Optimizing Tobacco-Free Workplace Programs: Applying Rapid Qualitative Analysis to Adapt Interventions for Texas Healthcare Centers Serving Rural and Medically Underserved Patients

Authors

• Hannah Wani
• Maggie Britton
• Tzuan A Chen
• Ammar D Siddiqi
• Asfand B Moosa
• Teresa Williams
• Kathleen Casey
• Lorraine R Reitzel
• Isabel Martinez Leal

Language

English

Publication Date

7-23-2025

Journal

Cancers

DOI

10.3390/cancers17152442

PMID

40805146

PMCID

PMC12346715

PubMedCentral® Posted Date

7-23-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Tobacco use is disproportionately high in rural areas, contributing to elevated cancer mortality, yet it often goes untreated due to limited access to care, high poverty and uninsured rates, and co-occurring substance use disorders (SUDs). This study explored the utility of using rapid qualitative analysis (RQA) to guide the adaptation of a tobacco-free workplace program (TFWP) in Texas healthcare centers serving adults with SUDs in medically underserved areas.

Methods: From September-December 2023 and May-July 2024, we conducted 11 pre-implementation, virtual semi-structured group interviews focused on adapting the TFWP to local contexts (N = 69); 7 with providers (n = 34) and managers (n = 12) and 4 with patients (n = 23) in 6 healthcare centers. Two qualified analysts independently summarized transcripts, using RQA templates of key domains drawn from interview guides to summarize and organize data in matrices, enabling systematic comparison.

Results: The main themes identified were minimal organizational tobacco cessation support and practices, and attitudinal barriers, as follows: (1) the need for program materials tailored to local populations; (2) limited tobacco cessation practices and partial policies-staff requested guidance on enhancing tobacco screenings and cessation delivery, and integrating new interventions; (3) contradictory views on treating tobacco use that can inhibit implementation (e.g., wanting to quit yet anxious that quitting would cause SUD relapse); and (4) inadequate environmental supports-staff requested treating tobacco-use training, patients group cessation counseling; both requested nicotine replacement therapy.

Conclusions: RQA identified key areas requiring capacity development through participants' willingness to adopt the following adaptations: program content (e.g., trainings and tailored educational materials), delivery methods/systems (e.g., adopting additional tobacco care interventions) and implementation strategies (e.g., integrating tobacco cessation practices into routine care) critical to optimizing TFWP fit and implementation. The study findings can inform timely formative evaluation processes to design and tailor similar intervention efforts by addressing site-specific needs and implementation barriers to enhance program uptake.

Keywords

cancer prevention, healthcare disparities, tobacco cessation interventions, tobacco-use disparities, medically underserved, social determinants of health, implementation science, rapid qualitative analysis, tobacco-free workplace policies, rural tobacco use

Published Open-Access

yes

Recommended Citation

Wani, Hannah; Britton, Maggie; Chen, Tzuan A; et al., "Optimizing Tobacco-Free Workplace Programs: Applying Rapid Qualitative Analysis to Adapt Interventions for Texas Healthcare Centers Serving Rural and Medically Underserved Patients" (2025). Faculty, Staff and Student Publications. 3889.
https://digitalcommons.library.tmc.edu/uthmed_docs/3889