{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T02:45:42Z","timestamp":1778035542351,"version":"3.51.4"},"reference-count":38,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health Ruth L Kirschstein Postdoctoral Fellowship","award":["T32CA193193"],"award-info":[{"award-number":["T32CA193193"]}]},{"name":"National Institutes of Health Ruth L Kirschstein Postdoctoral Fellowship","award":["IRG-16-222-56"],"award-info":[{"award-number":["IRG-16-222-56"]}]},{"name":"National Institutes of Health Ruth L Kirschstein Postdoctoral Fellowship","award":["P30 CA14599"],"award-info":[{"award-number":["P30 CA14599"]}]},{"name":"ACS_IRG","award":["T32CA193193"],"award-info":[{"award-number":["T32CA193193"]}]},{"name":"ACS_IRG","award":["IRG-16-222-56"],"award-info":[{"award-number":["IRG-16-222-56"]}]},{"name":"ACS_IRG","award":["P30 CA14599"],"award-info":[{"award-number":["P30 CA14599"]}]},{"name":"American Cancer Society and the UChicago Cancer Center Support Grant","award":["T32CA193193"],"award-info":[{"award-number":["T32CA193193"]}]},{"name":"American Cancer Society and the UChicago Cancer Center Support Grant","award":["IRG-16-222-56"],"award-info":[{"award-number":["IRG-16-222-56"]}]},{"name":"American Cancer Society and the UChicago Cancer Center Support Grant","award":["P30 CA14599"],"award-info":[{"award-number":["P30 CA14599"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Individuals from communities with a low socioeconomic status have the highest rates of tobacco use but are less likely to receive assistance with quitting. Community health workers (CHWs) are well-positioned to engage these communities; however, CHWs face barriers in receiving relevant tobacco cessation training. The objective of this study was to conduct a mixed methods needs assessment to describe tobacco practices and the desire for training among CHWs. After incorporating CHW feedback, we developed a needs assessment survey to understand knowledge, practices, and attitudes about tobacco cessation in Chicago, IL. CHWs (N = 23) recruited from local community-based organizations completed the survey online or in-person. We then conducted a focus group with CHWs (N = 6) to expand upon the survey and used the Framework Method to analyze the qualitative data. CHWs reported that their clients had low incomes, low literacy levels, and high smoking rates (e.g., \u201c99%\u201d of patients). About 73.3% reported discussing tobacco use during visits, but fewer reported that they had provided cessation advice (43%) or intervened directly (9%). CHWs described high variability in their work environments (e.g., location, duration, content of visits, etc.) and greater continuity of care. CHWs discussed that existing training on how to conduct tobacco interventions is ineffective, because of its stand-alone design. Our findings illustrate how CHWs adapt to their clients\u2019 needs, and that the currently available \u201cgold-standard\u201d cessation curricula are incompatible with the training needs and flexible care delivery model of CHWs. A curriculum tailored to the CHW experience is needed to maximize the strengths of the CHW care model by training CHWs to adaptively intervene regarding tobacco use in their highly burdened patients.<\/jats:p>","DOI":"10.3390\/ijerph20085574","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T02:01:11Z","timestamp":1681956071000},"page":"5574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Addressing Tobacco Use in Underserved Communities Outside of Primary Care: The Need to Tailor Tobacco Cessation Training for Community Health Workers"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8553-5319","authenticated-orcid":false,"given":"Marcia M.","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA"},{"name":"Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Chicago, IL 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shariwa","family":"Oke","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daryn","family":"Ellison","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarissa","family":"Huard","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Veluz-Wilkins","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637, USA"},{"name":"Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Chicago, IL 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3322\/canjclin.54.2.78","article-title":"Cancer disparities by race\/ethnicity and socioeconomic status","volume":"54","author":"Ward","year":"2004","journal-title":"CA A Cancer J. 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