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View full policyExternal facilitation to expand reach of tobacco treatment to SMI Veterans
NIH
About This Grant
Significance: Tobacco smoking and its health consequences disproportionally impact Veterans. Veterans with serious mental illness (SMI Veterans; schizophrenia spectrum, bipolar spectrum, and other psychotic disorders) have among the highest rates of smoking in VA and die 10-15 years earlier than those without SMI, largely due to smoking-related conditions. Seven FDA-approved tobacco medications are available in VA that are low-cost, safe, and effective for SMI Veterans when combined with brief behavioral counseling: nicotine replacement therapies (lozenge, gum, patch, nasal spray), bupropion, and varenicline. Nearly 70% of SMI Veterans who smoke want to quit, but they are 26% less likely to be prescribed tobacco medication (10.9% vs. 14.3% prescription rate). SMI providers face numerous barriers to treating smoking. External facilitation can address these barriers by coordinating evidence-supported implementation activities, such as educational outreach and auditing with feedback, and shows promise for improving tobacco medication prescriptions in VA mental health clinics. Despite the availability of tobacco treatment in VA, smoking-related conditions remain the leading cause of death for SMI Veterans and account for nearly 8% of VA health care expenditures: $2.7 billion annually. Integrating tobacco medication into routine mental health care can maximize the use of existing resources and expand the reach of tobacco medication to Veterans with the highest smoking, but lowest treatment rates. Innovation & Impact: Innovations of this project include evaluating evidence-supported implementation strategies in mental health clinics, addressing barriers to tobacco treatment across patient, provider, and system levels, evaluating changes in prescribing practices for all FDA-approved tobacco medications, including non- prescribers in implementation activities, using data to refine the implementation strategy, and capitalizing on existing VA resources that support quality improvement and tobacco treatment. This project will serve as preliminary data for a fully powered effectiveness-implementation trial with the potential to improve timely access to care, address a leading cause of death for SMI Veterans, and reduce smoking-related health care costs. Specific Aims: This pilot study will refine and evaluate the feasibility and acceptability of an externalfacilitation strategy that aims to increase prescriber adoption of tobacco medication. Specific aims are to: Aim 1: Trial an external facilitation strategy designed to improve tobacco medication prescribing in Perry Point SMI clinics. Aim 2: Evaluate the feasibility and acceptability of the external facilitation strategy, monitor provider adoption of tobacco medication, and refine the strategy accordingly. Aim 3: Implement the refined external facilitation strategy in Baltimore SMI clinics, re-evaluate feasibility, acceptability, and adoption, and explore reach and effectiveness of tobacco medication. Methodology: This pilot study will use mixed methods to evaluate changes in the feasibility and acceptability of an external facilitation strategy and provider adoption of tobacco medication through activity tracking, surveys, and semi-structured interviews with providers (Perry Point n ~ 11, Baltimore n ~ 24) at two VA Maryland Health Care System facilities. Secondary outcomes will be changes in monthly reach of tobacco medication to SMI Veterans (Perry Point n ~ 75, Baltimore n ~ 165) and changes in smoking rates using EHR data. Path to Implementation: With support from local leadership, VA’s Quality Enhancement Research Initiative, and operational partners, results from this proposal will a yield an implementation blueprint for how to tailor implementation activities designed to improve tobacco medication to local needs. Additionally, findings from this proposal will serve as preliminary data for a fully powered, multisite hybrid effectiveness-implementation trial as part of a Merit application that can establish the effectiveness of using external facilitation to expand the reach of underutilized, cost-effective tobacco medications for SMI Veterans.
Grant Summary
External facilitation to expand reach of tobacco treatment to SMI Veterans is a NIH grant providing funding that varies by award for university, nonprofit, healthcare org. Applications are due 2031-04-30 (open). Check eligibility and apply with FindGrants.
Focus Areas
Eligibility
How to Apply
Up to $0K
2031-04-30
- 1Confirm your organization is eligible for External facilitation to expand reach of tobacco treatment to SMI Veterans from NIH, checking organization type, location, and any population or project requirements.
- 2Gather the required documents and information, including your organization details, project plan, and budget figures.
- 3Draft your application narrative and budget addressing the funder's priorities and review criteria. FindGrants can draft each section for you to review and edit.
- 4Review every section against the requirements checklist, then export a submission-ready application pack and submit it to NIH before the deadline.
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External facilitation to expand reach of tobacco treatment to SMI Veterans: Frequently Asked Questions
Who is eligible for the External facilitation to expand reach of tobacco treatment to SMI Veterans?
External facilitation to expand reach of tobacco treatment to SMI Veterans is offered by NIH and is generally open to university, nonprofit, healthcare org. It is open to organizations nationwide unless the funder specifies otherwise. Review the specific eligibility terms before applying, since funders set their own requirements around organization type, location, and the population or project being served.
How much funding does the External facilitation to expand reach of tobacco treatment to SMI Veterans provide?
External facilitation to expand reach of tobacco treatment to SMI Veterans provides an amount that varies by award per award from NIH. Actual award sizes depend on the scope of your project, available program funds, and the number of applicants, so build a budget that reflects realistic, allowable costs rather than the maximum figure.
When is the External facilitation to expand reach of tobacco treatment to SMI Veterans deadline?
Applications for External facilitation to expand reach of tobacco treatment to SMI Veterans are due 2031-04-30 (open). Because deadlines can change, verify the date with the funder, NIH, and give yourself enough time to prepare a complete, competitive application before the close date.
How do you apply for the External facilitation to expand reach of tobacco treatment to SMI Veterans?
To apply for External facilitation to expand reach of tobacco treatment to SMI Veterans, confirm your eligibility, gather the required documents, and prepare a narrative and budget that address the funder's priorities. FindGrants guides you step by step and can draft each section, then exports a submission-ready application pack for this grant from NIH.