Neurobiology of Nicotine Dependence
• E-cigarettes: Tobacco Harm Reduction or Harm Perpetuation  
• Introduction to the Importance of Tobacco Cessation in Psychiatric Patients
• Managing Anxiety Associated with Withdrawal
  
• Selecting the Optimal Tobacco Cessation Medication
  
• Motivational Interviewing in Tobacco Cessation: A Brief Overview Part 2
  
• Overview of First-Line Tobacco Cessation Medication
• Motivational Interviewing: A Brief Overview Part 3 - Open-Ended Questions
• Common Beliefs About Smoking Cessation in Psychiatric Patients 
• E-cigarettes: What are They and Their Impact on Mental Health?
• Intake Assessment & Interdisciplinary Coordination of Medication Management 
• Tobacco Cessation for People with Schizophrenia
• Motivational Interviewing: A Brief Overview Part 4 - Affirmations
• Varenicline (Chantix): The Evolving Understanding of its Psychiatric and Cardiovascular Effects
• Motivational Interviewing: A Brief Overview Part 5 - Reflections
• Tobacco Control Among Youth: Emphasis on Mental Disorders
• Motivational Interviewing: A Brief Overview Part 6 - Summaries
• First Line Smoking Cessation Medications: Recognizing and Managing Side Effects
• Motivational Interviewing: A Brief Overview Part 7 - Four Oars - Putting it Together
• Cardiovascular and Psychiatric Events Associated with NRT and Bupropion
• Pathways for Treating Tobacco Use in the Clinic
• Motivational Interviewing (MI) in Tobacco Cessation: An Overview - Part 8: Change Talk/Sustain Talk
• Benefits of Quitting Tobacco for People with Mental Health Conditions
• Addressing Tobacco Treatment for Pregnant Women
• Interdisciplinary Coordination of Medication Management
• Behavioral Strategies in Tobacco Treatment: Stages of Change
• Tobacco Treatment with People Receiving Substance Abuse Treatment
• Coping Strategies for Tobacco Cessation Part I
• Ethics
• Coping Strategies for Tobacco Cessation Part II
• Behavioral Strategies in Tobacco Treatment: Identifying Triggers
• Smoking and Depression: What Every Clinician Should Know
• Relapse Prevention for Tobacco Cessation
• Tobacco Cessation Among People with Schizophrenia and Bipolar Disorder
• Group Counseling Tobacco

Instructions to submit new cases:

1. Download the following template for cases: ECHO-TEACH Case Presentation Template
2. Fill out the form (auto-fill available)
3. Send to AAAntwi@mdanderson.org by Friday morning

Continuing Education Credit

Instructions to obtain CME credit for attendance at the ECHO-TEACH clinic:

1. Review the following document for CME credit 
   CME Information/CME Disclosure Summary
2. Contact Andrea Antwi (AAAntwi@mdanderson.org) to get the CME evaluation links
3. Complete the survey

Note: The CME survey link becomes active at the end of the clinic and expires at 10 a.m. the following Monday

Instructions to obtain CEU credit for attendance at the ECHO-TEACH Clinic:  

• Contact Andrea Antwi by emailing AAAntwi@mdanderson.org

Upcoming Events

• ECHO Clinic: Every Tuesday from 12-1 p.m. CST

Project TEACH Schedule

• February 2016 - October 2016  
• October 2016 - August 2017