[D]

Impact = Reach x Efficacy x (AIM)

• Reach = Percent of people who would use intervention
• Efficacy = % who use intervention who benefit from it (i.e., quit)
• Reach & efficacy are moderated by rate of:
• Adoption
• Implementation
• Maintenance

  [D]

Work to maximize synergy with healthcare systems/providers

• Create consumer demand for cessation!
• Create purchaser demand
• medicare, medicaid/state plans/large employers - create a policy agenda
• Partner with HC systems to increase QL demand & share costs
• tie in with ALL cessation, not just QL
• incentivize practitioners
• use QL existence to increase coverage

Create national "standards"

• QL consortium works to create standards/Guide
• ammo for health depts to avoid "token" QL
• most powerful if CDC Best Practice
• address funding levels, reach, partnering with healthcare, evaluation
• implementation:
• funding mandates for CDC other fed $$

Marketing with solid QL funding

• Need strong ongoing effective marketing campaigns
• traditional strong mass media
• other approaches such as docs, mailing
• target key populations
• Must have sufficient QL capacity to handle volumes generated
• create sufficient capacity to handle high marketing, rather than have to cut back

More wisdom on service mix

• How modulate service offerings to create maximum impact:
• reach focus: provide less of intensive service
• effectiveness focus: provide more intensive service to targeted populations
• are there tailoring strategies that could work?
• No clear answers
• thought & research needed