{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:27:50Z","timestamp":1792114070661,"version":"4.4.0"},"reference-count":42,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["PP200051"],"award-info":[{"award-number":["PP200051"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["U54MD015946"],"award-info":[{"award-number":["U54MD015946"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Houston\u2019s Provost\u2019s Undergraduate Research Scholarship","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Despite prior successful implementation of Taking Texas Tobacco Free (TTTF), an evidence-based tobacco-free workplace program, in local mental health authorities (LMHAs), post-implementation employee attrition necessitated continuing education on tobacco-free policies and tobacco treatment practices. Here, we report on the outcomes of a train-the-trainer program which trained \u201cchampions\u201d to deliver tobacco cessation education at their LMHAs. Three LMHAs participated in program implementation via 10 champions, iteratively trained and coached by TTTF. Measures administered evaluated four goals: (1) increase champions\u2019 self-efficacy in delivering trainings, (2) achieve program fidelity via TTTF staff evaluation of trainer effectiveness and knowledge increases among attending employees, (3) achieve stakeholder program acceptability, and (4) achieve program adoption via an increase in follow-up trainings. Champions\u2019 self-efficacy increased throughout TTTF training. TTTF staff ratings of champion-led trainings met the targeted range for trainer effectiveness; employees had a 28.71% knowledge increase over baseline post-training (p &lt; 0.001). Employees rated champions\u2019 training delivery \u201cvery good\u201d to \u201cexcellent\u201d, on average; both champions and employees were, on average, \u201csatisfied\u201d to \u201cextremely satisfied\u201d with the curriculum and training received. There was an increase over baseline in trainings delivered during follow-up, and trainings increased in length and topic coverage. Ultimately, the train-the-trainer program achieved the intended goals, although not all changes were statistically significant, likely at least partially attributable to small sample sizes. Overall, these results suggest that TTTF\u2019s train-the-trainer program was successful in its delivery and intention to build capacity for the provision of in-house tobacco education trainings to behavioral health employees\/providers. However, further evaluation in additional settings, with more champions, et cetera, is necessary to validate these findings, ensure their replicability, link program implementation with reduced patient tobacco use rates, and assess long-term sustainability.<\/jats:p>","DOI":"10.3390\/ijerph182111635","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T10:33:09Z","timestamp":1636108389000},"page":"11635","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Implementation and Outcomes of a Train-the-Trainer Program at Behavioral Health Treatment Centers as a Mechanism to Maintain Organizational Capacity to Address Tobacco Use Disorder"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8310-3077","authenticated-orcid":false,"given":"Vijay","family":"Nitturi","sequence":"first","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4312-7258","authenticated-orcid":false,"given":"Tzuan A.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0073-339X","authenticated-orcid":false,"given":"Isabel","family":"Martinez Leal","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virmarie","family":"Correa-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Drenner","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryce","family":"Kyburz","sequence":"additional","affiliation":[{"name":"Integral Care, Austin, TX 78703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Williams","sequence":"additional","affiliation":[{"name":"Integral Care, Austin, TX 78703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezemenari M.","family":"Obasi","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Howard","sequence":"additional","affiliation":[{"name":"Heart of Texas Region MHMR, Waco, TX 76701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogelio","family":"Rangel","sequence":"additional","affiliation":[{"name":"Border Region Behavioral Health Center, Laredo, TX 78041, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7012-0767","authenticated-orcid":false,"given":"Jeni","family":"Sharp","sequence":"additional","affiliation":[{"name":"Heart of Texas Region MHMR, Waco, TX 76701, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Smith","sequence":"additional","affiliation":[{"name":"West Texas Centers, Big Springs, TX 79720, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-5720","authenticated-orcid":false,"given":"Lorraine R.","family":"Reitzel","sequence":"additional","affiliation":[{"name":"Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA"},{"name":"HEALTH Research Institute, University of Houston, Houston, TX 77204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"ref_1","unstructured":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health (2014). 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Serv."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11635\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:26:34Z","timestamp":1760167594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,5]]},"references-count":42,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["ijerph182111635"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182111635","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,5]]}}}