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Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses

Joseph GL Lee1*, Leah M Ranney1, Adam O Goldstein1, Anna McCullough1, Sterling M Fulton-Smith2 and Nicole O Collins3

Author Affiliations

1 Tobacco Prevention and Evaluation Program, Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, CB 7595, 590 Manning Drive, Chapel Hill, North Carolina 27599 USA

2 North Carolina Health and Wellness Trust Fund Commission, 7090 Mail Service Center, Raleigh, North Carolina 27699 USA

3 Southern Regional Area Health Education Center, 1601 Owen Drive, Fayetteville, North Carolina 28304 USA

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BMC Public Health 2011, 11:702  doi:10.1186/1471-2458-11-702

Published: 14 September 2011



Tobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness. This study evaluated the implementation, technical assistance, and perceived impact of a model curriculum ("Learning About Healthy Living") to promote wellness and motivation to quit tobacco use in psychosocial rehabilitation clubhouses.


We used semi-structured interviews (n = 9) with clubhouse staff (n = 12) and a survey of participating clubhouse members (n = 271) in nine clubhouses.


Fifty-eight percent of clubhouse participants completed surveys. Results showed tobacco users open to tobacco-free policies (62%) and perceiving more discussions about quitting tobacco with healthcare providers (69%). Analyses of staff interviews and member surveys revealed four key themes: (1) the curriculum was successfully implemented and appreciated; (2) technical assistance kept implementation on track; (3) adding wellness content and interactive components should enhance the curriculum; and, (4) the curriculum advanced other healthful policies and practices.


Mental health settings are important locations for implementing programs to address tobacco use. In this real-world implementation of a model curriculum in psychosocial rehabilitation clubhouses, the curriculum tested well, was feasible and well-received, and suggests potential impact on tobacco use outcomes. Revision, dissemination, and a randomized controlled trial evaluation of the model curriculum should now occur.