National Working Group for ACTTION

January 26, 2010

In early December, the first state ACTTION summit was held in Indianapolis.  Led by Dr. Judy Monroe, Indiana Health Commissioner and Karla Sneegas, Executive Director of Indiana Tobacco Prevention and Cessation, the Indiana Cessation Summit drew 79 attendees from around the state.  The group identified a list of strategies to increase cessation in Indiana with an emphasis on those which were low and no cost.  The areas of focus were business and industry, policy change, electronic and internet solutions, health care provider education, quit line promotion, and patient and community education.

ACTTION interviewed Karla Sneegas (KS) after the summit to learn about the process involved in planning a successful summit and staying the course afterwards.

ACTTION: What made you decide to hold a statewide cessation summit?

KS:   Several things came together to help us decide to hold the summit.  Our state health commissioner, Judy Monroe, who was president of ASTHO at the time, attended the ACTTION summit last fall.  She wanted to do something in Indiana to promote the ACTTIOn goals.  Separately, Karen Hudmon of Purdue and others became interested in pulling the “right” people together for a concentrated day of planning.  The “right” people are the people who should be engaged, who are in a position to implement specific action steps to reduce tobacco use.

ACTTION: What was the goal of the summit?

KS: People should walk out the door with things to do.  The plan that would be developed would not be an elaborate strategic plan that had to be vetted and reviewed.  Instead the plan would be a list of steps that the participants would commit to undertaking.

ACTTION: What was the best thing that came out of the summit?

KS: There was an “aha” moment when the participants saw that if Indiana is to reduce its smoking rate, policy change was necessary at the state or macro level.  For the first time, many of the participants understood that although small day-to-day steps were important to reducing tobacco use, a change at a higher level was necessary. 

Participants were shown data comparing the 10 states with the highest prevalence of smoking with the states with the lowest prevalence.  The biggest difference between those two groups of states was that the states with the most smoking had the lowest taxes on tobacco and the weakest bans on smoking, usually without a statewide ban.

The message that the participants saw for themselves was that a statewide smoking ban was needed, as well as an increase in tobacco taxes.

ACTTION: What sectors did you consider critical to have at the table?

KS: Providers, payers, employers—people and organizations who have not been deeply involved in tobacco control activities.

ACTTION: How did you get these players to the table?

KS: Having the state health commissioner as the convener of the meeting was critical.  The invitation was issued by three of us—the health commissioner; myself,  Karla Sneegas, Executive Director of Indiana Tobacco Prevention and Cessation; and Dr. Karen Hudmon, Associate Professor, Purdue University School of Pharmacy.
The lesson for successful attendance is to find a key convener.

ACTTION: How was the meeting structured?

KS: We had help from a professional facilitator in planning the structure for the day.

The meeting was held in one large room, with round tables provided for small group discussions. The meeting started with keynote challenges, including one from Diane Canova of the Partnership for Prevention.  This was followed by a “gallery walk” in which participants walked around the room looking at a series of displays—photos, flip charts, graphs, tobacco products, etc.—each providing data and information about tobacco and tobacco use.  Participants were provided with a worksheet to record their reactions to what they saw in the gallery walk.

The next agenda item was a brief—30minute—review of the best practices included in the PHS Guidelines for Cessation.

After the presentation, the groups dug in at their round tables to talk about what they had seen and learned and what their goals should be based on this information.  Each table had a facilitator and a note taker.  During the course of the day the notes were written up, printed and shared.

ACTTION: How will you monitor progress on these strategies? 

KS: It is now on “us”, the developers of the summit, to make this happen.  We will look at each group to decide if a partner or staff member is the best choice to follow up on efforts to implement the actions agreed on at the summit.  The follow-up process must be managed.  This will be an agenda item at our monthly ITPC staff meetings.  We will also have monthly conference calls with some of the groups to see how they are doing.

ACTTION: What suggestions do you have for other states that may want to follow your lead?

KS: Do it!

We thought it was very valuable to have tobacco cessation issues considered through the lens of individuals and groups who do not work on these issues 24/7 as some of us do.  We made a specific decision not to include our local tobacco control coalitions in this meeting.  The action items will be shared with them later.  However, it was key to make this summit an opportunity to bring new partners to the table.  And having a convener with clout was essential in getting these people to participate.

……………………………

Dr. Karen Hudmon is developing an Indiana summit case study that will be shared with others states and serve as a model as the ACTTION National Working Group expands its outreach and partnering efforts in 2010.